Chang Min Cheol, Kwak Sang Gyu, Park Donghwi
Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Department of Medical Statistics, College of Medicine, Catholic University of Daegu, Daegu, Republic of Korea.
Transl Neurosci. 2020 Sep 28;11(1):363-370. doi: 10.1515/tnsci-2020-0120. eCollection 2020.
Therapeutic management of pain in patients with complex regional pain syndrome (CRPS) is challenging. Repetitive transcranial magnetic stimulation (rTMS) has analgesic effects on several types of pain. However, its effect on CRPS has not been elucidated clearly. Therefore, we conducted a meta-analysis of the available clinical studies on rTMS treatment in patients with CRPS.
A comprehensive literature search was conducted using the PubMed, EMBASE, Cochrane Library, and SCOPUS databases. We included studies published up to February 09, 2020, that fulfilled our inclusion and exclusion criteria. Data regarding measurement of pain using the visual analog scale before and after rTMS treatment were collected to perform the meta-analysis. The meta-analysis was performed using Comprehensive Meta-analysis Version 2.
A total of three studies (one randomized controlled trial and two prospective observational studies) involving 41 patients were included in this meta-analysis. No significant reduction in pain was observed immediately after one rTMS treatment session or immediately after the entire schedule of rTMS treatment sessions (5 or 10 sessions; > 0.05). However, pain significantly reduced 1 week after the entire schedule of rTMS sessions ( < 0.001).
rTMS appears to have a functional analgesic effect in patients with CRPS.
复杂区域疼痛综合征（CRPS）患者疼痛的治疗管理具有挑战性。重复经颅磁刺激（rTMS）对多种类型的疼痛具有镇痛作用。然而，其对CRPS的影响尚未明确阐明。因此，我们对现有的关于rTMS治疗CRPS患者的临床研究进行了荟萃分析。
使用PubMed、EMBASE、Cochrane图书馆和SCOPUS数据库进行全面的文献检索。我们纳入了截至2020年2月9日发表的符合我们纳入和排除标准的研究。收集rTMS治疗前后使用视觉模拟量表测量疼痛的数据以进行荟萃分析。使用综合荟萃分析第2版进行荟萃分析。
本荟萃分析共纳入三项研究（一项随机对照试验和两项前瞻性观察性研究），涉及41名患者。在一次rTMS治疗后或整个rTMS治疗疗程（5或10次；P>0.05）后立即未观察到疼痛显著减轻。然而，在整个rTMS疗程后1周疼痛显著减轻（P<0.001）。
rTMS似乎对CRPS患者具有功能性镇痛作用。
