Effects of vagus nerve stimulation on cognitive function in patients with epilepsy: a systematic review and meta-analysis

Author: Yurou Kong1, Kun Zhao1, Duchun Zeng1, Feiao Lu1, Xiang Li2, Yulun Wu1, Zengming Jiang1, Wanshun Wen1
Affiliation:
1 Center for Rehabilitation Medicine, Rehabilitation and Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
2 School of Medicine, Xiang'an Hospital of Xiamen University, Xiamen University, Xiamen, China.
Conference/Journal: Front Neurol
Date published: 2024 Feb 9
Other: Volume ID: 15 , Pages: 1332882 , Special Notes: doi: 10.3389/fneur.2024.1332882. , Word Count: 238


Background:
Previous studies showed that vagus nerve stimulation (VNS) can improve cognitive function in patients with epilepsy, but there is still great controversy about the effect of VNS on cognitive function in patients with epilepsy.

Objective:
To investigate the effect of VNS on the cognitive function of epilepsy patients.

Methods:
Clinical trials published in PubMed, The Cochrane Library, and Embase before September 20, 2022, were comprehensively searched. Primary outcomes were overall cognitive performance, executive function, attention, memory; Secondary outcomes were seizure frequency, mood, and quality of life (QOL). Random effects were used to calculate the pooled outcome.

Results:
Twenty clinical trials were included. There was no significant improvement in overall cognitive performance in patients with epilepsy after VNS treatment (SMD = 0.07; 95% CI: -0.12 to 0.26; I2 = 0.00%) compared to pre-treatment. Compared to pre-treatment, there was no significant difference in executive function (SMD = -0.50; 95% CI: -1.50 to 0.50; p = 0.32), attention (SMD = -0.17; 95% CI: -0.43 to 0.09; p = 0.21) and memory (SMD = 0.64; 95% CI: -0.11 to 1.39; p = 0.09), but there were significant differences in seizure frequency, mood, and quality of life in patients with epilepsy after VNS.

Conclusion:
This meta-analysis did not establish that VNS can significantly improve cognitive function in patients with epilepsy, but it shows that VNS can significantly improve the seizure frequency, mood and quality of life of patients with epilepsy.

Systematic review registration:
https://www.crd.york.ac.uk/prospero/, identifier: CRD42023384059.

Keywords: cognitive function; epilepsy; meta-analysis; review; vagus nerve stimulation.

PMID: 38405400 PMCID: PMC10884318 DOI: 10.3389/fneur.2024.1332882

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