■中风后中枢疼痛(CPSP)的康复是一项复杂的临床挑战,重复经颅磁刺激(rTMS)已广泛应用于脑卒中后神经功能恢复的研究。然而,目前尚无可靠的循证医学支持rTMS治疗中风后中枢性疼痛的疗效.本综述旨在评估rTMS对中央性卒中后疼痛的影响。
■遵循PRISMA准则,我们在PubMed上进行了搜索,科克伦图书馆,Embase,WebofScience,CNKI,万方数据知识服务平台。我们搜索了随机对照试验(RCTs),研究rTMS在治疗中枢中风后疼痛中的应用,并根据纳入和排除标准进行筛查。提取所包括的RCT的特征。使用I2统计量评估试验的异质性。采用Stata17软件进行Meta分析。使用CochraneRoB2工具和Pedro量表评估偏倚风险和方法学质量。
■共有6项随机对照试验涉及288例患者符合我们的纳入标准。在我们的分析中,与安慰剂组相比,rTMS治疗CPSP患者更有效(SMD=-1.15,95%CI:-1.69,-0.61,P<0.001)。此外,亚组分析结果显示,rTMS与常规治疗相比,超过6个月的疼痛改善无统计学差异(SMD=-0.80,95%CI:-1.63,0.03,P=0.059).
■TMS可以减轻CPSP患者的疼痛并改善其运动功能,但是它对抑郁症的影响,焦虑,和MEP延迟不显著。
■https://www.crd.约克。AC.英国/普华永道/,CRD42024497530。
UNASSIGNED: The rehabilitation of central post-
stroke pain (CPSP) is a complex clinical challenge, and repetitive transcranial magnetic stimulation (rTMS) has been widely applied in the research of neurofunctional recovery following
stroke. However, there is currently no reliable evidence-based medicine supporting the efficacy of rTMS in central post-
stroke pain. This review aims to evaluate the effects of rTMS on central post-
stroke pain.
UNASSIGNED: Following the PRISMA guidelines, we conducted searches on PubMed, Cochrane Library, Embase, Web of Science, CNKI, and Wan Fang Data Knowledge Service Platform. We searched for randomized controlled trials (RCTs) investigating the use of rTMS in treating central post-
stroke pain, and conducted screening based on inclusion and exclusion criteria. Characteristics of the included RCTs were extracted. The heterogeneity of the trials was assessed using the I2 statistic. Meta-analysis was performed using Stata 17 software. Bias risk and methodological quality were evaluated using the Cochrane RoB 2 tool and the Pedro scale.
UNASSIGNED: A total of six randomized controlled trials involving 288 patients met our inclusion criteria. In our analysis, rTMS was more effective in treating patients with CPSP compared to the placebo group (SMD=-1.15, 95% CI: -1.69, -0.61, P < 0.001). Furthermore, results from subgroup analysis indicated no statistically significant difference in the improvement of pain for durations exceeding 6 months when comparing rTMS to conventional treatment (SMD=-0.80, 95% CI: -1.63, 0.03, P = 0.059).
UNASSIGNED: TMS can alleviate pain in CPSP patients and improve their motor function, but its effects on depression, anxiety, and MEP-latency are not significant.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, CRD42024497530.