Shlobin Nathan A, Wu Chengyuan
Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Neurological Surgery, Thomas Jefferson University Hospitals, 909 Walnut Street, Floor 2, Philadelphia, PA, 19107, USA.
Curr Pain Headache Rep. 2023 Nov;27(11):719-728. doi: 10.1007/s11916-023-01168-5. Epub 2023 Sep 20.
Neurostimulation treatment options have become more commonly used for chronic pain conditions refractory to these options. In this review, we characterize current neurostimulation therapies for chronic pain conditions and provide an analysis of their effectiveness and clinical adoption. This manuscript will inform clinicians of treatment options for chronic pain.
Non-invasive neurostimulation includes transcranial direct current stimulation and repetitive transcranial magnetic stimulation, while more invasive options include spinal cord stimulation (SCS), peripheral nerve stimulation (PNS), dorsal root ganglion stimulation, motor cortex stimulation, and deep brain stimulation. Developments in transcranial direct current stimulation, repetitive transcranial magnetic stimulation, spinal cord stimulation, and peripheral nerve stimulation render these modalities most promising for the alleviating chronic pain. Neurostimulation for chronic pain involves non-invasive and invasive modalities with varying efficacy. Well-designed randomized controlled trials are required to delineate the outcomes of neurostimulatory modalities more precisely.
神经刺激治疗方案已越来越普遍地用于对其他治疗方案难治的慢性疼痛病症。在本综述中,我们描述了目前用于慢性疼痛病症的神经刺激疗法,并分析了其有效性和临床应用情况。本文将为临床医生提供慢性疼痛的治疗选择信息。
非侵入性神经刺激包括经颅直流电刺激和重复经颅磁刺激,而侵入性更强的选择包括脊髓刺激(SCS)、外周神经刺激(PNS)、背根神经节刺激、运动皮层刺激和深部脑刺激。经颅直流电刺激、重复经颅磁刺激、脊髓刺激和外周神经刺激的发展使这些方式在缓解慢性疼痛方面最具前景。慢性疼痛的神经刺激涉及非侵入性和侵入性方式,疗效各异。需要设计良好的随机对照试验来更精确地描绘神经刺激方式的结果。