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Neurostimulation for drug-resistant epilepsy: a systematic review of clinical evidence for efficacy, safety, contraindications and predictors for response

Paul Boon UGent, Elien De Cock UGent, Ann Mertens UGent and Eugen Trinka (2018) CURRENT OPINION IN NEUROLOGY. 31(2). p.198-210
abstract
Purpose of reviewNeurostimulation is becoming an increasingly accepted treatment alternative for patients with drug-resistant epilepsy (DRE) who are unsuitable surgery candidates. Standardized guidelines on when or how to use the various neurostimulation modalities are lacking. We conducted a systematic review on the currently available neurostimulation modalities primarily with regard to effectiveness and safety.Recent findingsFor vagus nerve stimulation (VNS), there is moderate-quality evidence for its effectiveness in adults with drug-resistant partial epilepsies. Moderate-to-low-quality evidence supports the efficacy and safety of deep brain stimulation (DBS) and responsive neurostimulation (RNS) in patients with DRE. There is moderate-to-very low-quality evidence that transcranial direct current stimulation (tDCS) is effective or well tolerated. For transcutaneous vagus nerve stimulation (tVNS), transcranial magnetic stimulation (TMS) and trigeminal nerve stimulation (TNS), there are insufficient data to support the efficacy of any of these modalities for DRE. These treatment modalities, nevertheless, appear well tolerated, with no severe adverse events reported.SummaryHead-to-head comparison of treatment modalities such as VNS, DBS and RNS across different epileptic syndromes are required to decide which treatment modality is the most effective for a given patient scenario. Such studies are challenging and it is unlikely that data will be available in the near future. Additional data collection on potentially promising noninvasive neurostimulation modalities like tVNS, TMS, TNS and tDCS is warranted to get a more precise estimate of their therapeutic benefit and long-term safety.
Please use this url to cite or link to this publication:
author
year
type
journalArticle (review)
publication status
published
journal title
CURRENT OPINION IN NEUROLOGY
volume
31
issue
2
pages
198 - 210
Web of Science type
J
Web of Science id
000427985400014
ISSN
1350-7540
1473-6551
DOI
10.1097/WCO.0000000000000534
UGent publication?
yes
classification
U
copyright statement
I don't know the status of the copyright for this publication
id
8562014
handle
http://hdl.handle.net/1854/LU-8562014
date created
2018-05-16 11:58:48
date last changed
2018-05-16 11:59:44
@article{8562014,
  abstract     = {Purpose of reviewNeurostimulation is becoming an increasingly accepted treatment alternative for patients with drug-resistant epilepsy (DRE) who are unsuitable surgery candidates. Standardized guidelines on when or how to use the various neurostimulation modalities are lacking. We conducted a systematic review on the currently available neurostimulation modalities primarily with regard to effectiveness and safety.Recent findingsFor vagus nerve stimulation (VNS), there is moderate-quality evidence for its effectiveness in adults with drug-resistant partial epilepsies. Moderate-to-low-quality evidence supports the efficacy and safety of deep brain stimulation (DBS) and responsive neurostimulation (RNS) in patients with DRE. There is moderate-to-very low-quality evidence that transcranial direct current stimulation (tDCS) is effective or well tolerated. For transcutaneous vagus nerve stimulation (tVNS), transcranial magnetic stimulation (TMS) and trigeminal nerve stimulation (TNS), there are insufficient data to support the efficacy of any of these modalities for DRE. These treatment modalities, nevertheless, appear well tolerated, with no severe adverse events reported.SummaryHead-to-head comparison of treatment modalities such as VNS, DBS and RNS across different epileptic syndromes are required to decide which treatment modality is the most effective for a given patient scenario. Such studies are challenging and it is unlikely that data will be available in the near future. Additional data collection on potentially promising noninvasive neurostimulation modalities like tVNS, TMS, TNS and tDCS is warranted to get a more precise estimate of their therapeutic benefit and long-term safety.},
  author       = {Boon, Paul and De Cock, Elien and Mertens, Ann and Trinka, Eugen},
  issn         = {1350-7540},
  journal      = {CURRENT OPINION IN NEUROLOGY},
  number       = {2},
  pages        = {198--210},
  title        = {Neurostimulation for drug-resistant epilepsy: a systematic review of clinical evidence for efficacy, safety, contraindications and predictors for response},
  url          = {http://dx.doi.org/10.1097/WCO.0000000000000534},
  volume       = {31},
  year         = {2018},
}

Chicago
Boon, Paul, Elien De Cock, Ann Mertens, and Eugen Trinka. 2018. “Neurostimulation for Drug-resistant Epilepsy: a Systematic Review of Clinical Evidence for Efficacy, Safety, Contraindications and Predictors for Response.” Current Opinion in Neurology 31 (2): 198–210.
APA
Boon, Paul, De Cock, E., Mertens, A., & Trinka, E. (2018). Neurostimulation for drug-resistant epilepsy: a systematic review of clinical evidence for efficacy, safety, contraindications and predictors for response. CURRENT OPINION IN NEUROLOGY, 31(2), 198–210.
Vancouver
1.
Boon P, De Cock E, Mertens A, Trinka E. Neurostimulation for drug-resistant epilepsy: a systematic review of clinical evidence for efficacy, safety, contraindications and predictors for response. CURRENT OPINION IN NEUROLOGY. 2018;31(2):198–210.
MLA
Boon, Paul, Elien De Cock, Ann Mertens, et al. “Neurostimulation for Drug-resistant Epilepsy: a Systematic Review of Clinical Evidence for Efficacy, Safety, Contraindications and Predictors for Response.” CURRENT OPINION IN NEUROLOGY 31.2 (2018): 198–210. Print.