Noninvasive motor cortex stimulation effects on quantitative sensory testing in healthy and chronic pain subjects: a systematic review and meta-analysis.
Noninvasive motor cortex stimulation effects on quantitative sensory testing in healthy and chronic pain subjects: a systematic review and meta-analysis.
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非侵入性运动皮层刺激对健康和慢性疼痛受试者的定量感觉测试的影响：系统评价和荟萃分析。
DOI：
10.1097/j.pain.0000000000001893
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发表时间：
2020-09-01
期刊：
影响因子：
7.4
通讯作者：
Fregni F
中科院分区：
文献类型：
--
作者：
Giannoni-Luza S;Pacheco-Barrios K;Cardenas-Rojas A;Mejia-Pando PF;Luna-Cuadros MA;Barouh JL;Gnoatto-Medeiros M;Candido-Santos L;Barra A;Caumo W;Fregni F
非侵入性脑刺激 (NIBS) 刺激运动皮层对疼痛的潜在机制之一是通过恢复有缺陷的内源性抑制疼痛通路。然而，支持这一机制的定量感觉测试（QST），包括条件性疼痛调节（CPM）的数据仍然有限。这项系统回顾和荟萃分析旨在评估非侵入性运动皮层刺激对以 QST 结果变化为索引的疼痛感知的影响。数据库检索一直持续到 2019 年 7 月，其中包括随机对照试验，这些试验对健康和/或疼痛人群的运动皮层进行假对照 NIBS，并评估 QST 和 CPM。研究质量通过 Cochrane 工具进行评估。我们计算了 QST 和 CPM 结果的对冲效应大小、其 95% 置信区间 (95% CI)，并进行了随机效应荟萃分析。纳入了 38 项研究（1178 名参与者）。我们发现健康受试者（ES = 0.16，95％ CI = 0.02至0.31，I2 = 22.2％）和疼痛人群（ES = 0.48，95％ CI = 0.15至0.80，I2 = 68.8％）的疼痛阈值显着增加；与假手术组相比，主动 NIB 组在健康受试者（ES=-0.39，95% CI=-0.64 至 -0.14，I2=17%）和疼痛人群（ES=-0.35，95% CI=-0.60 至 -0.11，I2=0%）中均具有较高的 CPM 效果（疼痛等级降低）。这些结果支持了通过运动皮层刺激自上而下调节内源性疼痛通路的想法，这是 QST 评估的疼痛减轻的主要机制之一，这可能是 NIBS 慢性疼痛个性化治疗的有用的预测和预后生物标志物。
One of the potential mechanisms of motor cortex stimulation by non-invasive brain stimulation (NIBS) effects on pain is through the restoration of the defective endogenous inhibitory pain pathways. However, there is still limited data on quantitative sensory testing (QST), including conditioned pain modulation (CPM), supporting this mechanism. This systematic review and meta-analysis aimed to evaluate the effects of non-invasive motor cortex stimulation on pain perception as indexed by changes in QST outcomes. Database searches were conducted until July 2019 to included randomized controlled trials that performed sham-controlled NIBS on the motor cortex in either healthy and/or pain population and assessed the QST and CPM. Quality of studies was assessed through the Cochrane tool. We calculated the Hedge’s effect sizes of QST and CPM outcomes, their 95% confidence intervals (95% CI) and performed random-effects meta-analyses. Thirty-eight studies were included (1178 participants). We found significant increases of pain threshold in healthy subjects (ES=0.16, 95% CI=0.02 to 0.31, I2=22.2%) and pain population (ES=0.48, 95% CI=0.15 to 0.80, I2=68.8%); and homogeneous higher CPM effect (pain ratings reduction) in healthy subjects (ES=−0.39, 95% CI=−0.64 to −0.14, I2=17%) and pain population (ES=−0.35, 95% CI=−0.60 to −0.11, I2=0%) in active NIBs group compared with sham. These results support the idea of top-down modulation of endogenous pain pathways by motor cortex stimulation as one of the main mechanisms of pain reduction assessed by QST, which could be a useful predictive and prognostic biomarker for chronic pain personalized treatment with NIBS.
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影响因子：
4.3
作者：
Brietzke, Aline P.;Rozisky, Joanna R.;Caumo, Wolnei
通讯作者：
Caumo, Wolnei
影响因子：
7.4
作者：
García-Larrea, L;Peyron, R;Laurent, B
通讯作者：
Laurent, B
影响因子：
7.4
作者：
de Andrade, Daniel Ciampi;Mhalla, Alaa;Bouhassira, Didier
通讯作者：
Bouhassira, Didier
影响因子：
7.4
作者：
de Andrade, Daniel Ciampi;Mhalla, Alaa;Bouhassira, Didier
通讯作者：
Bouhassira, Didier
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N