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Table 1 Approved invasive stimulation methods for epilepsy. Replicated from [70]

From: Neural stimulation systems for the control of refractory epilepsy: a review

Data Vagus nerve stimulation Thalamic stimulation Responsive focus stimulation
Approval 1997 (FDA)/(EU) (also heart rate triggered closed loop since 2015) 2011 (EU) 2013 (FDA)
Stimulation site Left vagus nerve (neck) Anterior nuclei of the thalamus (bilaterally) Epileptic focus (cortex)
Stimulator placement Subcutaneous, left pectoral/sub clavicular Subcutaneous, abdominal Within the skull
Stimulation mode Open-loop/closed-loop based on detection of tachycardia Open-loop Closed-loop based on detection of ictal EEG patterns
Stimulus parameters Intensity: 0.25–3 mA Frequency: 20–30 Hz Pulse width: 250–500 μs Duty cycle: 30 s on/ 5 min off (standard);
7 s on/30 s off (“rapid cycling”)
Intensity: 5 V
Frequency: 145 Hz Pulse width: 95 μs Duty cycle: 1 min on/5 min off
Intensity: 1 mA Frequency: 200 Hz Pulse width: 160 μs Duty cycle: 5.9 min/day; (closed loop)
Side effects of implantation 1.6% infections 1% vocal cord paralysis 12,7% infections 10.9% local pain 18.2% paraesthesia at implantation site 4.5% in cranial bleeding 7.8% infections 4.7% intracranial bleeding
Side effects of stimulation Hoarseness (intensity-dependent up to 66%) Cough (up to 45%) 14.8% depression 13.0% memory impairment No statistics