Li Li, Luo Xueqin, Liu Yong, Jiang Yongjie, Chen Yankun, Chen Yangmei, Wang Jinping
Department of Pain and Rehabilitation, The Second Affiliated (Xinqiao) Hospital, The Army (Third Military) Medical University, Chongqing, 400037, China.
Department of Medical Records, Heze Municipal Hospital, Heze, 274000, China.
Neurol Ther. 2025 May 13. doi: 10.1007/s40120-025-00759-1.
Neuromodulation therapies (including non-invasive and invasive neuromodulation) are being used to treat painful diabetic neuropathy (PDN).
A systematic search of the PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases was conducted, from their inception until 1 October 2024, to identify randomized controlled trials (RCTs) on neuromodulation therapies for PDN. Data were collected on pain intensity of various adjunctive therapies for PDN, including transcutaneous electrical nerve stimulation (TENS), percutaneous electrical nerve stimulation, repetitive transcranial magnetic stimulation, pulsed electromagnetic field therapy, spinal cord stimulation (SCS), transcranial direct current stimulation, frequency rhythmic electrical modulation system, mesodiencephalic modulation, and sham.
The data from an aggregate of 12 separate studies, comprising a total sample size of 922 participants, was subject to analysis. All seven neuromodulation therapies exhibited better outcomes in pain intensity compared to the Sham intervention, with TENS achieving the highest ranking, followed by SCS. At the final follow-up time point, statistically significant reductions in pain intensity (vs. Sham) was only observed for SCS.
The results of this network meta-analysis should facilitate the development of clinical guidance and enhance the decision-making process for both patients and healthcare professionals, thereby identifying the most appropriate PDN treatment options.
PROSPERO: CRD42024597208.
神经调节疗法（包括非侵入性和侵入性神经调节）正被用于治疗疼痛性糖尿病神经病变（PDN）。
对PubMed、Embase、Cochrane图书馆、Web of Science和Scopus数据库进行系统检索，检索时间从各数据库创建至2024年10月1日，以确定关于神经调节疗法治疗PDN的随机对照试验（RCT）。收集了关于PDN各种辅助疗法疼痛强度的数据，包括经皮电神经刺激（TENS）、经皮神经电刺激、重复经颅磁刺激、脉冲电磁场疗法、脊髓刺激（SCS）、经颅直流电刺激、频率节律性电调制系统、中脑调制和假手术。
对总共12项独立研究的数据进行了分析，这些研究的总样本量为922名参与者。与假手术干预相比，所有七种神经调节疗法在疼痛强度方面均表现出更好的效果，TENS排名最高，其次是SCS。在最终随访时间点，仅观察到SCS的疼痛强度（与假手术相比）有统计学意义的降低。
该网络荟萃分析的结果应有助于制定临床指南，并加强患者和医疗保健专业人员的决策过程，从而确定最合适的PDN治疗方案。
PROSPERO：CRD42024597208。
