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  4. Motor cortex stimulation: a systematic literature-based analysis of effectiveness and case series experience

Motor cortex stimulation: a systematic literature-based analysis of effectiveness and case series experience

BMC Neurology, 2019 · DOI: https://doi.org/10.1186/s12883-019-1273-y · Published: March 14, 2019

NeurologyPain ManagementSurgery

Simple Explanation

Refractory pain is difficult to treat with standard medications. Motor cortex stimulation (MCS) is a potential treatment option. This study analyzes existing research to see how well MCS works for different types of refractory pain. The study combined data from multiple studies to get a better idea of how effective MCS is. It looked at different types of pain, like post-stroke pain and trigeminal neuropathic pain. The researchers found that MCS can help with refractory pain, but it works better for some types of pain than others. The duration of the disease and follow-up time are factors that can predict the outcome.

Study Duration
Not specified
Participants
198 (pooled from 12 trials)
Evidence Level
Level III: Systematic review and meta-analysis

Key Findings

  • 1
    MCS shows a positive effect on refractory pain, with a total percentage improvement of 35.2% in post-stroke pain and 46.5% in trigeminal neuropathic pain.
  • 2
    The highest improvement rate was seen in post-radicular plexopathy (65.1%).
  • 3
    MCS may aggravate the pain induced by spinal cord injury.

Research Summary

This study aimed to quantitatively analyze the clinical effectiveness of motor cortex stimulation (MCS) for refractory pain by systematically reviewing relevant literature. The pooled effect estimate from 12 trials (n = 198) elucidated that MCS shown the positive effect on 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.

Practical Implications

Treatment Option

MCS can be considered as a potential treatment for patients with refractory pain, particularly post-stroke pain, trigeminal neuropathic pain and post-radicular plexopathy.

Predictive Factors

The duration of the disease and the follow-up time can be considered as predictive factors for the success of MCS.

Further Research

Further studies are needed to understand the underlying mechanisms of MCS and to evaluate its cost-benefit ratio.

Study Limitations

  • 1
    Small sample sizes in some of the included studies.
  • 2
    Potential influence of different stimulation parameters across centers.
  • 3
    Lack of well-designed studies, such as randomized controlled trials.

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