Abstract：
BACKGROUND: The efficacy of spinal cord stimulation (SCS) in chronic pain studies is traditionally assessed by pain scores, which do not reflect the multidimensional nature of pain perception. Despite the evidence of SCS\'s influence on emotional functioning comprehensive assessments of its effect remain lacking.
OBJECTIVE: To assess changes in emotional and psychosocial functioning in patients who underwent SCS implantation for chronic pain.
METHODS: Ovid MEDLINE, EMBASE, PsychINFO, Cochrane CENTRAL and Scopus databases were searched for original peer-reviewed publications reporting emotional functioning after SCS. The primary outcomes were a pooled mean difference (MD) in anxiety, depression, global functioning, mental well-being and pain catastrophizing at 12 months. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to determine the quality of evidence.
RESULTS: Thirty-two studies were included in the primary analysis. Statistically significant improvements were observed in anxiety (MD -2.16; 95% CI -2.84 to -1.49; p<0.001), depression (MD -4.66; 95% CI -6.26 to -3.06; p<0.001), global functioning (MD 20.30; 95% CI 14.69 to 25.90; p<0.001), mental well-being (MD 4.95; 95% CI 3.60 to 6.31; p<0.001), and pain catastrophizing (MD -12.09; 95% CI -14.94 to -9.23; p<0.001). Subgroup analyses revealed differences in Global Assessment of Functioning and mental well-being based on study design and in depression based on waveform paradigm.
CONCLUSIONS: The results highlight the statistically and clinically significant improvements in emotional and psychosocial outcomes in patients with chronic pain undergoing SCS therapy. However, these results need to be interpreted with caution due to the very low certainty of evidence per the GRADE criteria.
UNASSIGNED: CRD42023446326.
OBJECTIVE: To assess changes in emotional and psychosocial functioning in patients who underwent SCS implantation for chronic pain.
METHODS: Ovid MEDLINE, EMBASE, PsychINFO, Cochrane CENTRAL and Scopus databases were searched for original peer-reviewed publications reporting emotional functioning after SCS. The primary outcomes were a pooled mean difference (MD) in anxiety, depression, global functioning, mental well-being and pain catastrophizing at 12 months. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to determine the quality of evidence.
RESULTS: Thirty-two studies were included in the primary analysis. Statistically significant improvements were observed in anxiety (MD -2.16; 95% CI -2.84 to -1.49; p<0.001), depression (MD -4.66; 95% CI -6.26 to -3.06; p<0.001), global functioning (MD 20.30; 95% CI 14.69 to 25.90; p<0.001), mental well-being (MD 4.95; 95% CI 3.60 to 6.31; p<0.001), and pain catastrophizing (MD -12.09; 95% CI -14.94 to -9.23; p<0.001). Subgroup analyses revealed differences in Global Assessment of Functioning and mental well-being based on study design and in depression based on waveform paradigm.
CONCLUSIONS: The results highlight the statistically and clinically significant improvements in emotional and psychosocial outcomes in patients with chronic pain undergoing SCS therapy. However, these results need to be interpreted with caution due to the very low certainty of evidence per the GRADE criteria.
UNASSIGNED: CRD42023446326.
摘要：
背景：传统上通过疼痛评分来评估脊髓刺激（SCS）在慢性疼痛研究中的疗效，这并不反映疼痛感知的多维性质。尽管有证据表明SCS对情绪功能的影响，但仍缺乏对其影响的全面评估。
目的：评估因慢性疼痛而接受SCS植入的患者的情绪和社会心理功能的变化。
方法：OvidMEDLINE，EMBASE,心理信息,在CochraneCENTRAL和Scopus数据库中搜索原始的同行评审出版物，报告SCS后的情绪功能。主要结果是焦虑的合并平均差(MD)，抑郁症,全球运作，12个月时精神健康和疼痛灾难化。建议的分级，评估,发展,和评估（等级）用于确定证据质量。
结果：32项研究纳入主要分析。在焦虑方面观察到统计学上显著的改善(MD-2.16;95%CI-2.84至-1.49;p<0.001),抑郁症（MD-4.66；95%CI-6.26至-3.06；p<0.001），全球功能(MD20.30；95%CI14.69至25.90；p<0.001)，心理健康(MD4.95；95%CI3.60至6.31；p<0.001)，和疼痛灾难（MD-12.09；95%CI-14.94至-9.23；p<0.001）。亚组分析显示，基于研究设计的全球功能和心理健康评估以及基于波形范式的抑郁症评估存在差异。
结论：结果强调了接受SCS治疗的慢性疼痛患者在情绪和社会心理方面的显著改善。然而,根据GRADE标准,这些结果需要谨慎解释,因为证据的确定性非常低.
■CRD42023446326。
目的：评估因慢性疼痛而接受SCS植入的患者的情绪和社会心理功能的变化。
方法：OvidMEDLINE，EMBASE,心理信息,在CochraneCENTRAL和Scopus数据库中搜索原始的同行评审出版物，报告SCS后的情绪功能。主要结果是焦虑的合并平均差(MD)，抑郁症,全球运作，12个月时精神健康和疼痛灾难化。建议的分级，评估,发展,和评估（等级）用于确定证据质量。
结果：32项研究纳入主要分析。在焦虑方面观察到统计学上显著的改善(MD-2.16;95%CI-2.84至-1.49;p<0.001),抑郁症（MD-4.66；95%CI-6.26至-3.06；p<0.001），全球功能(MD20.30；95%CI14.69至25.90；p<0.001)，心理健康(MD4.95；95%CI3.60至6.31；p<0.001)，和疼痛灾难（MD-12.09；95%CI-14.94至-9.23；p<0.001）。亚组分析显示，基于研究设计的全球功能和心理健康评估以及基于波形范式的抑郁症评估存在差异。
结论：结果强调了接受SCS治疗的慢性疼痛患者在情绪和社会心理方面的显著改善。然而,根据GRADE标准,这些结果需要谨慎解释,因为证据的确定性非常低.
■CRD42023446326。
