Department of Neurology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
Ann Clin Transl Neurol. 2024 Nov;11(11):2904-2911. doi: 10.1002/acn3.52201. Epub 2024 Sep 22.
Strokes involving sensory pathways can result in contralesional pain syndromes often refractory to pharmacologic interventions. Scrambler therapy (ST) is a noninvasive electroanalgesia device used to treat pain caused by peripheral neuropathy; however, data are scarce regarding its use in conditions secondary to central nervous system pathology. We evaluate the efficacy of ST to treat poststroke pain.
Twenty patients with a history of prior stroke resulting in contralesional pain were randomized to receive ST or Sham as an adjunct to their stable medication regimen. Participants underwent 5 consecutive daily 40-min sessions. The study was blinded to patient and assessor. Pain scores (0-10) were recorded at baseline, pre- and postsession, and 4 weeks after final treatment. Student's t-tests compared differences in the mean change in pain score between groups immediately post-treatment #5, and at 4-weeks. The chi-squared analysis compared the proportion of patients in each group with >50% pain reduction.
Participants randomized to ST had a mean change in pain score of -3.73 (SD 2.85) postintervention and -2.57 (SD 2.07) at 4 weeks, while the Sham group had a mean change in score of -0.94 (SD 1.36) and -0.25 (SD 0.84) (p between groups = 0.012, 0.004, respectively). Significantly more participants treated with ST reported a >50% reduction in pain immediately postintervention compared to Sham (70% vs. 10%, p = 0.006), but not at follow-up (30% vs. 10%, p = ns).
ST may effectively decrease poststroke pain compared to Sham. Larger studies are needed to evaluate confounders such as stroke location, time from stroke, and concomitant treatment with medications.
涉及感觉通路的中风可导致对药物干预反应不佳的对侧疼痛综合征。 scrambler 疗法（ST）是一种非侵入性电疗设备，用于治疗周围神经病变引起的疼痛；然而，关于其在中枢神经系统病变继发疾病中的应用的数据很少。我们评估 ST 治疗中风后疼痛的疗效。
20 例既往中风导致对侧疼痛的患者随机分为 ST 或假治疗组，作为其稳定药物治疗方案的辅助治疗。参与者接受连续 5 天，每天 40 分钟的治疗。研究对患者和评估者均设盲。在基线、治疗前、治疗后和最后一次治疗后 4 周记录疼痛评分（0-10）。学生 t 检验比较两组治疗后第 5 天和第 4 周时疼痛评分平均变化的差异。卡方分析比较两组中疼痛减轻>50%的患者比例。
随机接受 ST 治疗的患者治疗后疼痛评分平均变化为-3.73（SD 2.85），治疗后 4 周为-2.57（SD 2.07），而假治疗组的评分平均变化为-0.94（SD 1.36）和-0.25（SD 0.84）（组间差异 p=0.012，0.004）。治疗后即刻，接受 ST 治疗的患者中，有更多的患者报告疼痛减轻>50%，与假治疗组相比（70%比 10%，p=0.006），但在随访时两组无显著差异（30%比 10%，p=ns）。
与假治疗相比，ST 可能有效降低中风后疼痛。需要更大规模的研究来评估中风部位、中风后时间和同时应用药物等混杂因素。
