scholarly journals Tinnitus treatment by vagus nerve stimulation: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247221
Author(s):  
I. Stegeman ◽  
H. M. Velde ◽  
P. A. J. T. Robe ◽  
R. J. Stokroos ◽  
A. L. Smit
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Symptom Severity ◽  
Vagus Nerve Stimulation ◽  
Case Series ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Validated Questionnaire ◽  
Tinnitus Distress

Background Tinnitus is a phantom sensation of sound, which can have a negative impact on quality of life of those affected. No curative treatments are currently known. Neuromodulation by vagus nerve stimulation has emerged as a new treatment option for tinnitus, though till date the effectiveness remains unclear. Therefore, we aim to review the effect of vagus nerve stimulation on tinnitus distress and tinnitus symptom severity in patients with chronic tinnitus. Methods We searched Pubmed, Embase and the Cochrane Library systematically for RCTs, observational studies and case studies on the effect of VNS treatment for tinnitus on October 29, 2019. Studies including adult patients with subjective tinnitus, comparing transcutaneous or implantable VNS to placebo or no treatment or before and after application of VNS treatment on tinnitus distress and tinnitus symptom severity measured with a validated questionnaire were eligible. The risk of bias was assessed with the appropriate tool for each type of study. Results Our search identified 9 primary studies of which 2 RCTs, 5 cohort studies and 2 case series or reports. 5 studies used transcutaneous VNS treatment and 4 used implanted VNS treatment. 6 studies combined VNS treatment with sound therapy. There was a serious risk of bias in all studies, especially on confounding. Most studies reported a small decrease in tinnitus distress or tinnitus symptom severity. Conclusion Due to methodological limitations and low reporting quality of the included studies, the effect of VNS on tinnitus remains unclear. To draw conclusions for which patient population and to what extent (t)VNS is beneficial in the treatment of tinnitus, a randomised controlled trial should be considered.

scholarly journals Vagus Nerve Stimulation in Patients With Refractory Epilepsy: a case series

2019 ◽  
Vol 28 (04) ◽  
pp. 230-234
Author(s):  
Bruno Toshio Takeshita ◽  
Carolina Oldoni ◽  
Rafaella Do Rosario Tacla ◽  
Karina Slompo ◽  
Camilla Von Steinkirch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Refractory Epilepsy ◽  
Therapeutic Option ◽  
Statistical Significance ◽  
Case Series ◽  
Attention And Memory

Approximately 33% of patients with epilepsy do not respond to treatment with a single antiepileptic drug. Many of these patients can benefit from neurosurgical treatment. However, not all patients are candidates for surgery, and in these cases vagus nerve stimulation (VNS) presents as a good therapeutic option. Objectives: Evaluation of efficiency, tolerability and safety in the control of seizures after VNS implantation in patients from a reference hospital. Methods: cross-sectional study examined 20 patients who underwent implantation of the VNS in our facilities between 2007 and 2014. Proportions and chi-square test were applied (statistical significance level set to p ≤ 0.05). Results: Mean follow-up was 31.3 months. Seizure frequency decreased in 55% of the patients. Among them, 11 patients believed that VNS had improved their quality of life. The mean reduction reported by other patients was 78.3%. More than 30% reported no adverse effects. About 70% of patients no longer required hospitalizations and 95% reported reduction in the number of hospitalizations. Conclusion: In this population, VNS proved to be a good option in the treatment of refractory epilepsy and also in providing a significant improvement in quality of life, (reduction of seizures and hospitalizations), mood, attention and memory, which directly reflects on their social and cognitive.

Non-invasive vagus nerve stimulation significantly improves quality of life in patients with persistent postural-perceptual dizziness

2018 ◽  
Vol 265 (S1) ◽  
pp. 63-69 ◽  
Author(s):  
Ozan E. Eren ◽  
Filipp Filippopulos ◽  
Kristina Sönmez ◽  
Ken Möhwald ◽  
Andreas Straube ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Non Invasive

scholarly journals Health Technology Assessment Report on Vagus Nerve Stimulation in Drug-Resistant Epilepsy

2020 ◽  
Vol 17 (17) ◽  
pp. 6150
Author(s):  
Carlo Efisio Marras ◽  
Gabriella Colicchio ◽  
Luca De Palma ◽  
Alessandro De Benedictis ◽  
Giancarlo Di Gennaro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Technology Assessment ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Technology Assessment ◽  
Vagus Nerve Stimulation ◽  
Palliative Treatment ◽  
Health Technology ◽  
Drug Resistant

