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Analgesic Effect of Noninvasive Brain Stimulation for Neuropathic Pain Patients: A Systematic Review.

作者信息

Zhang Kun-Long, Yuan Hua, Wu Fei-Fei, Pu Xue-Yin, Liu Bo-Zhi, Li Ze, Li Kai-Feng, Liu Hui, Yang Yi, Wang Ya-Yun

机构信息

Specific Lab for Mitochondrial Plasticity Underlying Nervous System Diseases, National Demonstration Center for Experimental Preclinical Medicine Education, Air Force Medical University, Xi'an, 710032, China.

Department of Rehabilitation Medicine, Xi-Jing Hospital, Air Force Medical University, Xi'an, 710032, China.

出版信息

Pain Ther. 2021 Jun;10(1):315-332. doi: 10.1007/s40122-021-00252-1. Epub 2021 Mar 22.


DOI:10.1007/s40122-021-00252-1
PMID:33751453
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8119533/
Abstract

INTRODUCTION: The objective of this review is to systematically summarize the consensus on best practices for different NP conditions of the two most commonly utilized noninvasive brain stimulation (NIBS) technologies, repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS). METHODS: PubMed was searched according to the predetermined keywords and criteria. Only English language studies and studies published up to January 31, 2020 were taken into consideration. Meta-analyses, reviews, and systematic reviews were excluded first, and those related to animal studies or involving healthy volunteers were also excluded. Finally, 29 studies covering 826 NP patients were reviewed. RESULTS: The results from the 24 enrolled studies and 736 NP patients indicate that rTMS successfully relieved the pain symptoms of 715 (97.1%) NP patients. Also, five studies involving 95 NP patients (81.4%) also showed that tDCS successfully relieved NP. In the included studied, the M1 region plays a key role in the analgesic treatment of NIBS. The motor evoked potentials (MEPs), the 10-20 electroencephalography system (EEG 10/20 system), and neuro-navigation methods are used in clinical practice to locate therapeutic targets. Based on the results of the review, the stimulation parameters of rTMS that best induce an analgesic effect are a stimulation frequency of 10-20 Hz, a stimulation intensity of 80-120% of RMT, 1000-2000 pulses, and 5-10 sessions, and the most effective parameters of tDCS are a current intensity of 2 mA, a session duration of 20-30 min, and 5-10 sessions. CONCLUSIONS: Our systematically reviewed the evidence for positive and negative responses to rTMS and tDCS for NP patient care and underscores the analgesic efficacy of NIBS in patients with NP. The treatment of NP should allow the design of optimal treatments for individual patients.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/707ce85664a9/40122_2021_252_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/e873fc5d7de0/40122_2021_252_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/e0aa9d61fa2f/40122_2021_252_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/be913243ca6b/40122_2021_252_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/c17906b0f263/40122_2021_252_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/707ce85664a9/40122_2021_252_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/e873fc5d7de0/40122_2021_252_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/e0aa9d61fa2f/40122_2021_252_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/be913243ca6b/40122_2021_252_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/c17906b0f263/40122_2021_252_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f906/8119533/707ce85664a9/40122_2021_252_Fig5_HTML.jpg

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[2]
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[3]
Transcranial direct current stimulation regulates phenotypic transformation of microglia to relieve neuropathic pain induced by spinal cord injury.

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[4]
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[5]
Effect of high-frequency repetitive transcranial magnetic stimulation under different intensities upon rehabilitation of chronic pelvic pain syndrome: protocol for a randomized controlled trial.

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[6]
Non-invasive brain neuromodulation techniques for chronic low back pain.

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[7]
Better Fields or Currents? A Head-to-Head Comparison of Transcranial Magnetic (rTMS) Versus Direct Current Stimulation (tDCS) for Neuropathic Pain.

Neurotherapeutics. 2023-1

[8]
Transcranial direct current stimulation in the management of phantom limb pain: a systematic review of randomized controlled trials.

Eur J Phys Rehabil Med. 2022-10

[9]
Repetitive Transcranial Magnetic Stimulation of the Primary Motor Cortex beyond Motor Rehabilitation: A Review of the Current Evidence.

Brain Sci. 2022-6-10

[10]
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本文引用的文献

[1]
Invasive Electrical Neuromodulation for the Treatment of Painful Diabetic Neuropathy: Systematic Review and Meta-Analysis.

Neuromodulation. 2021-1

[2]
No efficacy of transcranial direct current stimulation on chronic migraine with medication overuse: A double blind, randomised clinical trial.

Cephalalgia. 2020-10

[3]
Non-invasive brain stimulation modalities for the treatment and prevention of opioid use disorder: a systematic review of the literature.

J Addict Dis. 2020

[4]
Combining Transcranial Direct Current Stimulation and Transcutaneous Electrical Nerve Stimulation to Relieve Persistent Pain in a Patient Suffering from Complex Regional Pain Syndrome: A Case Report.

J Pain Res. 2020-3-2

[5]
Effect of Transcranial Direct Current Stimulation Combined With Patient-Controlled Intravenous Morphine Analgesia on Analgesic Use and Post-Thoracotomy Pain. A Prospective, Randomized, Double-Blind, Sham-Controlled, Proof-of-Concept Clinical Trial.

Front Pharmacol. 2020-2-25

[6]
Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018).

Clin Neurophysiol. 2020-1-1

[7]
Insular and anterior cingulate cortex deep stimulation for central neuropathic pain: Disassembling the percept of pain.

Neurology. 2019-4-5

[8]
Is There a Future for Non-invasive Brain Stimulation as a Therapeutic Tool?

Front Neurol. 2019-1-24

[9]
The effect of coil type and limb dominance in the assessment of lower-limb motor cortex excitability using TMS.

Neurosci Lett. 2019-1-30

[10]
Emerging targets and uses of neuromodulation for pain.

Expert Rev Neurother. 2019-1-25

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