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Closed-Loop Vagus Nerve Stimulation Based on State Transition Models

Abstract : Objective Vagus nerve stimulation (VNS) is a potential therapeutic approach in a number of clinical applications. Although VNS is commonly delivered in an open-loop approach, it is now recognized that closed-loop stimulationmay be necessary to optimize the therapy. In this paper, we propose an original generic closed-loop control system that can be readily integrated into an implantable device and allows for the adaptive modulation of multiple VNS parameters. Methods The proposed control method consists of a state transition model (STM), in which each state represents a set of VNS parameters, and a state transition algorithm that optimally selects the best STM state, minimizing the error between an observed physiological variable and a given target value. The proposed method has been integrated into a real-time adaptive VNS prototype system and has been applied here to the regulation of the instantaneous heart rate, working synchronously with cardiac cycles. A quantitative performance evaluation is performed on seven sheep by computing classical control performance indicators. A comparison with a proportional-integral (PI) controller is also performed. Results The STM controller presents a median mean square error, overshoot, and settling time, respectively, equal to 622.21 ms(2), 72.8%, and 7.5 beats. Conclusion The proposed control method yields satisfactory accuracy and time response, while presenting a number of benefits over classical PI controllers. It represents a feasible approach for multiparametric VNS control on implantable devices. Significance Closed-loop multiparametric stimulation may improve response and minimize side effects on current pathologies treated by VNS.
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Contributor : Laurent Jonchère <>
Submitted on : Monday, July 9, 2018 - 1:32:21 PM
Last modification on : Friday, February 15, 2019 - 1:29:37 AM




Hector M. Romero-Ugalde, Virginie Le Rolle, Jean-Luc Bonnet, Christine Henry, Philippe Mabo, et al.. Closed-Loop Vagus Nerve Stimulation Based on State Transition Models. IEEE Transactions on Biomedical Engineering, Institute of Electrical and Electronics Engineers, 2018, 65 (7), pp.1630-1638. ⟨10.1109/TBME.2017.2759667⟩. ⟨hal-01833092⟩



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