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This review article briefly describes the vagus nerve stimulator (VNS) and then focuses on the programmable aspects of the device.
The authors review the stimulus parameters used in pilot and pivotal studies of depression and epilepsy, as well as results from four prospective and two retrospective studies designed to evaluate the effects of different stimulus parameters on response by patients with epilepsy. Special emphasis is given to the therapeutic and adverse effects of changes in stimulus output current, pulse frequency, pulse width, and duty cycle (that is, the schedule of stimulus on vs. off). Finally, the authors recommend initial settings and propose a strategy for adjusting device parameters according to patient response.