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Deep brain stimulation for chronic pain: a systematic review and meta-analysis
Nour Shaheen1, Ahmed Shaheen1, Abdelrahman Elgendy2
1Alexandria Faculty of Medicine, Alexandria, Egypt.
Frontiers in Human Neuroscience
|December 15, 2023
Summary
Deep brain stimulation (DBS) effectively treats chronic pain, with specific protocols (DBS-P) showing significant relief. Further research is needed to optimize patient-specific treatment responses for chronic pain management.
Area of Science:
- Neurology
- Neurosurgery
- Pain Management
Background:
- Deep brain stimulation (DBS) is a promising treatment for chronic pain.
- This study systematically evaluated the efficacy of DBS for chronic pain management.
Approach:
- A systematic literature search was conducted using PubMed, Scopus, and Web of Science, adhering to PRISMA guidelines.
- Meta-analysis included 966 patients from 43 studies, comparing DBS for pain (DBS-P) versus other indications (DBS-O).
- Statistical analyses included heterogeneity assessment (tau^2, I^2, Cochran's Q-test) and meta-regression.
Key Points:
- DBS-P demonstrated a significant effect on chronic pain relief (SMD 1.65, CI [1.31; 2.00]), despite substantial heterogeneity (I^2 = 85.8%).
- No significant difference in effectiveness was observed between DBS-P and DBS-O subgroups.
- Subgroup and meta-regression analyses indicated variable evidence across different patient groups and targets, with no significant impact of age or pain duration on outcomes.
Conclusions:
- DBS is a valuable tool in managing chronic pain, contributing significantly to current knowledge.
- Further research is essential to refine treatment protocols and identify patient-specific factors influencing DBS effectiveness for chronic pain.
