Antidepressant effect of vagal nerve stimulation in epilepsy patients: a systematic review
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REVIEW ARTICLE
Antidepressant effect of vagal nerve stimulation in epilepsy patients: a systematic review Giovanni Assenza 1 & Mario Tombini 1 & Jacopo Lanzone 1 & Lorenzo Ricci 1 & Vincenzo Di Lazzaro 1 & Sara Casciato 2 & Alessandra Morano 3 & Anna Teresa Giallonardo 3 & Carlo Di Bonaventura 3 & Ettore Beghi 4 & Edoardo Ferlazzo 5 & Sara Gasparini 5 & Loretta Giuliano 6 & Francesco Pisani 7 & Paolo Benna 8 & Francesca Bisulli 9,10 & Fabrizio A. De Falco 11 & Silvana Franceschetti 12 & Angela La Neve 13 & Stefano Meletti 14 & Barbara Mostacci 9 & Ferdinando Sartucci 15 & Pasquale Striano 16,17 & Flavio Villani 18 & Umberto Aguglia 5 & Giuliano Avanzini 12 & Vincenzo Belcastro 19 & Amedeo Bianchi 20 & Vittoria Cianci 5 & Angelo Labate 21 & Adriana Magaudda 7 & Roberto Michelucci 9 & Annapia Verri 22 & Gaetano Zaccara 23 & Vincenzo Pizza 24 & Paolo Tinuper 9,10 & Giancarlo Di Gennaro 2 & on behalf of the Epilepsy Study Group of the Italian Neurological Society Received: 19 March 2020 / Accepted: 20 May 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Vagal nerve stimulation (VNS) is an effective palliative therapy in drug-resistant epileptic patients and is also approved as a therapy for treatment-resistant depression. Depression is a frequent comorbidity in epilepsy and it affects the quality of life of patients more than the seizure frequency itself. The aim of this systematic review is to analyze the available literature about the VNS effect on depressive symptoms in epileptic patients. Material and methods A comprehensive search of PubMed, Medline, Scopus, and Google Scholar was performed, and results were included up to January 2020. All studies concerning depressive symptom assessment in epileptic patients treated with VNS were included. Results Nine studies were included because they fulfilled inclusion criteria. Six out of nine papers reported a positive effect of VNS on depressive symptoms. Eight out of nine studies did not find any correlation between seizure reduction and depressive symptom amelioration, as induced by VNS. Clinical scales for depression, drug regimens, and age of patients were broadly different among the examined studies. Conclusions Reviewed studies strongly suggest that VNS ameliorates depressive symptoms in drug-resistant epileptic patients and that the VNS effect on depression is uncorrelated to seizure response. However, more rigorous studies addressing this issue are encouraged. Keywords Vagal nerve stimulation . Depression . Epilepsy . Drug-resistant epilepsy . Systematic review
Background One out of three adult people with epilepsy (PWE) is drugresistant [1]. A surgical approach has been shown to provide long-term seizure freedom in about 40–80% [2, 3]. However, a proportion of PWE continue to have seizures after surgery. Moreover, several drug-resistant PWE (DRE) are not good candidates for resective surgery [4].
* Giancarlo Di Gennaro [email protected] Extended author information available on the last page of the article
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