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The following is a summary of “Evidence-Based Umbrella Review of Non-Invasive Neuromodulation in Chronic Neuropathic Pain,” published in the January 2025 issue of Pain by Duarte-Moreira et al.
Non-invasive neuromodulation techniques (NIN), including transcranial Direct Current Stimulation (tDCS) and repetitive Transcranial Magnetic Stimulation (rTMS), had been extensively researched for alleviating neuropathic pain (NP), but treatment remained challenging due to varying techniques, dosages, and aetiologies.
Researchers conducted a retrospective study to consolidate existing evidence on the effectiveness of various NIN techniques in managing chronic NP.
They searched the PubMed/MEDLINE database, focusing on meta-analyses of controlled trials that compared NIN techniques with sham interventions for NP treatment. The quality of the included studies was evaluated using the AMSTAR-2 tool and the GRADE system and the effect sizes were adjusted to the standard mean difference (SMD).
The results showed 22 meta-analyses with 8,151 participants from 214 controlled trials, tDCS and rTMS were the NIN techniques were studied the most, targeting the motor cortex and dorsolateral prefrontal cortex. Excitatory protocols, especially high frequency rTMS and anodal tDCS, were effective in reducing pain intensity in NP. However, the quality of evidence was low due to study heterogeneity and small sample sizes.
Investigators concluded that the NIN techniques demonstrated the potential for pain reduction in NP management.
Source: onlinelibrary.wiley.com/doi/full/10.1002/ejp.4786
