Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong 523710, China.
School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi 341000, China.
Neural Plast. 2022 Aug 24;2022:6131696. doi: 10.1155/2022/6131696. eCollection 2022.
Repetitive transcranial magnetic stimulation (rTMS) has been widely used in the treatment of neuropathic orofacial pain (NOP). The consistency of its therapeutic efficacy with the optimal protocol is highly debatable.
To assess the effectiveness of rTMS on pain intensity, psychological conditions, and quality of life (QOL) in individuals with NOP based on randomized controlled trials (RCTs).
We carefully screened and browsed 5 medical databases from inception to January 1, 2022. The study will be included that use of rTMS as the intervention for patients with NOP. Two researchers independently completed record retrieval, data processing, and evaluation of methodological quality. Quality and evidence were assessed using the PEDro scores and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.
Six RCTs with 214 participants were included in this systematic review: 2 studies were considered level 1 evidence, and 4 were considered level 2 evidence. Six studies found that high-frequency rTMS had a pain-relieving effect, while 4 studies found no improvement in psychological conditions and QOL. Quality of evidence (GRADE system) ranged from moderate to high. No significant side effects were found.
There is moderate-to-high evidence to prove that high-frequency rTMS is effective in reducing pain in individuals with NOP, but it has no significant positive effect on psychological conditions and QOL. High-frequency rTMS can be used as an alternative treatment for pain in individuals with NOP, but further studies will be conducted to unify treatment parameters, and the sample size will be expanded to explore its influence on psychological conditions and QOL.
重复经颅磁刺激（rTMS）已广泛应用于治疗神经性口面痛（NOP）。其疗效与最佳方案的一致性存在很大争议。
基于随机对照试验（RCT）评估 rTMS 对 NOP 患者疼痛强度、心理状况和生活质量（QOL）的影响。
我们仔细筛选和浏览了 5 个医学数据库，从建库到 2022 年 1 月 1 日。将使用 rTMS 作为 NOP 患者干预的研究纳入。两位研究人员独立完成记录检索、数据处理和方法学质量评估。使用 PEDro 评分和推荐评估、制定与评估分级（GRADE）系统评估质量和证据。
本系统评价共纳入 6 项 RCT，共 214 名参与者：2 项研究被认为是 1 级证据，4 项研究被认为是 2 级证据。6 项研究发现高频 rTMS 具有止痛作用，而 4 项研究发现心理状况和 QOL 没有改善。证据质量（GRADE 系统）为中至高。未发现明显的副作用。
有中至高证据证明高频 rTMS 可有效减轻 NOP 患者的疼痛，但对心理状况和 QOL 没有显著的积极影响。高频 rTMS 可作为 NOP 患者疼痛的替代治疗方法，但需要进一步研究来统一治疗参数，并扩大样本量以探讨其对心理状况和 QOL 的影响。
