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重复经颅磁刺激治疗神经性疼痛的疗效:系统评价和荟萃分析。

Effects of repetitive transcranial magnetic stimulation on neuropathic pain: A systematic review and meta-analysis.

机构信息

Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China; Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China; Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Neurosci Biobehav Rev. 2022 Jan;132:130-141. doi: 10.1016/j.neubiorev.2021.11.037. Epub 2021 Nov 24.

DOI:10.1016/j.neubiorev.2021.11.037
PMID:34826512
Abstract

Neuropathic pain (NP) is a chronic pain condition caused by lesion or disease of the somatosensory nervous system. Repetitive transcranial magnetic stimulation (rTMS) is a neuroregulatory tool that uses pulsed magnetic fields to modulate the cerebral cortex. This review aimed to ascertain the therapeutic effect of rTMS on NP and potential factors regulating the therapeutic effect of rTMS. Database search included Web of Science, Embase, Pubmed, and Cochrane Library from inception to July 2021. Eligible studies included randomized controlled studies of the analgesic effects of rTMS in patients with NP. Thirty-eight studies were included. Random effect analysis showed effect sizes of -0.66 (95 % CI, -0.87 to -0.46), indicating that real rTMS was better than sham condition in reducing pain (P < 0.001). This comprehensive review indicated that stimulation frequency, intervention site, and location of lesion were important factors affecting the therapeutic effect. The findings of this study may guide clinical decisions and future research.

摘要

神经性疼痛(NP)是一种由躯体感觉神经系统的损伤或疾病引起的慢性疼痛状况。重复经颅磁刺激(rTMS)是一种神经调节工具,利用脉冲磁场来调节大脑皮层。本综述旨在确定 rTMS 治疗 NP 的疗效以及调节 rTMS 疗效的潜在因素。数据库检索包括从建库到 2021 年 7 月的 Web of Science、Embase、Pubmed 和 Cochrane Library。纳入的研究为 rTMS 治疗 NP 患者镇痛效果的随机对照研究。共纳入 38 项研究。随机效应分析显示效应大小为-0.66(95 % CI,-0.87 至-0.46),表明真实 rTMS 比假刺激在减轻疼痛方面更有效(P < 0.001)。这项综合综述表明,刺激频率、干预部位和病变部位是影响疗效的重要因素。本研究的结果可能为临床决策和未来的研究提供指导。

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