The antalgic effects of non-invasive physical modalities on central post-stroke pain: a systematic review

Abstract

Abstract. [Purpose] This study systematically reviewed the antalgic effects of non-invasive physical modalities (NIPMs) on central post-stroke pain (CPSP). [Subjects and Methods] Clinical studies were sought on September 2015 in 10 electronic databases, including Medline and Scopus. The searching strings were "central pain and stroke" and "treatment, and physical or non-pharmacological". The inclusion and exclusion criteria were set for screening the clinical articles by two reviewers. Pain scores on visual analog scale in an article were used as the outcome measure for resulting judgment. The NIPMs intervention summarized from the eligible articles was rated from Levels A to C according to Evidence Classification Scheme for Therapeutic Interventions.[Results] Over 1200 articles were identified in the initial searches and 85 studies were retrieved. Sixteen studies were eligible and judged. Caloric vestibular stimulation (n=3), heterotopic noxious conditioning stimulation (n=1), and transcutaneous electrical stimulation (n=1) were rated below Level C. Transcranial direct current stimulation (TDCS; n=2) and transcranial magnetic stimulation (TMS; n=9) were rated as Level B.[Conclusion] The findings suggest that TMS and TDCS were better than other treatments for CPSP relief but the studies were of insufficient quality.

Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls

“…58 A recent systematic review that included nine HF-rTMS studies suggested an effect on CPSP relief, but also underlined the insufficient quality of the studies considered. 60…”

Desensitisation Therapy in Post Stroke Pain Syndrome: A Case Study

“…These reduce the pain and induce neuro modulatory effects for motor deficits. These non invasive modalities such as TENS, which have no side effects and easy to operate and inexpensive [17]. However the current stream of treatment for thalamic pain syndrome is by pharmacological interventions , deep brain stimulation , boutlinum toxin , motor cortex stimulation, transcranial magnetic stimulation and caloric vestibular stimulation.…”

Nonpharmacological therapies for central poststroke pain

“…[ 6 , 8 , 9 ] The current mainstream treatments are pharmacological in nature. [ 10 ] Several nonpharmacological therapies have also been demonstrated to be effective for patients with CPSP in clinical trials; [ 9 , 11 , 12 ] however, few systematic reviews have summarized their effectiveness and safety. [ 10 , 13 ] Hence, this systematic review was conducted to evaluate the efficacy and safety of nonpharmacological therapies for controlling CPSP, based on scientific evidence.…”