ArticleSystematic reviews2025
Non-invasive neuromodulation for the treatment of drug-resistant epilepsy: Protocol for a systematic review and meta-analysis investigating efficacy, safety, and optimal stimulation parameters.
Article in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Non-invasive neurostimulation for drug-resistant epilepsy: systematic review and meta-analysis of effectiveness, safety, and optimal stimulation parameters.Journal of neurology · 2025Pooled it
- Efficacy and safety of neuromodulation and multimodal therapies for traumatic brain injury-induced disorders of consciousness: an updated umbrella review.Frontiers in neurologyPooled it
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNon-invasive neuromodulation presents as an exciting potential adjunctive therapy for people with drug-resistant epilepsy (DRE). A major advantage of this approach is the absence of the neurocognitive and systemic adverse events commonly associated with anti-seizure medications (ASM), and the significant risks that accompany both resective epilepsy surgery and invasive neuromodulation techniques. The proposed systematic review and meta-analysis will investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), low-intensity focused ultrasound (LI-FUS), transcutaneous vagus nerve stimulation (tVNS), and trigeminal nerve stimulation (TNS) for seizure reduction amongst patients diagnosed with DRE, with comparisons also being made between intervention types where applicable. Both immediate and long-term adverse events will also be discussed to offer greater insight into its use as a safe, viable, and reliable method of seizure control. The study's secondary aim will be to identify optimal stimulation parameters to better inform future clinical trial protocols and to maximise treatment efficacy in clinical applications.
methodsPubMed, OVID Embase, OVID Medline, and Web of Science will be searched for studies investigating the efficacy and safety of non-invasive nerve and brain stimulation techniques for the management of DRE. Two authors will independently screen relevant studies in Covidence, extract data, and assess risks of bias, with discrepancies being resolved by a third reviewer. The primary outcome will be seizure reduction, measured by mean/median change in seizure frequency and responder rate. Secondary outcomes will include the percentage of patients reporting specified adverse events. A meta-analysis will assess the primary outcome. Subgroup analyses will be performed to investigate potential sources of heterogeneity and the optimal protocol settings for each intervention. Sensitivity analyses will also be conducted to evaluate the robustness of the results. DISCUSSION: This study will analyse all relevant non-invasive brain and nerve stimulation methods using a consistent protocol, uniquely allowing for rigorous comparisons and result-pooling to evaluate the overall efficacy and safety of each stimulation method. Additionally, it will identify optimal stimulation parameters, where possible, to facilitate the use of these methods in future trials and clinical applications. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023446051.
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