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Latin American and Caribbean consensus on noninvasive central nervous system neuromodulation for chronic pain management (LAC 2 -NIN-CP)

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Date
2019
Author
Baptista, Abrahão Fontes
Fernandes, Ana Mércia B L
Sá, Katia Nunes
Okano, Alexandre Hideki
Brunoni, André Russowsky
Lara-Solares, Argelia
Jreige Iskandar, Aziza
Guerrero, Carlos
Amescua-García, César
Kraychete, Durval Campos
Caparelli-Daquer, Egas
Atencio, Elias
Piedimonte, Fabián
Colimon, Frantz
Hazime, Fuad Ahmed
Garcia, João Batista S
Hernandez-Castro, John-JairoAutoridad Universidad de Rosario
Cantisani, José Alberto Flores
Karina do Monte-Silva, Kátia
Lemos Correia, Luis Claudio
Gallegos, Manuel Sempértegui
Marcolin, Marco Antonio
Ricco, María Antonieta
Cook, María Berenguel
Bonilla, Patricia
Schestatsky, Pedro
Galhardoni, Ricardo
Silva, Valquíria
Delgado Barrera, William
Caumo, Wolnei
Bouhassira, Didier
Chipchase, Lucy S
Lefaucheur, Jean-Pascal
Teixeira, Manoel Jacobsen
de Andrade, Daniel Ciampi
Métricas

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Citation
URI
https://doi.org/10.1097/PR9.0000000000000692
https://repository.urosario.edu.co/handle/10336/22745

Abstract
Introduction: Chronic pain (CP) is highly prevalent and generally undertreated health condition. Noninvasive brain stimulation may contribute to decrease pain intensity and influence other aspects related to CP. Objective: To provide consensus-based recommendations for the use of noninvasive brain stimulation in clinical practice. Methods: Systematic review of the literature searching for randomized clinical trials followed by consensus panel. Recommendations also involved a cost-estimation study. Results: The systematic review wielded 24 transcranial direct current stimulation (tDCS) and 22 repetitive transcranial magnetic stimulation (rTMS) studies. The following recommendations were provided: (1) Level A for anodal tDCS over the primary motor cortex (M1) in fibromyalgia, and level B for peripheral neuropathic pain, abdominal pain, and migraine; bifrontal (F3/F4) tDCS and M1 high-definition (HD)-tDCS for fibromyalgia; Oz/Cz tDCS for migraine and for secondary benefits such as improvement in quality of life, decrease in anxiety, and increase in pressure pain threshold; (2) level A recommendation for high-frequency (HF) rTMS over M1 for fibromyalgia and neuropathic pain, and level B for myofascial or musculoskeletal pain, complex regional pain syndrome, and migraine; (3) level A recommendation against the use of anodal M1 tDCS for low back pain; and (4) level B recommendation against the use of HF rTMS over the left dorsolateral prefrontal cortex in the control of pain. Conclusion: Transcranial DCS and rTMS are recommended techniques to be used in the control of CP conditions, with low to moderate analgesic effects, and no severe adverse events. These recommendations are based on a systematic review of the literature and a consensus made by experts in the field. Readers should use it as part of the resources available to decision-making. Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike License 4.0 (CCBY-NC-SA).

Keyword

Mixed pain ; Neuropathic pain ; Nociceptive pain ; RTMS ; TDCS ;

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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85061476557&doi=10.1097%2fPR...

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