Efficacy of transcutaneous vagus nerve stimulation (t-VNS) in treating drug-resistant epilepsy: A systematic review and meta-analysis.

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 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. PubMed, Elsevier, CENTRAL, and Web of Science databases 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 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. Quality of life improvements were observed in some studies, while adverse effects were generally mild and transient.

CONCLUSION

t-VNS has a favorable safety profile to reduce seizure frequency in drug-resistant epilepsy. Despite these positive findings, variations in study methodologies and a high risk of bias necessitate further high-quality research to confirm these results and better integrate t-VNS into clinical practice.