Objectives

To compare the short- and long-term efficacies as well as tolerability of vagus nerve stimulation (VNS) for the patients with drug-resistant epilepsy (DRE) in comparison with status at baseline.

Materials and Methods

We conducted a specific and systematic search in online data bases for relevant literature published prior to December 2020. The literature retrieved, including randomized clinical trials (RCTs) and observational studies, were then reviewed and analyzed. A fixed-effect model was used to evaluate the pooled odds ratio (OR) of responder rates and complications associated with RCTs. A random-effect model was used to generate overall responder rates and overall incidences of complication.

Results

A total of 61 studies, featuring 5223 patients, were included in our study. The pooled ORs of responder rates, hoarseness/voice change, throat pain, coughing, dyspnea, paresthesia, muscle pain, and headache during the short-term phase were 2.195 (p = 0.001), 5.527 (p = 0.0001), 0.935 (p = 0.883), 1.119 (p = 0.655), 2.901 (p = 0.005), 1.775 (p = 0.061), 3.606 (p = 0.123), and 0.928 (p = 0.806), respectively. The overall responder rates in 3, 6, 12, 24, 36, 48, and 60 months postoperatively were 0.421, 0.455, 0.401, 0.451, 0.482, 0.502, and 0.508, respectively. The overall incidences of complication were 0.274 for hoarseness/voice change, 0.099 for throat pain, 0.133 for coughing, 0.099 for dyspnea, 0.102 for paresthesia, 0.062 for muscle pain, 0.101 for headache, 0.015 for dysphagia, 0.013 for neck pain, 0.040 for infection, 0.030 for lead fracture, 0.019 for vocal cord palsy, and 0.020 for device malfunction, respectively.

Conclusions

The estimating of efficacy and tolerability, using data from the existing literature, indicated VNS therapy is a safe and effective treatment option for patients with DRE.

中文翻译：

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迷走神经刺激治疗耐药性癫痫的短期和长期反应：系统评价和荟萃分析

目标

比较耐药性癫痫（DRE）患者迷走神经刺激（VNS）与基线状态的短期和长期疗效以及耐受性。

材料和方法

我们在在线数据库中对 2020 年 12 月之前发表的相关文献进行了具体和系统的搜索。然后对检索到的文献进行了审查和分析，包括随机临床试验 (RCT) 和观察性研究。使用固定效应模型评估响应率和与 RCT 相关的并发症的汇总优势比 (OR)。随机效应模型用于生成总体反应率和并发症的总体发生率。

结果

我们的研究共纳入了 61 项研究，包括 5223 名患者。短期阶段反应率、声音嘶哑/声音变化、喉咙痛、咳嗽、呼吸困难、感觉异常、肌肉疼痛和头痛的汇总 OR 分别为 2.195 ( p  = 0.001)、5.527 ( p  = 0.0001)、0.935 ( p  = 0.883)、1.119 ( p  = 0.655)、2.901 ( p  = 0.005)、1.775 ( p  = 0.061)、3.606 ( p  = 0.123) 和 0.928 ( p = 0.806），分别。术后 3、6、12、24、36、48 和 60 个月的总体反应率分别为 0.421、0.455、0.401、0.451、0.482、0.502 和 0.508。并发症的总体发生率为：声音嘶哑/声音变化 0.274、喉咙痛 0.099、咳嗽 0.133、呼吸困难 0.099、感觉异常 0.102、肌肉疼痛 0.062、头痛 0.101、吞咽困难 0.015、颈部疼痛 0.013、颈部疼痛 0.040感染，铅断裂为 0.030，声带麻痹为 0.019，设备故障为 0.020，分别。

结论

使用来自现有文献的数据对疗效和耐受性的估计表明，VNS 治疗对于 DRE 患者是一种安全有效的治疗选择。