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Eficacia de la estimulación cerebral no invasiva para pacientes con dolor central postictus: una revisión sistemática

Tieshan Li¹, Xianjun Zhang², Xiaoming Yu³

¹Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.

American journal of physical medicine & rehabilitation

|January 27, 2026

Abstracto

Objective:

To systematically evaluate the effects of noninvasive brain stimulation (NIBS) on pain intensity, psychological symptoms, and quality of life in patients with central poststroke pain (CPSP).

Design:

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. Databases including PubMed, Embase, Cochrane Library, Web of Science, and CNKI were searched through April 2025. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated, and subgroup analyses were performed by stimulation target and modality.

Results:

Thirteen RCTs involving 430 participants were included. Compared with sham stimulation, NIBS significantly reduced pain intensity (SMD = -0.64, 95% CI: -1.24 to -0.05, p = 0.035). Subgroup analyses showed greater pain reduction when stimulation targeted the primary motor cortex (M1) (SMD = -1.07, 95% CI: -1.62 to -0.52) and when using transcranial direct current stimulation (tDCS) (SMD = -1.08, 95% CI: -1.99 to -0.17). However, no significant effects were observed on depression, anxiety, or quality of life.

Conclusion:

NIBS, particularly M1 stimulation and tDCS, may provide analgesic benefits for CPSP but appears ineffective for psychosocial outcomes. Larger, well-designed trials are required to validate stimulation-specific efficacy and clarify the broader therapeutic role of NIBS in CPSP.

Palabras clave:

dolor central postictus meta-análisis estimulación cerebral no invasiva ensayos controlados aleatorizados

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