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. 2024 Jun 19:18:1429223.
doi: 10.3389/fnhum.2024.1429223. eCollection 2024.

The comparison of DBS and RNS for adult drug-resistant epilepsy: a systematic review and meta-analysis

Qinghua Li  1 , Yongzhi Shan  1 , Penghu Wei  1 , Guoguang Zhao  1   2   3
Affiliations

The comparison of DBS and RNS for adult drug-resistant epilepsy: a systematic review and meta-analysis

Qinghua Li et al. Front Hum Neurosci. .

Abstract

Objective: Neuromodulation has been proven to be a promising alternative treatment for adult patients with drug-resistant epilepsy (DRE). Deep brain stimulation (DBS) and responsive neurostimulation (RNS) were approved by many countries for the treatment of DRE. However, there is a lack of systematic studies illustrating the differences between them. This meta-analysis is performed to assess the efficacy and clinical characteristics of DBS and RNS in adult patients with DRE.

Methods: PubMed, Web of Science, and Embase were retrieved to obtain related studies including adult DRE patients who accepted DBS or RNS. The clinical characteristics of these patients were compiled for the following statistical analysis.

Results: A total of 55 studies (32 of DBS and 23 of RNS) involving 1,568 adult patients with DRE were included in this meta-analysis. There was no significant difference in seizure reduction and responder rate between DBS and RNS for DRE. The seizure reduction of DBS and RNS were 56% (95% CI 50-62%, p > 0.05) and 61% (95% CI 54-68%, p > 0.05). The responder rate of DBS and RNS were 67% (95% CI 58-76%, p > 0.05) and 71% (95% CI 64-78%, p > 0.05). Different targets of DBS did not show significant effect on seizure reduction (p > 0.05). Patients with DRE who accepted DBS were younger than those of RNS (32.9 years old vs. 37.8 years old, p < 0.01). The mean follow-up time was 47.3 months for DBS and 39.5 months for RNS (p > 0.05).

Conclusion: Both DBS and RNS are beneficial and alternative therapies for adult DRE patients who are not eligible to accept resection surgery. Further and larger studies are needed to clarify the characteristics of different targets and provide tailored treatment for patients with DRE.

Keywords: deep brain stimulation; epilepsy; meta analysis; neuromodulation; responsive neurostimulation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of the study selection.
Figure 2
Figure 2
Funnel plot of publication bias of included studies.
Figure 3
Figure 3
Forest plot for the comparison of the efficacy of seizure reduction between DBS and RNS.
Figure 4
Figure 4
Forest plot for the efficacy of DBS in seizure reduction in different target subgroups.
Figure 5
Figure 5
Forest plot for the comparison of the efficacy in achieving responder rate between DBS and RNS.
Figure 6
Figure 6
Forest plot for the efficacy of DBS in achieving responder rate in different target subgroups.
See this image and copyright information in PMC

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