{"title":"不同频率重复经颅磁刺激治疗神经性口面部疼痛的疗效和安全性：系统文献综述和meta分析。","authors":"Manxia Liao, Yingxiu Diao, Jiaxin Pan, Ling Shing Wong, Geetha Subramaniam, Rajkumar Krishnan Vasanthi, Linrong Liao","doi":"10.22514/jofph.2024.013","DOIUrl":null,"url":null,"abstract":"<p><p>Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique used to treat neuropathic orofacial pain (NOP). This study aimed to evaluate the efficacy and safety of rTMS in managing NOP and reducing health risks. A comprehensive literature search was conducted in various databases, including PubMed, Physiotherapy Evidence Database (PEDro), the Cochrane Library, Web of Science, Embase and Clinical Trials.gov. Thirteen relevant articles were identified and assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Risk of Bias assessment tool. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was utilized to evaluate the evidence rating for the studies. The analysis of the thirteen randomized controlled trials, involving 355 eligible patients, demonstrated moderate evidence supporting the significant effect of rTMS in reducing pain intensity (Mean Difference (MD): -1.01, 95% Confidence Interval (CI) -2.39 to -1.48, <i>p</i> < 0.001) and improving the quality of life (QOL) based on various instruments (MD: -9.23, 95% CI -11.91 to -6.54, <i>p</i> < 0.001; MD: -2.1, 95% CI -3.74 to -0.45, <i>p</i> < 0.05). Patients also reported favorable improvements in global impression (MD: -0.54, 95% CI -1.02 to -0.07, <i>p</i> < 0.05) and sensory status (Standardized Mean Difference (SMD): -1.30, 95% CI -1.74 to -0.87, <i>p</i> < 0.001). However, there were no significant improvements in sleep quality (MD: -1.72, 95% CI -4.13 to 0.68, <i>p</i> > 0.05) or psychological status (<i>p</i> > 0.05). Overall, the study demonstrated that rTMS is an effective and safe way to reduce pain, improve QOL, enhance sensory status, and create a positive clinical impression in patients with NOP. Further research is needed to investigate the effects of rTMS on sleep and psychological well-being in individuals with NOP.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"38 2","pages":"48-67"},"PeriodicalIF":1.9000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of repetitive transcranial magnetic stimulation with different frequencies on neuropathic orofacial pain: a systematic literature review and meta-analysis.\",\"authors\":\"Manxia Liao, Yingxiu Diao, Jiaxin Pan, Ling Shing Wong, Geetha Subramaniam, Rajkumar Krishnan Vasanthi, Linrong Liao\",\"doi\":\"10.22514/jofph.2024.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique used to treat neuropathic orofacial pain (NOP). This study aimed to evaluate the efficacy and safety of rTMS in managing NOP and reducing health risks. A comprehensive literature search was conducted in various databases, including PubMed, Physiotherapy Evidence Database (PEDro), the Cochrane Library, Web of Science, Embase and Clinical Trials.gov. Thirteen relevant articles were identified and assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Risk of Bias assessment tool. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was utilized to evaluate the evidence rating for the studies. The analysis of the thirteen randomized controlled trials, involving 355 eligible patients, demonstrated moderate evidence supporting the significant effect of rTMS in reducing pain intensity (Mean Difference (MD): -1.01, 95% Confidence Interval (CI) -2.39 to -1.48, <i>p</i> < 0.001) and improving the quality of life (QOL) based on various instruments (MD: -9.23, 95% CI -11.91 to -6.54, <i>p</i> < 0.001; MD: -2.1, 95% CI -3.74 to -0.45, <i>p</i> < 0.05). Patients also reported favorable improvements in global impression (MD: -0.54, 95% CI -1.02 to -0.07, <i>p</i> < 0.05) and sensory status (Standardized Mean Difference (SMD): -1.30, 95% CI -1.74 to -0.87, <i>p</i> < 0.001). However, there were no significant improvements in sleep quality (MD: -1.72, 95% CI -4.13 to 0.68, <i>p</i> > 0.05) or psychological status (<i>p</i> > 0.05). Overall, the study demonstrated that rTMS is an effective and safe way to reduce pain, improve QOL, enhance sensory status, and create a positive clinical impression in patients with NOP. Further research is needed to investigate the effects of rTMS on sleep and psychological well-being in individuals with NOP.