Functional seizure therapy via transauricular vagus nerve stimulation

This article explores the potential of transauricular Vagus nerve stimulation (taVNS) in treating Functional Seizures (FS), a condition that significantly burdens healthcare systems. Traditional seizure treatments are ineffective for FS due to its unique pathophysiology, highlighting the urgent need for alternative therapeutic strategies. While invasive VNS has shown promise in improving autonomic balance, its invasive nature poses limitations in FS treatment. taVNS, a non-invasive alternative, enhances parasympathetic tone and reduces sympathetic activity. Additionally, it is hypothesized to modulate interoceptive processing by influencing Heart Rate Evoked Potential and normalizing interoceptive signals. This hypothesis article examines taVNS from a closed-loop perspective, focusing on the controllability and observability of its effects using wearable physiological sensors. It postulates regulating desired therapeutic states through physiological sensor feedback, suggesting the potential for customized, adaptive stimulation in FS treatment. However, rigorous testing of its controller and observer functions will be necessary for optimal clinical translation of adaptive taVNS.