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. 2020 Sep 28;11(1):363-370.
doi: 10.1515/tnsci-2020-0120. eCollection 2020.

The effect of rTMS in the management of pain associated with CRPS

Min Cheol Chang  1 , Sang Gyu Kwak  2 , Donghwi Park  3
Affiliations

The effect of rTMS in the management of pain associated with CRPS

Min Cheol Chang et al. Transl Neurosci. .

Abstract

Background: Therapeutic management of pain in patients with complex regional pain syndrome (CRPS) is challenging. Repetitive transcranial magnetic stimulation (rTMS) has analgesic effects on several types of pain. However, its effect on CRPS has not been elucidated clearly. Therefore, we conducted a meta-analysis of the available clinical studies on rTMS treatment in patients with CRPS.

Materials and methods: A comprehensive literature search was conducted using the PubMed, EMBASE, Cochrane Library, and SCOPUS databases. We included studies published up to February 09, 2020, that fulfilled our inclusion and exclusion criteria. Data regarding measurement of pain using the visual analog scale before and after rTMS treatment were collected to perform the meta-analysis. The meta-analysis was performed using Comprehensive Meta-analysis Version 2.

Results: A total of three studies (one randomized controlled trial and two prospective observational studies) involving 41 patients were included in this meta-analysis. No significant reduction in pain was observed immediately after one rTMS treatment session or immediately after the entire schedule of rTMS treatment sessions (5 or 10 sessions; P > 0.05). However, pain significantly reduced 1 week after the entire schedule of rTMS sessions (P < 0.001).

Conclusion: rTMS appears to have a functional analgesic effect in patients with CRPS.

Keywords: complex regional pain syndrome; meta-analysis; pain; repetitive regional pain syndrome.

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Conflict of interest statement

Conflict of interest: The authors state no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart showing the search results of the meta-analysis.
Figure 2
Figure 2
Changes in the visual analog scale scores immediately after one rTMS treatment session (a), immediately after the completion of the entire schedule of rTMS treatment sessions (5 or 10 sessions) (b), and 1 week after the completion of the entire schedule of rTMS sessions (5 or 10 sessions) (c).
Figure 3
Figure 3
Graphic funnel plot of the included studies, depicting the change in visual analog scale scores immediately after 1 rTMS session.
See this image and copyright information in PMC

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