</p>\",\"PeriodicalId\":48800,\"journal\":{\"name\":\"Journal of Oral & Facial Pain and Headache\",\"volume\":\"38 2\",\"pages\":\"48-67\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Oral & Facial Pain and Headache\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.22514/jofph.2024.013\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Oral & Facial Pain and Headache","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.22514/jofph.2024.013","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
重复经颅磁刺激（rTMS）是一种用于治疗神经性口面部疼痛（NOP）的非侵入性技术。本研究旨在评价rTMS治疗NOP和降低健康风险的有效性和安全性。在PubMed、物理治疗证据数据库（PEDro）、Cochrane图书馆、Web of Science、Embase和Clinical Trials.gov等数据库中进行了全面的文献检索。使用系统评价和荟萃分析首选报告项目（PRISMA）指南和Cochrane偏倚风险评估工具对13篇相关文章进行了识别和评估。采用建议评估、发展和评价分级（GRADE）系统对研究的证据等级进行评价。对13项随机对照试验的分析，包括355名符合条件的患者，显示了中等证据支持rTMS在减轻疼痛强度（平均差值（MD）： -1.01, 95%可信区间(CI) -2.39至-1.48,p < 0.001）和改善各种工具的生活质量（MD: -9.23, 95% CI -11.91至-6.54,p < 0.001）方面的显着效果；MD: -2.1, 95% CI -3.74 ~ -0.45, p < 0.05)。患者还报告了总体印象（MD: -0.54, 95% CI -1.02至-0.07,p < 0.05）和感觉状态（标准化平均差（SMD）： -1.30, 95% CI -1.74至-0.87,p < 0.001）的良好改善。然而，睡眠质量（MD: -1.72, 95% CI: -4.13 ~ 0.68, p < 0.05）或心理状态（p < 0.05）没有显著改善。总的来说，研究表明rTMS是一种有效和安全的方法，可以减轻NOP患者的疼痛，改善生活质量，改善感觉状态，并创造积极的临床印象。rTMS对NOP患者睡眠和心理健康的影响有待进一步研究。
Efficacy and safety of repetitive transcranial magnetic stimulation with different frequencies on neuropathic orofacial pain: a systematic literature review and meta-analysis.
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique used to treat neuropathic orofacial pain (NOP). This study aimed to evaluate the efficacy and safety of rTMS in managing NOP and reducing health risks. A comprehensive literature search was conducted in various databases, including PubMed, Physiotherapy Evidence Database (PEDro), the Cochrane Library, Web of Science, Embase and Clinical Trials.gov. Thirteen relevant articles were identified and assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Risk of Bias assessment tool. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was utilized to evaluate the evidence rating for the studies. The analysis of the thirteen randomized controlled trials, involving 355 eligible patients, demonstrated moderate evidence supporting the significant effect of rTMS in reducing pain intensity (Mean Difference (MD): -1.01, 95% Confidence Interval (CI) -2.39 to -1.48, p < 0.001) and improving the quality of life (QOL) based on various instruments (MD: -9.23, 95% CI -11.91 to -6.54, p < 0.001; MD: -2.1, 95% CI -3.74 to -0.45, p < 0.05). Patients also reported favorable improvements in global impression (MD: -0.54, 95% CI -1.02 to -0.07, p < 0.05) and sensory status (Standardized Mean Difference (SMD): -1.30, 95% CI -1.74 to -0.87, p < 0.001). However, there were no significant improvements in sleep quality (MD: -1.72, 95% CI -4.13 to 0.68, p > 0.05) or psychological status (p > 0.05). Overall, the study demonstrated that rTMS is an effective and safe way to reduce pain, improve QOL, enhance sensory status, and create a positive clinical impression in patients with NOP. Further research is needed to investigate the effects of rTMS on sleep and psychological well-being in individuals with NOP.
期刊介绍：
Founded upon sound scientific principles, this journal continues to make important contributions that strongly influence the work of dental and medical professionals involved in treating oral and facial pain, including temporomandibular disorders, and headache. In addition to providing timely scientific research and clinical articles, the journal presents diagnostic techniques and treatment therapies for oral and facial pain, headache, mandibular dysfunction, and occlusion and covers pharmacology, physical therapy, surgery, and other pain-management methods.
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