Transforming Chronic Pain Management: Integrating Neuromodulation with Advanced Technologies to Tackle Cognitive Dysfunction - A Narrative Review.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Journal of Pain Research Pub Date : 2025-05-16 eCollection Date: 2025-01-01 DOI:10.2147/JPR.S514285
Maja Green, Amie Hayley, Jenny M Gunnersen, Vida Nazemian, Adam Cabble, Sandra Thompson, Krishnan Chakravarthy
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Abstract

Chronic pain is a complex and multidimensional condition that disrupts both physical function and cognitive processing, creating a bidirectional cycle that amplifies symptom burden and complicates clinical management. Cognitive dysfunction, characterized by deficits in memory, attention, and executive function, further impairs treatment adherence and functional recovery. Conventional pharmacologic therapies frequently fail to address this dual burden and are associated with adverse effects, including dependence and cognitive impairment. Neuromodulation has emerged as a promising nonpharmacologic alternative, capable of modulating neuroplastic, neuroinflammatory, and neurotransmitter pathways implicated in both pain and cognitive decline. This narrative review examines the mechanisms and clinical applications of spinal cord stimulation (SCS), transcutaneous electrical nerve stimulation (TENS), and neuromuscular electrical stimulation (NMES), and evaluates emerging innovations such as EcoAI™, an artificial intelligence-driven, non-invasive neuromodulation platform. By integrating physiological and behavioral biomarkers with real-time adaptive therapy, EcoAI and similar technologies represent a shift toward personalized, precision-based interventions. Additional advances in remote patient monitoring (RPM) and closed-loop feedback systems further enhance therapeutic responsiveness and continuity of care. Collectively, these approaches offer a scalable, patient-centered framework for managing chronic pain and its cognitive comorbidities. Future priorities include the development of validated biomarkers, rigorous clinical evaluation of AI-integrated systems, and equitable implementation strategies to ensure broad access to next-generation neuromodulation.

转变慢性疼痛管理:整合神经调节与先进技术来解决认知功能障碍-叙述性回顾。
慢性疼痛是一种复杂的、多维度的疾病,它会破坏身体功能和认知过程,形成一个双向循环,加重症状负担,使临床管理复杂化。认知功能障碍,以记忆、注意力和执行功能缺陷为特征,进一步损害治疗依从性和功能恢复。传统的药物治疗往往不能解决这种双重负担,并伴有不良反应,包括依赖性和认知障碍。神经调节已经成为一种很有前途的非药物替代方法,能够调节与疼痛和认知能力下降有关的神经可塑性、神经炎症和神经递质通路。本文综述了脊髓刺激(SCS)、经皮神经电刺激(TENS)和神经肌肉电刺激(NMES)的机制和临床应用,并评估了新兴的创新技术,如人工智能驱动的非侵入性神经调节平台EcoAI™。通过将生理和行为生物标志物与实时适应性治疗相结合,EcoAI和类似技术代表着向个性化、精准化干预的转变。远程患者监测(RPM)和闭环反馈系统的进一步进步进一步提高了治疗反应性和护理的连续性。总的来说,这些方法为管理慢性疼痛及其认知合并症提供了一个可扩展的、以患者为中心的框架。未来的优先事项包括开发经过验证的生物标志物,对人工智能集成系统进行严格的临床评估,以及公平的实施策略,以确保下一代神经调节的广泛使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Pain Research
Journal of Pain Research CLINICAL NEUROLOGY-
CiteScore
4.50
自引率
3.70%
发文量
411
审稿时长
16 weeks
期刊介绍: Journal of Pain Research is an international, peer-reviewed, open access journal that welcomes laboratory and clinical findings in the fields of pain research and the prevention and management of pain. Original research, reviews, symposium reports, hypothesis formation and commentaries are all considered for publication. Additionally, the journal now welcomes the submission of pain-policy-related editorials and commentaries, particularly in regard to ethical, regulatory, forensic, and other legal issues in pain medicine, and to the education of pain practitioners and researchers.
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