Motor Cortex Stimulation: a Systematic Literature-based Analysis of Effectiveness and Case Series Experience

Overview

Journal BMC Neurol

Publisher Biomed Central

Specialty Neurology

Date 2019 Mar 31

PMID 30925914

Citations 11

Authors

Jia-Jie Mo

Wen-Han Hu

Chao Zhang

Xiu Wang

Chang Liu

Bao-Tian Zhao

Jun-Jian Zhou

Kai Zhang

Affiliations

Soon will be listed here.

Abstract

Background: Aim to quantitatively analyze the clinical effectiveness for motor cortex stimulation (MCS) to refractory pain.

Methods: The literatures were systematically searched in database of Cocharane library, Embase and PubMed, using relevant strategies. Data were extracted from eligible articles and pooled as mean with standard deviation (SD). Comparative analysis was measured by non-parametric t test and linear regression model.

Results: The pooled effect estimate from 12 trials (n = 198) elucidated that MCS shown the positive effect on refractory pain, and the total percentage improvement was 35.2% in post-stroke pain and 46.5% in trigeminal neuropathic pain. There is no statistical differences between stroke involved thalamus or non-thalamus. The improvement of plexus avulsion (29.8%) and phantom pain (34.1%) was similar. The highest improvement rate was seen in post-radicular plexopathy (65.1%) and MCS may aggravate the pain induced by spinal cord injury, confirmed by small sample size. Concurrently, Both the duration of disease (r = 0.233, p = 0.019*) and the time of follow-up (r = 0.196, p = 0.016*) had small predicative value, while age (p = 0.125) had no correlation to post-operative pain relief.

Conclusions: MCS is conducive to the patients with refractory pain. The duration of disease and the time of follow-up can be regarded as predictive factor. Meanwhile, further studies are needed to reveal the mechanism of MCS and to reevaluate the cost-benefit aspect with better-designed clinical trials.

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