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Cochrane Database of Systematic Reviews

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 (83rd percentile)

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396 Mendeley
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.

X Demographics

X Demographics

The data shown below were collected from the profiles of 42 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 396 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 2 <1%
Italy 2 <1%
Germany 1 <1%
China 1 <1%
United States 1 <1%
Unknown 389 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 55 14%
Researcher 51 13%
Student > Ph. D. Student 50 13%
Student > Bachelor 37 9%
Student > Postgraduate 33 8%
Other 97 24%
Unknown 73 18%
Readers by discipline Count As %
Medicine and Dentistry 106 27%
Neuroscience 56 14%
Psychology 49 12%
Nursing and Health Professions 25 6%
Agricultural and Biological Sciences 15 4%
Other 49 12%
Unknown 96 24%
Attention Score in Context

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
#919,837
of 25,932,719 outputs
Outputs from Cochrane database of systematic reviews
#1,697
of 13,164 outputs
Outputs of similar age
#8,552
of 240,937 outputs
Outputs of similar age from Cochrane database of systematic reviews
#38
of 236 outputs
Altmetric has tracked 25,932,719 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 13,164 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 35.1. This one has done well, scoring higher than 87% 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 240,937 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 236 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 83% of its contemporaries.