• Am J Phys Med Rehabil · Sep 2020

    Meta Analysis

    Noninvasive Brain Stimulation Does Not Improve Neuropathic Pain in Individuals With Spinal Cord Injury: Evidence From a Meta-Analysis of 11 Randomized Controlled Trials.

    • Binbin Yu, Huaide Qiu, Jiahui Li, Caiyun Zhong, and Jianan Li.
    • From the Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China (BY, HQ, Jiahui L, Jianan L); School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China (BY, HQ, Jiahui L, Jianan L); and School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, China (CZ).
    • Am J Phys Med Rehabil. 2020 Sep 1; 99 (9): 811-820.

    ObjectiveThe aim of the study was to examine the effectiveness of noninvasive brain stimulation on neuropathic pain in individuals with spinal cord injury.MethodsA meta-analysis on pain intensity, depression, and anxiety levels was conducted to evaluate the effect of noninvasive brain stimulation on neuropathic pain in individuals with spinal cord injury. The authors searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), Embase (OvidSP), PsycINFO (OvidSP), and Physiotherapy Evidence Database (PEDro). Randomized controlled trials comparing noninvasive brain stimulation with sham stimulation were included.ResultsEleven studies were selected. The pooled analysis demonstrated no significant effect of repetitive transcranial magnetic stimulation, transcranial direct current stimulation, or cranial electrotherapy stimulation on neuropathic pain reduction after spinal cord injury. In addition, noninvasive brain stimulation showed no beneficial effect over sham stimulation on the improvement of depression, while it yielded a significant reduction of anxiety levels immediately after treatment. Subgroup analysis showed that only cranial electrotherapy stimulation had a significant effect on the reduction of anxiety levels among the three types of noninvasive brain stimulation.ConclusionsIn individuals with spinal cord injury, no significant effects of noninvasive brain stimulation on neuropathic pain and depression were observed. Cranial electrotherapy stimulation may be beneficial for the management of anxiety. These findings do not support the routine use of noninvasive brain stimulation for neuropathic pain in individuals with spinal cord injury.

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