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Non-invasive brain stimulation techniques for chronic pain

Overview of attention for article published in Cochrane database of systematic reviews, April 2014
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (85th percentile)

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Title
Non-invasive brain stimulation techniques for chronic pain
Published in
Cochrane database of systematic reviews, April 2014
DOI 10.1002/14651858.cd008208.pub3
Pubmed ID
Authors

Neil E O'Connell, Benedict M Wand, Louise Marston, Sally Spencer, Lorraine H DeSouza

Abstract

Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronic pain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES) and transcranial direct current stimulation (tDCS). To evaluate the efficacy of non-invasive brain stimulation techniques in chronic pain. We searched CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, the Cochrane PaPaS Group Trials Register and clinical trials registers. Randomised and quasi-randomised studies of rTMS, CES or tDCS if they employed a sham stimulation control group, recruited patients over the age of 18 with pain of three months duration or more and measured pain as a primary outcome. Two authors independently extracted and verified data. Where possible we entered data into meta-analyses. We excluded studies judged as being at high risk of bias from the analysis. We included 33 trials in the review (involving 937 people)(19 rTMS, eight CES and six tDCS). Only one study was judged as being at low risk of bias.Studies of rTMS (involving 368 participants ) demonstrated significant heterogeneity. Pre-specified subgroup analyses suggest that low-frequency stimulation is ineffective. A short-term effect on pain of active high-frequency stimulation of the motor cortex in single-dose studies was suggested (standardised mean difference (SMD) -0.40, 95% confidence interval (CI) -0.26 to -0.54, P < 0.00001). This equates to a 15% (95% CI 10% to 20%) reduction in pain which does not clearly exceed the pre-established criteria for a minimally clinically important difference (> 15%).For CES (four studies, 133 participants) no statistically significant difference was found between active stimulation and sham. Analysis of tDCS studies (five studies, 83 people) demonstrated significant heterogeneity and did not find a significant difference between active and sham stimulation. Pre-specified subgroup analysis of tDCS applied to the motor cortex suggested superiority of active stimulation over sham (SMD -0.59, 95% CI -1.10 to -0.08).Non-invasive brain stimulation appears to be associated with minor and transient side effects. Single doses of high-frequency rTMS of the motor cortex may have small short-term effects on chronic pain. The effects do not clearly exceed the predetermined threshold of minimal clinical significance. Low-frequency rTMS is not effective in the treatment of chronic pain. There is insufficient evidence from which to draw firm conclusions regarding the efficacy of CES or tDCS. The available evidence suggests that tDCS applied to the motor cortex may have short-term effects on chronic pain and that CES may be ineffective. There is a need for further, rigorously designed studies of all types of stimulation.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 301 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 3 <1%
United Kingdom 2 <1%
Italy 2 <1%
China 1 <1%
Germany 1 <1%
Unknown 292 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 51 17%
Student > Ph. D. Student 46 15%
Researcher 41 14%
Student > Bachelor 28 9%
Student > Postgraduate 26 9%
Other 92 31%
Unknown 17 6%
Readers by discipline Count As %
Medicine and Dentistry 104 35%
Neuroscience 43 14%
Psychology 39 13%
Unspecified 18 6%
Agricultural and Biological Sciences 18 6%
Other 48 16%
Unknown 31 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 47. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 May 2018.
All research outputs
#342,783
of 12,980,487 outputs
Outputs from Cochrane database of systematic reviews
#1,012
of 10,428 outputs
Outputs of similar age
#6,089
of 190,576 outputs
Outputs of similar age from Cochrane database of systematic reviews
#31
of 210 outputs
Altmetric has tracked 12,980,487 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,428 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.4. This one has done particularly well, scoring higher than 90% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 190,576 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 210 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 85% of its contemporaries.