How Timing, Titration Speed, and Antiseizure Medication Burden Influence VNS Therapy Outcomes in Epilepsy

Ryan Verner: 

Hi, my name's Ryan Verner. I manage clinical strategy for the epilepsy business at LivaNova. 

At AES 2025, we are delivering some of the results of our CORE-VNS study. This was a large perspective global observational study of over 800 patients treated with VNS therapy. 

One of the outcomes that we're really excited to share from the study is a statistical analysis of clinical factors of early use of VNS in the refractory treatment population. One thing we found was significant improvements in clinical response associated with lower numbers of ASMs used by patients at baseline. We hope that clinicians are excited and encouraged by these results to consider VNS as early as it is indicated for the treatment of refractory epilepsy. 

We hope to use CORE-VNS to answer really complicated statistical questions that require a lot of  complex multivariate analysis or multivariable analysis. One of those important questions was the early use question, but others include questions about dosing the therapy, the speed of titration of the therapy, the types of antiseizure medications that are used in the follow-up. All of these are important questions to answer. 

I think that one thing that we should look forward to in the device space, especially for epilepsy, but including other devices for the treatment of chronic disorders, is more connectivity in the way these devices interact with the patient and other types of tools that they use to manage their chronic diseases. 

We hope that these results will encourage providers to consider VNS as soon as it's indicated for refractory focal epilepsy.