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Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis

BACKGROUND: In this meta-analysis, we explore the role of repetitive transcranial magnetic stimulation (rTMS), a noninvasive neuromodulation technique in the treatment of chronic pain. METHODS: Studies comparing rTMS and conventional treatment for chronic pain were searched. The comparison was made...

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Autores principales: Goudra, Basavana, Shah, Dipal, Balu, Ganesh, Gouda, Gowri, Balu, Alan, Borle, Anuradha, Singh, Preet Mohinder
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594801/
https://www.ncbi.nlm.nih.gov/pubmed/28928582
http://dx.doi.org/10.4103/aer.AER_10_17
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author Goudra, Basavana
Shah, Dipal
Balu, Ganesh
Gouda, Gowri
Balu, Alan
Borle, Anuradha
Singh, Preet Mohinder
author_facet Goudra, Basavana
Shah, Dipal
Balu, Ganesh
Gouda, Gowri
Balu, Alan
Borle, Anuradha
Singh, Preet Mohinder
author_sort Goudra, Basavana
collection PubMed
description BACKGROUND: In this meta-analysis, we explore the role of repetitive transcranial magnetic stimulation (rTMS), a noninvasive neuromodulation technique in the treatment of chronic pain. METHODS: Studies comparing rTMS and conventional treatment for chronic pain were searched. The comparison was made for decrease in the pain scores with and without (sham) the use of rTMS after a follow-up interval of 4–8 weeks. All reported pain scores were converted into a common scale ranging from “0” (no pain) to “10” (worst pain). RESULTS: Nine trials with 183 patients in each of the groups were included in the analysis. The decrease in pain scores with rTMS was 1.12 (95% confidence interval [CI] being 1.46–0.78) (fixed effects, I(2) = 0%, P < 0.001) and in sham-rTMS was 0.28 (95% CI being 0.49–0.07) (Fixed effects, I(2) = 0, P = 0.01). The pooled mean drop in pain scores with rTMS therapy was higher by 0.79 (95% CI being 0.26–1.33) (fixed effects, I(2) = 0, P < 0.01). The duration and frequency of rTMS were highly variable across trials. Publication bias was unlikely (Egger's test, X-intercept = 0.13, P = 0.75). CONCLUSIONS: Use of rTMS improves the efficacy of conventional medical treatment in chronic pain patients. This treatment is not associated with any direct adverse effects. However, the duration and frequency of rTMS therapy is presently highly variable and needs standardization.
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spelling pubmed-55948012017-09-19 Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis Goudra, Basavana Shah, Dipal Balu, Ganesh Gouda, Gowri Balu, Alan Borle, Anuradha Singh, Preet Mohinder Anesth Essays Res Original Article BACKGROUND: In this meta-analysis, we explore the role of repetitive transcranial magnetic stimulation (rTMS), a noninvasive neuromodulation technique in the treatment of chronic pain. METHODS: Studies comparing rTMS and conventional treatment for chronic pain were searched. The comparison was made for decrease in the pain scores with and without (sham) the use of rTMS after a follow-up interval of 4–8 weeks. All reported pain scores were converted into a common scale ranging from “0” (no pain) to “10” (worst pain). RESULTS: Nine trials with 183 patients in each of the groups were included in the analysis. The decrease in pain scores with rTMS was 1.12 (95% confidence interval [CI] being 1.46–0.78) (fixed effects, I(2) = 0%, P < 0.001) and in sham-rTMS was 0.28 (95% CI being 0.49–0.07) (Fixed effects, I(2) = 0, P = 0.01). The pooled mean drop in pain scores with rTMS therapy was higher by 0.79 (95% CI being 0.26–1.33) (fixed effects, I(2) = 0, P < 0.01). The duration and frequency of rTMS were highly variable across trials. Publication bias was unlikely (Egger's test, X-intercept = 0.13, P = 0.75). CONCLUSIONS: Use of rTMS improves the efficacy of conventional medical treatment in chronic pain patients. This treatment is not associated with any direct adverse effects. However, the duration and frequency of rTMS therapy is presently highly variable and needs standardization. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5594801/ /pubmed/28928582 http://dx.doi.org/10.4103/aer.AER_10_17 Text en Copyright: © 2017 Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Goudra, Basavana
Shah, Dipal
Balu, Ganesh
Gouda, Gowri
Balu, Alan
Borle, Anuradha
Singh, Preet Mohinder
Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis
title Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis
title_full Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis
title_fullStr Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis
title_full_unstemmed Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis
title_short Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis
title_sort repetitive transcranial magnetic stimulation in chronic pain: a meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594801/
https://www.ncbi.nlm.nih.gov/pubmed/28928582
http://dx.doi.org/10.4103/aer.AER_10_17
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