Non-invasive brain stimulation improves pain in patients with central post-stroke pain: a systematic review and meta-analysis.

IF 2.2 4区医学 Q1 REHABILITATION Topics in Stroke Rehabilitation Pub Date : 2024-06-03 DOI:10.1080/10749357.2024.2359341

Hu Lizi, Kou Jiaojiao, Wang Dan, Wang Shuyao, Wang Qingyuan, Yang Zijiang, Kang Hua

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Abstract

Background: Central post-stroke pain (CPSP) significantly interferes with the quality of life and psychological well-being of stroke patients. Non-invasive brain stimulation (NIBS) has attracted significant attention as an emerging method for treating patients with CPSP.

Objective: To compare the clinical efficacy of noninvasive brain stimulation on pain, and psychological status of patients with central post-stroke pain using meta-analysis.

Methods: A computerized search of multiple databases was performed for identification of randomized controlled trials involving NIBS-led treatment of CPSP patients. Two researchers worked independently on literature screening, data extraction, and quality assessment. Research was conducted from inception of the database until October 2023. RevMan 5.0 and Stata 15.0 software were used to conduct statistical analysis.

Results: Sixteen papers with 807 patients were finally included. The results showed that NIBS reduced patients' pain intensity [SMD = -0.39, 95% CI (-0.54, -0.24), p < 0.01] and was more effective in short-term CPSP patients. However, the included studies did not show a significant impact on psychological status, particularly depression. Subgroup analysis suggested that the M1 stimulation point was more effective than other stimulation points [SMD = -0.45, 95% CI (-0.65, -0.25), p < 0.001]. Other stimulation modalities also demonstrated favorable outcomes when compared to rTMS [SMD = -0.67, 95% CI (-1.09, -0.25), p < 0.01].

Conclusion: NIBS has a positive impact on pain relief in patients with CPSP, but does not enhance patients' psychological well-being in terms of anxiety or depression. Furthermore, large-sample, high-quality, and multi-center RCTs are needed to explore the benefits of different stimulation durations and parameters in patients with CPSP. The current study has been registered with Prospero under the registration number CRD42023468419.

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非侵入性脑部刺激可改善中枢性卒中后疼痛患者的疼痛：系统回顾和荟萃分析。

背景：中风后中枢性疼痛（CPSP）严重影响中风患者的生活质量和心理健康。无创脑部刺激（NIBS）作为一种治疗中枢性卒中后疼痛患者的新兴方法，已经引起了广泛关注：通过荟萃分析比较无创脑部刺激对中枢性卒中后疼痛患者的疼痛和心理状态的临床疗效：对多个数据库进行了计算机化检索，以确定涉及以 NIBS 为主导治疗中枢性卒中后疼痛患者的随机对照试验。两名研究人员独立进行文献筛选、数据提取和质量评估。研究从数据库建立之初一直持续到 2023 年 10 月。使用RevMan 5.0和Stata 15.0软件进行统计分析：最终收录了16篇论文，共807名患者。结果显示，NIBS降低了患者的疼痛强度[SMD = -0.39，95% CI (-0.54，-0.24)，p SMD = -0.45，95% CI (-0.65，-0.25)，p SMD = -0.67，95% CI (-1.09，-0.25)，p 结论：NIBS对患者的疼痛有积极影响：NIBS 对缓解 CPSP 患者的疼痛有积极影响，但并不能提高患者在焦虑或抑郁方面的心理健康水平。此外，还需要进行大样本、高质量和多中心的 RCT 研究，以探讨不同刺激持续时间和参数对 CPSP 患者的益处。本研究已在 Prospero 注册，注册号为 CRD42023468419。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Topics in Stroke Rehabilitation 医学-康复医学

CiteScore

5.10

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Topics in Stroke Rehabilitation is the leading journal devoted to the study and dissemination of interdisciplinary, evidence-based, clinical information related to stroke rehabilitation. The journal’s scope covers physical medicine and rehabilitation, neurology, neurorehabilitation, neural engineering and therapeutics, neuropsychology and cognition, optimization of the rehabilitation system, robotics and biomechanics, pain management, nursing, physical therapy, cardiopulmonary fitness, mobility, occupational therapy, speech pathology and communication. There is a particular focus on stroke recovery, improving rehabilitation outcomes, quality of life, activities of daily living, motor control, family and care givers, and community issues. The journal reviews and reports clinical practices, clinical trials, state-of-the-art concepts, and new developments in stroke research and patient care. Both primary research papers, reviews of existing literature, and invited editorials, are included. Sharply-focused, single-issue topics, and the latest in clinical research, provide in-depth knowledge.