Houlind Bjarke Kaae, Jensen Henrik Boye
Brain and Nerve Diseases, Lillebælt Hospital, 6000 Kolding, Denmark.
Neurol Int. 2025 May 20;17(5):77. doi: 10.3390/neurolint17050077.
This systematic review assessed the current literature regarding the analgesic treatment of central neuropathic pain (CNP) in central nervous system (CNS) conditions, such as spinal cord injuries, multiple sclerosis, post-stroke disorders, and Parkinson's disease. The aim of this systematic review was to compare the current algorithmic treatment of CNP, which generally does not discriminate among underlying conditions, with RCTs investigating algorithm-recommended and non-algorithm-recommended drugs for differing underlying conditions. : The PubMed and EMBASE databases were used to identify relevant randomized control trials (RCTs). MeSH terms and EmTree terms were searched as well as free text words in the title/abstract of the studies. A risk of bias tool was used to assess all included studies. : A total of 903 RCTs were identified from the initial search. Thirty-eight RCTs published between January 2002 and November 2024 fulfilled all the inclusion criteria and none of the exclusion criteria. The review investigated progressive and stable neurological diseases and conditions with associated CNP. : From the majority of the included studies, the current recommended treatment algorithm seems to be effective and safe; however, the underlying condition seems to influence how the patient responds to tier-appropriate medication.
本系统评价评估了有关中枢神经系统（CNS）疾病（如脊髓损伤、多发性硬化症、中风后疾病和帕金森病）中中枢神经性疼痛（CNP）镇痛治疗的现有文献。本系统评价的目的是将目前通常不区分潜在疾病的CNP算法治疗与针对不同潜在疾病研究算法推荐药物和非算法推荐药物的随机对照试验（RCT）进行比较。使用PubMed和EMBASE数据库识别相关的随机对照试验（RCT）。检索了医学主题词（MeSH）和EmTree词以及研究标题/摘要中的自由文本词。使用偏倚风险工具评估所有纳入研究。从最初的检索中总共识别出903项RCT。2002年1月至2024年11月发表的38项RCT符合所有纳入标准且无排除标准。该评价研究了伴有CNP的进行性和稳定性神经疾病及病症。从大多数纳入研究来看，目前推荐的治疗算法似乎有效且安全；然而，潜在疾病似乎会影响患者对分级适当药物的反应。
