Giovanni Assenza1, Mario Tombini1, Jacopo Lanzone1, Lorenzo Ricci1, Vincenzo Di Lazzaro1, Sara Casciato2, Alessandra Morano3, Anna Teresa Giallonardo3, Carlo Di Bonaventura3, Ettore Beghi4, Edoardo Ferlazzo5, Sara Gasparini5, Loretta Giuliano6, Francesco Pisani7, Paolo Benna8, Francesca Bisulli9,10, Fabrizio A De Falco11, Silvana Franceschetti12, Angela La Neve13, Stefano Meletti14, Barbara Mostacci9, Ferdinando Sartucci15, Pasquale Striano16,17, Flavio Villani18, Umberto Aguglia5, Giuliano Avanzini12, Vincenzo Belcastro19, Amedeo Bianchi20, Vittoria Cianci5, Angelo Labate21, Adriana Magaudda7, Roberto Michelucci9, Annapia Verri22, Gaetano Zaccara23, Vincenzo Pizza24, Paolo Tinuper9,10, Giancarlo Di Gennaro25. 1. Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy. 2. Epilepsy Surgery Center, IRCCS NEUROMED, Via Atinense 18, 86170, Pozzilli (IS), Italy. 3. Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy. 4. Laboratory of Neurological Disorders, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. 5. Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital Bianchi-Melacrino-Morelli, Reggio Calabria, Italy. 6. Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy. 7. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy. 8. Department of Neurosciences, University of Torino, Torino, Italy. 9. IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy. 10. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. 11. Neurology Unit, Ospedale del Mare, Via Enrico Russo, Naples, Italy. 12. Department of Neurophysiopathology, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy. 13. Department of Neurological and Psychiatric Sciences, Centre for Epilepsy, University of Bari, Bari, Italy. 14. Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy; Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. 15. Section of Neurophysiopathology, Department of Clinical and Experimental Medicine, University of Pisa, Azienda Ospedaliero Universitaria Pisana and Neuroscience Institute, CNR, Pisa, Italy. 16. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genoa, Genoa, Italy. 17. Pediatric Neurology and Muscular Diseases Unit, IRCCS 'G. Gaslini' Institute, Genoa, Italy. 18. Division of Clinical Neurophysiology and Epilepsy Center, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. 19. Child Neuropsychiatry Unit, Department of Mental Health, ASST-Lariana, Como, Italy. 20. Division of Neurology, Hospital San Donato Arezzo, Arezzo, Italy. 21. Institute of Neurology, University Magna Graecia, Germaneto (CZ), Italy. 22. Department of Behavioural Neurology and Laboratory of Cognitive Behavioural Psychology, Fondazione Istituto Neurologico Casimiro Mondino, Pavia, Italy. 23. Regional Health Agency of Tuscany, Florence, Italy. 24. Neurophysiopatology Unit, S. Luca Hospital, Vallo della Lucania (SA), Italy. 25. Epilepsy Surgery Center, IRCCS NEUROMED, Via Atinense 18, 86170, Pozzilli (IS), Italy. gdigennaro@neuromed.it.
Abstract
BACKGROUND: Vagal nerve stimulation (VNS) is an effective palliative therapy in drug-resistant epileptic patients and is also approved as a therapy for treatment-resistant depression. Depression is a frequent comorbidity in epilepsy and it affects the quality of life of patients more than the seizure frequency itself. The aim of this systematic review is to analyze the available literature about the VNS effect on depressive symptoms in epileptic patients. MATERIAL AND METHODS: A comprehensive search of PubMed, Medline, Scopus, and Google Scholar was performed, and results were included up to January 2020. All studies concerning depressive symptom assessment in epileptic patients treated with VNS were included. RESULTS: Nine studies were included because they fulfilled inclusion criteria. Six out of nine papers reported a positive effect of VNS on depressive symptoms. Eight out of nine studies did not find any correlation between seizure reduction and depressive symptom amelioration, as induced by VNS. Clinical scales for depression, drug regimens, and age of patients were broadly different among the examined studies. CONCLUSIONS: Reviewed studies strongly suggest that VNS ameliorates depressive symptoms in drug-resistant epileptic patients and that the VNS effect on depression is uncorrelated to seizure response. However, more rigorous studies addressing this issue are encouraged.
BACKGROUND: Vagal nerve stimulation (VNS) is an effective palliative therapy in drug-resistant epilepticpatients and is also approved as a therapy for treatment-resistant depression. Depression is a frequent comorbidity in epilepsy and it affects the quality of life of patients more than the seizure frequency itself. The aim of this systematic review is to analyze the available literature about the VNS effect on depressive symptoms in epilepticpatients. MATERIAL AND METHODS: A comprehensive search of PubMed, Medline, Scopus, and Google Scholar was performed, and results were included up to January 2020. All studies concerning depressive symptom assessment in epilepticpatients treated with VNS were included. RESULTS: Nine studies were included because they fulfilled inclusion criteria. Six out of nine papers reported a positive effect of VNS on depressive symptoms. Eight out of nine studies did not find any correlation between seizure reduction and depressive symptom amelioration, as induced by VNS. Clinical scales for depression, drug regimens, and age of patients were broadly different among the examined studies. CONCLUSIONS: Reviewed studies strongly suggest that VNS ameliorates depressive symptoms in drug-resistant epilepticpatients and that the VNS effect on depression is uncorrelated to seizure response. However, more rigorous studies addressing this issue are encouraged.
Authors: Jane de Tisi; Gail S Bell; Janet L Peacock; Andrew W McEvoy; William F J Harkness; Josemir W Sander; John S Duncan Journal: Lancet Date: 2011-10-15 Impact factor: 79.321
Authors: S L Helmers; J W Wheless; M Frost; J Gates; P Levisohn; C Tardo; J A Conry; D Yalnizoglu; J R Madsen Journal: J Child Neurol Date: 2001-11 Impact factor: 1.987
Authors: Robert E Elliott; Amr Morsi; Stephen P Kalhorn; Joshua Marcus; Jonathan Sellin; Matthew Kang; Alyson Silverberg; Edwin Rivera; Eric Geller; Chad Carlson; Orrin Devinsky; Werner K Doyle Journal: Epilepsy Behav Date: 2010-12-08 Impact factor: 2.937
Authors: E Ben-Menachem; R Mañon-Espaillat; R Ristanovic; B J Wilder; H Stefan; W Mirza; W B Tarver; J F Wernicke Journal: Epilepsia Date: 1994 May-Jun Impact factor: 5.864