IEEE Circuits and Systems Magazine - Q3 2022 - 24

Stimulating-Vagus
Nerve
RecordingECG
Note
that the closed-loop system
experimental results are not presented
since we do not have the
authority to conduct such an experiment
for the moment.
This paper presents the design
(a)
StimulatingVagus
Nerve
RecordingCAP
(b)
StimulatingBrain
Nuclei
RecordingiEEG
considerations
for and the system
design of the HybridVNS, and is
organized as follows. Sections II
reviews the available closed-loop
neurostimulators used to treat RE.
Section III discusses the architecture
of the HybridVNS and Section
IV provides its hardware implementation
with discrete components.
Designs of the key building
blocks of the HybridVNS, such as
the 4-channel preamplifier, thresholding
epileptic seizure detector,
switched-resistor array pulse generator
and wireless power transmitter
and receiver, are discussed
in Sections V-VIII, respectively.
Finally, Section IX shows the test
results of the HybridVNS.
II. Review of Available ClosedLoop
Neurostimulators Used to
Treat Refractory Epilepsy
(c)
StimulatingBrain
Nuclei
RecordingiEEG
(d)
Figure
1. Closed-loop neurostimulators used to treat RE. (a) LivaNova SenTiva [10].
(b) Neurotech ADNS-300 [13]. (c) Percept™ PC B35200 [14] [15]. (d) RNS [17].
24
IEEE CIRCUITS AND SYSTEMS MAGAZINE
A. Closed-Loop VNS
A closed-loop VNS should be able
to continuously extract physiological
signals, detect a seizure onset,
and adjust stimuli in response to
stimulation simultaneously. The
SenTiva (developed by LivaNova,
previously Cyberonics) is such
a closed-loop VNS [10], as it provides
responsive stimulation via a
cardiac-based seizure detector, as
shown in Fig. 1(a). It comprises an
ECG sensor and a pulse generator.
The ECG sensor can sense the ECG
using the pulse generator case
and one VNS lead electrode, and
monitor heart-rate changes that
associated with seizures to detect
the onset of an epileptic seizure
(because more than 80% of epileptic
patients experience a rapid increase
in heart rate with a seizure,
and ictal heart rate increases
THIRD QUARTER 2022

IEEE Circuits and Systems Magazine - Q3 2022

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