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Effects of Non-Invasive Brain Stimulation on Clinical Pain Intensity and Experimental Pain Sensitivity Among Individuals with Central Post-Stroke Pain: A Systematic Review
PURPOSE: Central post-stroke pain (CPSP) is a neuropathic disorder resulting in pain and disability. An emerging treatment for CPSP is non-invasive brain stimulation including direct current stimulation [tDCS] and repetitive transcranial magnetic stimulation [rTMS]. This systematic review analyzes t...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916700/ https://www.ncbi.nlm.nih.gov/pubmed/31853195 http://dx.doi.org/10.2147/JPR.S216081 |
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author | Ramger, Benjamin Curtis Bader, Kimberly Anne Davies, Samantha Pauline Stewart, David Andrew Ledbetter, Leila Snow Simon, Corey Brae Feld, Jody Ann |
author_facet | Ramger, Benjamin Curtis Bader, Kimberly Anne Davies, Samantha Pauline Stewart, David Andrew Ledbetter, Leila Snow Simon, Corey Brae Feld, Jody Ann |
author_sort | Ramger, Benjamin Curtis |
collection | PubMed |
description | PURPOSE: Central post-stroke pain (CPSP) is a neuropathic disorder resulting in pain and disability. An emerging treatment for CPSP is non-invasive brain stimulation including direct current stimulation [tDCS] and repetitive transcranial magnetic stimulation [rTMS]. This systematic review analyzes the efficacy and quality of non-invasive brain stimulation intervention studies for CPSP. METHODS: Studies were sought from three research databases published between 2007 and 2017. Studies were included if the sole intervention was non-invasive brain stimulation and the primary outcome either clinical or experimental pain intensity. Studies were qualitatively assessed for risk of bias. RESULTS: Of 1107 articles extracted, six met eligibility criteria. Five studies found a decrease in pain intensity (p<0.05) immediately and 3 weeks after rTMS or tDCS was delivered over the primary motor cortex. For experimental pain, one study found thermal pain thresholds improved for those receiving tDCS compared to sham (p<0.05), while another found normalization of the cold detection threshold only after rTMS (p<0.05). Qualitative assessment revealed only one study rated as “excellent/good” quality, while the other five were rated as “fair” or “poor”. CONCLUSION: Non-invasive brain stimulation may have a therapeutic effect on pain level for individuals with CPSP, as evidenced by significant decreases in clinical and experimental pain scores. However, despite the impact of CPSP and the promise of non-invasive brain stimulation, few rigorous studies have been performed in this area. Future studies should aim to standardize treatment parameters, measure both clinical and experimental pain, and include long-term follow-up. |
format | Online Article Text |
id | pubmed-6916700 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-69167002019-12-18 Effects of Non-Invasive Brain Stimulation on Clinical Pain Intensity and Experimental Pain Sensitivity Among Individuals with Central Post-Stroke Pain: A Systematic Review Ramger, Benjamin Curtis Bader, Kimberly Anne Davies, Samantha Pauline Stewart, David Andrew Ledbetter, Leila Snow Simon, Corey Brae Feld, Jody Ann J Pain Res Review PURPOSE: Central post-stroke pain (CPSP) is a neuropathic disorder resulting in pain and disability. An emerging treatment for CPSP is non-invasive brain stimulation including direct current stimulation [tDCS] and repetitive transcranial magnetic stimulation [rTMS]. This systematic review analyzes the efficacy and quality of non-invasive brain stimulation intervention studies for CPSP. METHODS: Studies were sought from three research databases published between 2007 and 2017. Studies were included if the sole intervention was non-invasive brain stimulation and the primary outcome either clinical or experimental pain intensity. Studies were qualitatively assessed for risk of bias. RESULTS: Of 1107 articles extracted, six met eligibility criteria. Five studies found a decrease in pain intensity (p<0.05) immediately and 3 weeks after rTMS or tDCS was delivered over the primary motor cortex. For experimental pain, one study found thermal pain thresholds improved for those receiving tDCS compared to sham (p<0.05), while another found normalization of the cold detection threshold only after rTMS (p<0.05). Qualitative assessment revealed only one study rated as “excellent/good” quality, while the other five were rated as “fair” or “poor”. CONCLUSION: Non-invasive brain stimulation may have a therapeutic effect on pain level for individuals with CPSP, as evidenced by significant decreases in clinical and experimental pain scores. However, despite the impact of CPSP and the promise of non-invasive brain stimulation, few rigorous studies have been performed in this area. Future studies should aim to standardize treatment parameters, measure both clinical and experimental pain, and include long-term follow-up. Dove 2019-12-13 /pmc/articles/PMC6916700/ /pubmed/31853195 http://dx.doi.org/10.2147/JPR.S216081 Text en © 2019 Ramger et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Review Ramger, Benjamin Curtis Bader, Kimberly Anne Davies, Samantha Pauline Stewart, David Andrew Ledbetter, Leila Snow Simon, Corey Brae Feld, Jody Ann Effects of Non-Invasive Brain Stimulation on Clinical Pain Intensity and Experimental Pain Sensitivity Among Individuals with Central Post-Stroke Pain: A Systematic Review |
title | Effects of Non-Invasive Brain Stimulation on Clinical Pain Intensity and Experimental Pain Sensitivity Among Individuals with Central Post-Stroke Pain: A Systematic Review |
title_full | Effects of Non-Invasive Brain Stimulation on Clinical Pain Intensity and Experimental Pain Sensitivity Among Individuals with Central Post-Stroke Pain: A Systematic Review |
title_fullStr | Effects of Non-Invasive Brain Stimulation on Clinical Pain Intensity and Experimental Pain Sensitivity Among Individuals with Central Post-Stroke Pain: A Systematic Review |
title_full_unstemmed | Effects of Non-Invasive Brain Stimulation on Clinical Pain Intensity and Experimental Pain Sensitivity Among Individuals with Central Post-Stroke Pain: A Systematic Review |
title_short | Effects of Non-Invasive Brain Stimulation on Clinical Pain Intensity and Experimental Pain Sensitivity Among Individuals with Central Post-Stroke Pain: A Systematic Review |
title_sort | effects of non-invasive brain stimulation on clinical pain intensity and experimental pain sensitivity among individuals with central post-stroke pain: a systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916700/ https://www.ncbi.nlm.nih.gov/pubmed/31853195 http://dx.doi.org/10.2147/JPR.S216081 |
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