Source 1review2025MED
Toolkit/trigeminal nerve stimulation
trigeminal nerve stimulation
Also known as: TNS
Taxonomy: Technique Branch / Method. Workflows sit above the mechanism and technique branches rather than replacing them.
Summary
The proposed systematic review and meta-analysis will investigate the efficacy of ... trigeminal nerve stimulation (TNS) for seizure reduction amongst patients diagnosed with DRE.
Usefulness & Problems
No literature-backed usefulness or problem-fit explainer has been materialized for this record yet.
Published Workflows
Objective: Synthesize and compare efficacy, safety, and stimulation-parameter evidence across non-invasive neuromodulation modalities for drug-resistant epilepsy.
Why it works: The protocol uses a consistent review process across all relevant non-invasive brain and nerve stimulation methods so that results can be rigorously compared and pooled. Subgroup and sensitivity analyses are included to investigate heterogeneity, parameter optimization, and robustness.
database searchingindependent study screeningdata extractionrisk-of-bias assessmentmeta-analysissubgroup analysissensitivity analysis
Stages
- 1.Literature search across bibliographic databases(in_silico_filter)
To identify the body of eligible literature across multiple databases before screening and synthesis.
Selection: Studies investigating efficacy and safety of non-invasive nerve and brain stimulation techniques for management of drug-resistant epilepsy.
- 2.Independent study screening(broad_screen)
To filter search results to relevant studies using independent reviewers.
Selection: Relevant studies identified from database searches.
- 3.Data extraction and risk-of-bias assessment(functional_characterization)
To collect outcome data and assess study quality before quantitative synthesis.
Selection: Screened-in relevant studies.
- 4.Meta-analysis of primary outcome(confirmatory_validation)
To quantitatively assess the primary efficacy outcome across included studies.
Selection: Extracted primary outcome data on seizure reduction.
- 5.Subgroup analysis for heterogeneity and protocol settings(secondary_characterization)
To investigate why results differ across studies and to identify optimal stimulation parameters for each intervention where possible.
Selection: Included studies and pooled outcome data.
- 6.Sensitivity analysis for robustness(decision_gate)
To test whether the synthesized results remain stable under alternative analytical assumptions or study subsets.
Selection: Meta-analytic and subgroup-analysis results.
Steps
- 1.Search bibliographic databases for relevant DRE neuromodulation studies
Identify studies on efficacy and safety of non-invasive nerve and brain stimulation techniques for drug-resistant epilepsy.
Relevant literature must be assembled before screening, extraction, and synthesis can occur.
- 2.Independently screen retrieved studies in Covidence
Determine which retrieved studies are relevant for inclusion.
Screening follows retrieval so irrelevant records can be removed before detailed extraction.
- 3.Resolve screening discrepancies with a third reviewer
Adjudicate disagreements in study selection.
Discrepancy resolution is needed after independent screening and before final inclusion decisions.
- 4.Extract study data and assess risk of bias
Collect outcome and study-quality information needed for synthesis.
Quantitative synthesis depends on having extracted outcomes and quality assessments from included studies.
- 5.Perform meta-analysis on seizure reduction outcomes
Quantitatively assess the primary efficacy outcome across included studies.
Meta-analysis follows data extraction because pooled estimates require harmonized outcome data.
- 6.Run subgroup analyses to examine heterogeneity and optimal settings
Identify potential sources of heterogeneity and optimal protocol settings for each intervention.
Subgroup analysis is performed after pooled analysis so differences across studies and parameter regimes can be interpreted in context of overall results.
- 7.Conduct sensitivity analyses to test robustness
Evaluate how robust the synthesized results are.
Robustness testing follows the main and subgroup analyses so conclusions can be checked before final interpretation.
Taxonomy & Function
Primary hierarchy
Technique Branch
Method: A concrete method used to build, optimize, or evolve an engineered system.
Techniques
No technique tags yet.
Target processes
No target processes tagged yet.
Input: Chemical
Validation
Cell-freeBacteriaMammalianMouseHumanTherapeuticIndep. Replication
Supporting Sources
Source 2review2025MED
Ranked Claims
Among the reviewed non-invasive neurostimulation modalities for drug-resistant epilepsy, rTMS and tDCS have the strongest evidence for effectiveness.
The review found insufficient data to determine effect sizes for tACS, LI-FUS, and TNS in drug-resistant epilepsy.
In the review meta-analysis, rTMS was associated with a pooled mean seizure-frequency change of -30.2% and a responder rate of 38% at end of follow-up.
95% confidence interval [-49.6, -10.7%]95% confidence interval [24, 51%]pooled mean change in seizure frequency -30.2 %responder rate 38 %
In the review meta-analysis, tDCS was associated with a pooled mean seizure-frequency change of -46.9% and a responder rate of 49% at end of follow-up.
95% confidence interval [-66.6, -27.3%]95% confidence interval [32, 66%]pooled mean change in seizure frequency -46.9 %responder rate 49 %
In the review meta-analysis, tVNS was associated with a pooled mean seizure-frequency change of -49.2% and a responder rate of 29% at end of follow-up.
95% confidence interval [-86.7, -11.8%]95% confidence interval [7, 50%]pooled mean change in seizure frequency -49.2 %responder rate 29 %
The review reported a responder rate of 42% for TNS, but effect-size estimation was limited by inadequate data.
95% confidence interval [24, 60%]responder rate 42 %
A secondary aim of the planned review is to identify optimal stimulation parameters for each intervention where possible to inform future clinical trial protocols and clinical applications.
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.
The planned systematic review and meta-analysis will evaluate efficacy and safety of multiple non-invasive brain and nerve stimulation modalities for drug-resistant epilepsy and compare intervention types where applicable.
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.
Approval Evidence
2 sources4 linked approval claimsfirst-pass slug trigeminal-nerve-stimulation
The proposed systematic review and meta-analysis will investigate the efficacy of ... trigeminal nerve stimulation (TNS) for seizure reduction amongst patients diagnosed with DRE.
Source:
This review systematically appraises and compares the effectiveness and safety of... trigeminal nerve stimulation (TNS) in drug-resistant epilepsy.
Source:
data sufficiencysupports
The review found insufficient data to determine effect sizes for tACS, LI-FUS, and TNS in drug-resistant epilepsy.
Source:
meta analysis outcomemixed
The review reported a responder rate of 42% for TNS, but effect-size estimation was limited by inadequate data.
Source:
review objectivesupports
A secondary aim of the planned review is to identify optimal stimulation parameters for each intervention where possible to inform future clinical trial protocols and clinical applications.
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.
Source:
review objectivesupports
The planned systematic review and meta-analysis will evaluate efficacy and safety of multiple non-invasive brain and nerve stimulation modalities for drug-resistant epilepsy and compare intervention types where applicable.
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.
Source:
Comparisons
No literature-backed comparison notes have been materialized for this record yet.
Ranked Citations
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