ArticleAnnals of clinical and translational neurology2024
Optimized microburst VNS elicits fMRI responses beyond thalamic-specific response from standard VNS.
Article in Annals of clinical and translational neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03446664 (Microburst VNS Therapy Feasibility Study in Subjects With Refractory Epilepsy), which is not on this map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Microburst VNS Therapy Feasibility Study in Subjects With Refractory Epilepsy
Who cites it
6 citing papers in PubMed.
- A guide to neuromodulation in drug-resistant epilepsy.Epileptic disorders : international epilepsy journal with videotape · 2026Review
- Resting-state functional connectivity changes with microburst vagus nerve stimulation therapy.Epilepsia open · 2025Article
- Invasive Neurostimulation for the Treatment of Epilepsy.Seminars in neurology · 2025Review
- Vagus nerve stimulation: Novel concept for the treatment of glioblastoma and solid cancers by cytokine (interleukin-6) reduction, attenuating the SASP, enhancing tumor immunity.Brain, behavior, & immunity - health · 2024Review
- Identifying responders to vagus nerve stimulation based on microstructural features of thalamocortical tracts in drug-resistant epilepsy.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2024Article
- Syncing the brain's networks: dynamic functional connectivity shifts from temporal interference.Frontiers in human neuroscience · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveIn parallel to standard vagus nerve stimulation (VNS), microburst stimulation delivery has been developed. We evaluated the fMRI-related signal changes associated with standard and optimized microburst stimulation in a proof-of-concept study (NCT03446664).
methodsTwenty-nine drug-resistant epilepsy patients were prospectively implanted with VNS. Three 3T fMRI scans were collected 2 weeks postimplantation. The maximum tolerated VNS intensity was determined prior to each scan starting at 0.125 mA with 0.125 mA increments. FMRI scans were block-design with alternating 30 sec stimulation [ON] and 30 sec no stimulation [OFF]: Scan 1 utilized standard VNS and Scan 3 optimized microburst parameters to determine target settings. Semi-automated on-site fMRI data processing utilized ON-OFF block modeling to determine VNS-related fMRI activation per stimulation setting. Anatomical thalamic mask was used to derive highest mean thalamic t-value for determination of microburst stimulation parameters. Paired t-tests corrected at P < 0.05 examined differences in fMRI responses to each stimulation type.
resultsStandard and microburst stimulation intensities at Scans 1 and 3 were similar (P = 0.16). Thalamic fMRI responses were obtained in 28 participants (19 with focal; 9 with generalized seizures). Group activation maps showed standard VNS elicited thalamic activation while optimized microburst VNS showed widespread activation patterns including thalamus. Comparison of stimulation types revealed significantly greater cerebellar, midbrain, and parietal fMRI signal changes in microburst compared to standard VNS. These differences were not associated with seizure responses.
interpretationWhile standard and optimized microburst VNS elicited thalamic activation, microburst also engaged other brain regions. Relationship between these fMRI activation patterns and clinical response warrants further investigation. CLINICAL
trial registrationThe study was registered with clinicaltrials.gov (NCT03446664).
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