Background: Vagus nerve stimulation (VNS) is a palliative treatment for medical intractable epileptic syndromes not eligible for resective surgery. Health technology assessment (HTA) represents a modern approach to the analysis of technologies used for healthcare. The purpose of this study is to assess the clinical, organizational, financial, and economic impact of VNS therapy in drug-resistant epilepsies and to establish the congruity between costs incurred and health service reimbursement. Methods: The present study used an HTA approach. It is based on an extensive detailed bibliographic search on databases (Medline, Pubmed, Embase and Cochrane, sites of scientific societies and institutional sites). The HTA study includes the following issues: (a) social impact and costs of the disease; (b) VNS eligibility and clinical results; (c) quality of life (QoL) after VNS therapy; (d) economic impact and productivity regained after VNS; and (e) costs of VNS. Results: Literature data indicate VNS as an effective treatment with a potential positive impact on social aspects and on quality of life. The diagnosis-related group (DRG) financing, both on national and regional levels, does not cover the cost of the medical device. There was an evident insufficient coverage of the DRG compared to the full cost of implanting the device. Conclusions: VNS is a palliative treatment for reducing seizure frequency and intensity. Despite its economic cost, VNS should improve patients’ quality of life and reduce care needs.

scholarly journals P.022 The effect of vagus nerve stimulation on the quality of sleep in medically refractory epileptic patients

2021 ◽  
Vol 48 (s3) ◽  
pp. S26-S26
Author(s):  
J Seth ◽  
A Suller-Marti
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Limited Data ◽  
Quality Of Sleep ◽  
Obstructive Sleep ◽  
Clinical Trails ◽  
Patients With Epilepsy ◽  
The Impact

Background: The quality of sleep is frequently impacted in patients with epilepsy. Vagus Nerve Stimulation is a relatively common treatment used in patients with medically resistant epilepsy. Some studies show an improvement in quality of life, however, there is limited data on the impact on sleep quality. Methods: A database analysis was conducted on Medline, Embase, and Cochrane to find studies that examined the VNS’s effect on quality of sleep in medically resistant epilepsy. These studies included randomized clinical trails, case studies or reports, cohort studies, and systematic reviews. Results: 75 papers were reviewed and 16 studies from eight countries were included in the analysis. A total of 93 patients with ages ranged from 10 – 49 were included. Analyzing the change in the quality of sleep after VNS was evaluated using Multiple Sleep Latency Test. The literature showed that at low stimulus intensities, VNS treatment improves daytime sleepiness in patients. However, VNS setting titration has a dose-dependent effect on obstructive sleep apnea where higher VNS frequencies are related to higher apnea events. Conclusions: Limited data is available on the impact of VNS on the quality of sleep. Further studies are required to evaluate the improvement of sleep in patients with VNS.

Safety and Efficacy of Vagus Nerve Stimulation Paired With Tones for the Treatment of Tinnitus: A Case Series

2013 ◽  
Vol 17 (2) ◽  
pp. 170-179 ◽  
Author(s):  
Dirk De Ridder ◽  
Sven Vanneste ◽  
Navzer D. Engineer ◽  
Michael P. Kilgard
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Case Series ◽  
Safety And Efficacy

Transcutaneous vagus nerve stimulation for refractory epilepsy: a randomized controlled trial

2014 ◽  
Author(s):  
Peijing Rong ◽  
Aihua Liu ◽  
Jianguo Zhang ◽  
Yuping Wang ◽  
Wei He ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Seizure Frequency ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Refractory Epilepsy ◽  
Controlled Trial ◽  
Control Group ◽  
Transcutaneous Vagus Nerve Stimulation ◽  
Significant Difference

Abstract This trial was designed to test the safety and effectiveness of transcutaneous auricular vagus nerve stimulation (ta-VNS) for patients with refractory epilepsy. Pre-trial：144 patients were randomly assigned to ta-VNS group (n=98) or transcutaneous auricular non-vagus nerve stimulation (tn-VNS) control group (n=46). Treatment was conducted twice per day for 24 weeks. After 8, 16 and 24 weeks of treatment，the patients were evaluated according to the Modified Engel Scale (four classes). After 8 weeks，according to the medical ethic design, patients in tn-VNS group were switched into ta-VNS group uniquely. After 8 weeks’ treatment 41.0% and 27.5% of patients from ta-VNS and tn-VNS groups, respectively, experienced reduction in seizure frequency that reached I, II and III levels according to the standards of the Modified Engel Scale compared with the baselines, indicating significant difference in seizure reduction between the two groups. After 24 weeks of treatment, ta-VNS patients had a 47.7% reduction, and tn-VNS, with an additional 16 weeks of treatment, reached 47.5% in reduction. After 8 weeks’ treatment, the percentages of average seizure frequency in ta-VNS and tn-VNS were reduced by 42.6% and 11.5% respectively, providing a statistically significant difference in the results between the two groups (P<0.05). In addition, there were significant improvements in electroencephalograph (EEG) and the quality of daily life of the patients after treatment. The results show that this ta-VNS treatment can effectively reduce the frequency of seizures and improve the patient's quality of life. This may be an effective treatment for refractory epilepsy. At the same time，it is also safe，economic, and widely applicable.

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