{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:39:56Z","timestamp":1792809596460,"version":"4.5.0"},"reference-count":75,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Drug-resistant epilepsy (DRE) affects many children. Vagus nerve stimulation (VNS) may improve seizure control; however, its role in children with genetic etiologies of epilepsy is not well described. The authors systematically reviewed the literature to examine the effectiveness of VNS in this cohort.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n In January 2021, the authors performed a systematic review of the PubMed\/MEDLINE, SCOPUS\/Embase, Cochrane, and Web of Science databases to investigate the impact of VNS on seizure outcomes in children with genetic etiologies of epilepsy. Primary outcomes included seizure freedom rate, \u2265 90% seizure reduction rate, and \u2265 50% seizure reduction rate. Secondary outcomes were seizure severity and quality of life (QOL), including cognitive, functional, and behavioral outcomes. A random-effects meta-analysis was performed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The authors identified 125 articles, of which 47 with 216 nonduplicate patients were analyzed. Common diagnoses were Dravet syndrome (DS) (92\/216 patients [42.6%]) and tuberous sclerosis complex (TSC) (63\/216 [29.2%]). Seizure freedom was not reported in any patient with DS; the pooled proportion (95% CI) of patients with \u2265 50% seizure reduction was 41% (21%\u201358%). Secondary cognitive outcomes of VNS were variable in DS patients, but these patients demonstrated benefits in seizure duration and status epilepticus. In TSC patients, the pooled (95% CI) seizure freedom rate was 40% (12%\u201371%), \u2265 90% seizure reduction rate was 31% (8%\u201356%), and \u2265 50% reduction rate was 68% (48%\u201391%). Regarding the secondary outcomes of VNS in TSC patients, several studies reported decreased seizure severity and improved QOL outcomes. There was limited evidence regarding the use of VNS to treat patients with other genetic etiologies of epilepsy, such as mitochondrial disease, Rett syndrome, Doose syndrome, Landau-Kleffner syndrome, Aicardi syndrome, Angelman syndrome, ring chromosome 20 syndrome, and lissencephaly; variable responses were reported in a limited number of cases.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The authors conducted a systematic review of VNS outcomes in children with genetic etiologies of DRE. Among the most studied conditions, patients with TSC had substantial seizure reduction and improvements in QOL, whereas those with DS had less robust seizure reduction. Increased testing, diagnosis, and long-term follow-up studies are necessary to better characterize VNS response in these children.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2022.1.peds222","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T04:20:21Z","timestamp":1647577221000},"page":"667-680","source":"Crossref","is-referenced-by-count":33,"title":["The role of vagus nerve stimulation in genetic etiologies of drug-resistant epilepsy: a meta-analysis"],"prefix":"10.3171","volume":"29","author":[{"given":"Sabastian","family":"Hajtovic","sequence":"first","affiliation":[{"name":"Sophie Davis Biomedical Education Program, City College of New York, City University of New York School of Medicine, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa A.","family":"LoPresti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Baylor College of Medicine, Texas Children\u2019s Hospital, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Northwestern University, Lurie Children\u2019s Hospital, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalman A.","family":"Katlowitz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Baylor College of Medicine, Texas Children\u2019s Hospital, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic J.","family":"Kizek","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Baylor College of Medicine, Texas Children\u2019s Hospital, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandi","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Northwestern University, Lurie Children\u2019s Hospital, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Epilepsia","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1111\/j.1528-1167.2009.02397.x","article-title":"Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies","volume":"51","author":"Kwan P","year":"2010","unstructured":"Kwan P, Arzimanoglou A, Berg AT, Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. 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