Please use this identifier to cite or link to this item: https://doi.org/10.1007/s10143-022-01757-9
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dc.titleVagus nerve stimulation for treatment of drug-resistant epilepsy: a systematic review and meta-analysis
dc.contributor.authorRui, Lim Mervyn Jun
dc.contributor.authorYung, Fong Khi
dc.contributor.authorZheng, Yilong
dc.contributor.authorKit, Chua Christopher Yuan
dc.contributor.authorMiny, Samuel
dc.contributor.authorLin, Jeremy Bingyuan
dc.contributor.authorNga, Vincent Diong Weng
dc.contributor.authorOng, Hian Tat
dc.contributor.authorRathakrishnan, Rahul
dc.contributor.authorYeo, Tseng Tsai
dc.date.accessioned2023-11-07T06:31:33Z
dc.date.available2023-11-07T06:31:33Z
dc.date.issued2022-06
dc.identifier.citationRui, Lim Mervyn Jun, Yung, Fong Khi, Zheng, Yilong, Kit, Chua Christopher Yuan, Miny, Samuel, Lin, Jeremy Bingyuan, Nga, Vincent Diong Weng, Ong, Hian Tat, Rathakrishnan, Rahul, Yeo, Tseng Tsai (2022-06). Vagus nerve stimulation for treatment of drug-resistant epilepsy: a systematic review and meta-analysis. NEUROSURGICAL REVIEW 45 (3) : 2361-2373. ScholarBank@NUS Repository. https://doi.org/10.1007/s10143-022-01757-9
dc.identifier.issn0344-5607
dc.identifier.issn1437-2320
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/245777
dc.description.abstractTo analyze the efficacy and safety of high-frequency VNS versus control (low-frequency VNS or no VNS) in patients with DRE using data from randomized controlled trials (RCTs). An electronic literature search was conducted on PubMed, EMBASE, and Cochrane Controlled Register of Trials (CENTRAL); 12 RCTs reporting seizure frequency or treatment response in studies containing a high-frequency VNS treatment arm (conventional VNS or transcutaneous VNS [tVNS]) compared to control (low-frequency VNS or no VNS) were included. Seizure frequency, treatment response (number of patients with ≥ 50% reduction in seizure frequency), quality of life (QOL), and adverse effects were analyzed. Seizure frequency was reported in 9 studies (718 patients). Meta-analysis with random-effects models favored high-frequency VNS over control (standardized mean difference = 0.82, 95%-CI = 0.39–1.24, p <.001). This remained significant for subgroup analyses of low-frequency VNS as the control, VNS modality, and after removing studies with moderate-to-high risk of bias. Treatment response was reported in 8 studies (758 patients). Random-effects models favored high-frequency VNS over control (risk ratio = 1.57, 95%-CI = 1.19–2.07, p <.001). QOL outcomes were reported descriptively in 4 studies (363 patients), and adverse events were reported in 11 studies (875 patients). Major side effects and death were not observed to be more common in high-frequency VNS compared to control. High-frequency VNS results in reduced seizure frequency and improved treatment response compared to control (low-frequency VNS or no VNS) in patients with drug-resistant epilepsy. Greater consideration for VNS in patients with DRE may be warranted to decrease seizure frequency in the management of these patients.
dc.language.isoen
dc.publisherSPRINGER
dc.sourceElements
dc.subjectSystematic review
dc.subjectMeta-analysis
dc.subjectVagus nerve stimulation
dc.subjectEpilepsy
dc.typeReview
dc.date.updated2023-11-07T04:59:56Z
dc.contributor.departmentDEAN'S OFFICE (MEDICINE)
dc.contributor.departmentMEDICINE
dc.contributor.departmentPAEDIATRICS
dc.contributor.departmentSURGERY
dc.contributor.departmentLIFE SCIENCES INSTITUTE
dc.description.doi10.1007/s10143-022-01757-9
dc.description.sourcetitleNEUROSURGICAL REVIEW
dc.description.volume45
dc.description.issue3
dc.description.page2361-2373
dc.published.statePublished
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