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Non-Invasive Brain Stimulation Techniques for Chronic Pain (Review) Cochrane Database of Systematic Reviews Non-invasive brain stimulation techniques for chronic pain (Review) O’Connell NE, Wand BM, Marston L, Spencer S, DeSouza LH O’Connell NE, Wand BM, Marston L, Spencer S, DeSouza LH. Non-invasive brain stimulation techniques for chronic pain. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD008208. DOI: 10.1002/14651858.CD008208.pub3. www.cochranelibrary.com Non-invasive brain stimulation techniques for chronic pain (Review) Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 SUMMARY OF FINDINGS FOR THE MAIN COMPARISON . ..... 4 BACKGROUND .................................... 6 OBJECTIVES ..................................... 8 METHODS ...................................... 8 RESULTS....................................... 11 Figure2. ..................................... 12 DISCUSSION ..................................... 24 AUTHORS’CONCLUSIONS . 28 ACKNOWLEDGEMENTS . 29 REFERENCES ..................................... 29 CHARACTERISTICSOFSTUDIES . 37 DATAANDANALYSES. 126 Analysis 1.1. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 1 Pain: short-term follow- up. ..................................... 130 Analysis 1.2. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 2 Pain: short-term follow-up, subgroup analysis: multiple-dose vs single-dose studies. ................. 132 Analysis 1.3. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 3 Pain: short-term follow-up, subgroup analysis, neuropathic pain participants only. ................. 135 Analysis 1.4. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 4 Pain: short-term follow-up, subgroup analysis, non-neuropathic pain participants only. .................. 137 Analysis 1.5. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 5 Pain: short-term follow-up, subgroup analysis: motor cortex studies only, low-frequency studies excluded. 138 Analysis 1.6. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 6 Sensitivity analysis - imputed correlation coefficient increased. Pain: short-term follow-up. ................. 140 Analysis 1.7. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 7 Sensitivity analysis - imputed correlation coefficient decreased. Pain: short-term follow-up. ................. 142 Analysis 1.8. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 8 Sensitivity analysis - imputed correlation increased. Pain: short-term follow-up, subgroup analysis: motor cortex studies only, low-frequency studies excluded. ................................... 145 Analysis 1.9. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 9 Sensitivity analysis - imputed correlation decreased. Pain: short-term follow-up, subgroup analysis: motor cortex studies only, low-frequency studies excluded. ................................... 147 Analysis 1.10. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 10 Sensitivity analysis - inclusion of high risk of bias studies. Pain: short-term follow-up. ................ 149 Analysis 1.11. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 11 Sensitivity analysis - inclusion of high risk of bias studies. Pain: short-term follow-up, subgroup analysis: motor cortex studies only, low- frequencystudiesexcluded. 152 Analysis 1.12. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 12 Pain: short-term follow- up, subgroup analysis: prefrontal cortex studies only. ................ 154 Analysis 1.13. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 13 Sensitivity analysis - inclusion of high risk of bias studies. Pain: short-term follow-up, subgroup analysis: prefrontal cortex studies only. 155 Analysis 1.14. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 14 Pain: medium-term follow-up.................................... 156 Analysis 1.15. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 15 Sensitivity analysis - inclusion of high risk of bias studies. Pain: medium-term follow-up. ............... 157 Analysis 1.16. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 16 Pain: long-term follow- up. ..................................... 159 Non-invasive brain stimulation techniques for chronic pain (Review) i Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Analysis 1.17. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 17 Sensitivity analysis - inclusion of high risk of bias studies. Pain: long-term follow-up. ................ 160 Analysis 1.18. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 18 Disability/pain interference:short-termfollow-up. 161 Analysis 1.19. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 19 Disability/pain interference:medium-termfollow-up. 162 Analysis 1.20. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 20 Disability/pain interference:long-termfollow-up. 163 Analysis 1.21. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 21 Quality of life: short-term follow-up (Fibromyalgia Impact Questionnaire). .......... 164 Analysis 1.22. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 22 Quality of life: medium- term follow-up (Fibromyalgia Impact Questionnaire). ............ 165 Analysis 1.23. Comparison 1 Repetitive transcranial magnetic stimulation (rTMS), Outcome 23 Quality of life: long-term follow-up.................................... 165 Analysis 2.1. Comparison 2 Cranial electrotherapy stimulation (CES), Outcome 1 Pain: short-term follow-up. 166 Analysis 2.2. Comparison 2 Cranial electrotherapy stimulation (CES), Outcome 2 Disability/function/pain interference. 167 Analysis 2.3. Comparison 2 Cranial electrotherapy stimulation (CES), Outcome 3 Quality of life. 167 Analysis 3.1. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 1 Pain: short-term follow-up. 168 Analysis 3.2. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 2 Pain: short-term follow-up, subgroup analysis: motor cortex studies only. ........... 169 Analysis 3.3. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 3 Pain: short-term sensitivity analysis: correlation increased. 170 Analysis 3.4. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 4 Pain: short-term sensitivity analysis: correlation decreased. 171 Analysis 3.5. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 5 Pain: short-term follow-up, subgroup analysis: motor cortex studies only, sensitivity analysis: correlation increased. 173 Analysis 3.6. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 6 Pain: short-term follow-up, subgroup analysis: motor cortex studies only, sensitivity analysis: correlation decreased. 174 Analysis 3.7. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 7 Pain: medium-term follow-up. 175 Analysis 3.8. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 8 Disability (pain interference): short-termfollow-up. 176 Analysis 3.9. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 9 Quality of life: short-term follow- up. ..................................... 176 Analysis 3.10. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 10 Quality of life: medium-term follow-up.................................... 177 Analysis 3.11. Comparison 3 Transcranial direct current stimulation (tDCS), Outcome 11 Pain: short-term follow-up, subgroup analysis: motor cortex studies only. ........... 178 Analysis 4.1. Comparison 4 Reduced impedance non-invasive cortical electrostimulation (RINCE), Outcome 1 Pain: short-termfollow-up. 179 Analysis 4.2. Comparison 4 Reduced impedance non-invasive cortical electrostimulation (RINCE), Outcome 2 Fibromyalgia Impact Questionnaire total score. ........... 179 ADDITIONALTABLES. 179 APPENDICES ..................................... 187 WHAT’SNEW..................................... 214 HISTORY....................................... 215 Figure1. ..................................... 216 CONTRIBUTIONSOFAUTHORS . 217 DECLARATIONSOFINTEREST . 217 DIFFERENCES BETWEEN PROTOCOL AND REVIEW . .... 217 INDEXTERMS .................................... 217 Non-invasive brain stimulation techniques for chronic pain (Review) ii Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. [Intervention Review] Non-invasive brain stimulation techniques for chronic pain Neil E O’Connell1, Benedict M Wand2, Louise Marston3, Sally Spencer4, Lorraine H DeSouza1 1Centre for Research in Rehabilitation, School of Health Sciences and Social Care, Brunel University, Uxbridge, UK. 2School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia. 3Research Department of Primary Care & Population Health, University College London, London, UK. 4Faculty of Health and Medicine, Lancaster University, Lancaster, UK Contact address: Neil E O’Connell, Centre for Research in Rehabilitation, School of Health Sciences and Social Care, Brunel University, Kingston Lane, Uxbridge, Middlesex, UB8 3PH, UK. [email protected].
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