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
Abstract
Non-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. PubMed, 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…
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