Assessing an fMRI-guided titration paradigm for microburst VNS therapy

Titration of VNS using an fMRI-guided approach is feasible and safe in PwE (when using appropriate investigational devices), but our specific biomarker, used in this specific study design, was ultimately too variable to be used for patient-specific titration. An increase in thalamic BOLD signal that occurred across multiple stimulation parameter combinations and multiple visits with microburst settings was associated with seizure response that could be visualized early in the titration process.