title: The Human Body's Own Language to be Considered for Safe and Effective Neurostimulation.
abstract: BACKGROUND
  The general objective of this study was to provide an improved software for safer and more effective neurostimulation therapy.
  
  
  METHODS
  Tulgar implants, employing combined modulation of stimulation synchronized with heart rate, breathing frequency, and position of the patient (HBP), were applied as vagus nerve stimulation (VNS) for the management of refractory epilepsy in 105 patients who were followed up for 1 year.
  
  
  RESULTS
  Fifty-nine out of 105 (56.19%) patients were seizure free, 34 (32.38%) patients had partial improvement in quality of life with a decrease in intensity and frequency of the seizures, and 12 (11.43%) patients did not respond to stimulation.
  
  
  CONCLUSIONS
  Other similar studies, undertaken with non-Tulgar equipment, reported a 10% full recovery, 60% partial improvement in quality of life, and 30% zero response. Comparisons of these results reveal an approximate fivefold increase in seizure freedom, and threefold decrease in the number of nonresponsive patients.
  
  
  CONCLUSIONS
  The findings of the present study imply that HBP-modulated mode of stimulation could be safer and more effective in neurostimulation, at least in VNS.
authors.affiliation: Neurotechnology Research Center, Alanaldi Cd. Didem Sk. 7/1 D.7 İcerenkoy, Atasehir, 34752 Istanbul, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Tulgar
authors.affiliation: Neurology Clinic, Hisar Hospital, Umraniye, Istanbul Turkey.
authors.forename: Safiye
authors.initials: S
authors.lastname: Bilgin
authors.affiliation: Neurosurgery Clinic, Yasam Hospital, Bahcelievler, Istanbul Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Yildirim
keywords: Epilepsy; Heart, breath and position mode of stimulation; Neurostimulation; Quality of life; Seizures; Tulgar implants; Vagus nerve stimulation