Title : Efficacy of Transcutaneous Vagus Nerve Stimulation (t-VNS) in treating drug-resistant epilepsy: A systematic review and meta-analysis
Abstract:
Background: Epilepsy is a disease that affects over 50 million people globally. It poses significant challenges, especially for those with drug-resistant forms. This study aims to evaluate the efficacy of transcutaneous vagus nerve stimulation (t-VNS) in treating drug-resistant epilepsy by conducting a systematic review and meta-analysis.
Methods: We adhered to PRISMA [AA1] guidelines and registered the study with PROSPERO. Randomized clinical trials (RCTs) focusing on t-VNS for patients aged 14 and above with drug-resistant epilepsy were included. Databases of PubMed, Elsevier, CENTRAL, and Web of Science were searched up to December 2023. Data extraction and risk of bias assessment were independently conducted by two reviewers, with discrepancies resolved by a third.
Results: Out of 2782[AA2] studies identified, four RCTs involving 417 subjects were included. The meta-analysis revealed that t-VNS significantly reduced seizure frequency at various time points, notably at 8, 12, 16, and 52 weeks. However, no significant difference in responder rates between the t-VNS and control groups was found. However, the sensitivity analysis revealed potential efficacy. Quality of life improvements were observed in some studies, while adverse effects were generally mild and transient.
Conclusion: t-VNS shows potential in reducing seizure frequency in drug-resistant epilepsy, with a favorable safety profile. Despite positive findings, variations in study methodologies and high risk of bias necessitate further high-quality research to confirm these results and better integrate t-VNS into clinical practice.
