磁刺激
神经病理性疼痛
医学
随机对照试验
脊髓损伤
背外侧前额叶皮质
初级运动皮层
神经学
运动皮层
麻醉
物理医学与康复
前额叶皮质
物理疗法
刺激
脊髓
内科学
认知
精神科
作者
Christian Saleh,Tatiani Soultana Ilia,Phillip Jaszczuk,Margret Hund-Georgiadis,Anna Walter
标识
DOI:10.1007/s10072-022-05978-0
摘要
Background and purposeNeuropathic pain is a clinically relevant complication in individuals with spinal cord injury (SCI). Pharmacological pain treatment is often insufficient and leads to undesirable side effects. Thus, alternative therapeutic approaches such as repetitive transcranial magnetic stimulation (rTMS) are of critical importance. We aimed to evaluate the effectiveness of rTMS in neuropathic pain secondary to SCI.MethodsWe conducted a systematic review using the PubMed/MEDLINE, EMBASE, and PsycInfo (via OVID) database up April 2021. Only randomized controlled trials were included. Results regarding the pain intensity scores were pooled using a random-effects model.ResultsThe search identified a total of 203 potential articles. Of these, eight randomized controlled trials (RCTs) met the eligibility criteria for qualitative synthesis providing the total data of 141 patients. All studies applied high-frequency rTMS. In seven studies, rTMS was applied over the motor cortex, and in one study over the left dorsolateral prefrontal cortex. Five studies reported a significant improvement in baseline pain scores after treatment, and three studies found a significant difference between sham vs. non-sham stimulation at any time. Six RCTs were included in the quantitative synthesis and showed a significant overall reduction of pain intensity in the rTMS groups compared with the sham groups (mean difference − 0.81, 95%CI − 1.45 to − 0.17).ConclusionsOur findings indicate that high-frequency rTMS of the primary motor cortex and left dorsolateral prefrontal cortex might be promising stimulation targets for neuropathic pain in SCI.
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