TY - JOUR
T1 - Latin American and Caribbean consensus on noninvasive central nervous system neuromodulation for chronic pain management (LAC 2 -NIN-CP)
AU - Baptista, Abrahão Fontes
AU - Fernandes, Ana Mércia B.L.
AU - Sá, Katia Nunes
AU - Okano, Alexandre Hideki
AU - Brunoni, André Russowsky
AU - Lara-Solares, Argelia
AU - Iskandar, Aziza Jreige
AU - Guerrero, Carlos
AU - Amescua-García, César
AU - Kraychete, Durval Campos
AU - Caparelli-Daquer, Egas
AU - Atencio, Elias
AU - Piedimonte, Fabián
AU - Colimon, Frantz
AU - Hazime, Fuad Ahmed
AU - Garcia, João Batista S.
AU - Hernández-Castro, John Jairo
AU - Cantisani, José Alberto Flores
AU - Do Monte-Silva, Kátia Karina
AU - Correia, Luis Claudio Lemos
AU - Gallegos, Manuel Sempértegui
AU - Marcolin, Marco Antonio
AU - Ricco, María Antonieta
AU - Cook, María Berenguel
AU - Bonilla, Patricia
AU - Schestatsky, Pedro
AU - Galhardoni, Ricardo
AU - Silva, Valquíria
AU - Barrera, William Delgado
AU - Caumo, Wolnei
AU - Bouhassira, Didier
AU - Chipchase, Lucy S.
AU - Lefaucheur, Jean Pascal
AU - Teixeira, Manoel Jacobsen
AU - De Andrade, Daniel Ciampi
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Introduction: Chronic pain (CP) is highly prevalent and generally undertreated health condition. Noninvasive brain stimulation may contribute to decrease pain intensity and influence other aspects related to CP. Objective: To provide consensus-based recommendations for the use of noninvasive brain stimulation in clinical practice. Methods: Systematic review of the literature searching for randomized clinical trials followed by consensus panel. Recommendations also involved a cost-estimation study. Results: The systematic review wielded 24 transcranial direct current stimulation (tDCS) and 22 repetitive transcranial magnetic stimulation (rTMS) studies. The following recommendations were provided: (1) Level A for anodal tDCS over the primary motor cortex (M1) in fibromyalgia, and level B for peripheral neuropathic pain, abdominal pain, and migraine; bifrontal (F3/F4) tDCS and M1 high-definition (HD)-tDCS for fibromyalgia; Oz/Cz tDCS for migraine and for secondary benefits such as improvement in quality of life, decrease in anxiety, and increase in pressure pain threshold; (2) level A recommendation for high-frequency (HF) rTMS over M1 for fibromyalgia and neuropathic pain, and level B for myofascial or musculoskeletal pain, complex regional pain syndrome, and migraine; (3) level A recommendation against the use of anodal M1 tDCS for low back pain; and (4) level B recommendation against the use of HF rTMS over the left dorsolateral prefrontal cortex in the control of pain. Conclusion: Transcranial DCS and rTMS are recommended techniques to be used in the control of CP conditions, with low to moderate analgesic effects, and no severe adverse events. These recommendations are based on a systematic review of the literature and a consensus made by experts in the field. Readers should use it as part of the resources available to decision-making.
AB - Introduction: Chronic pain (CP) is highly prevalent and generally undertreated health condition. Noninvasive brain stimulation may contribute to decrease pain intensity and influence other aspects related to CP. Objective: To provide consensus-based recommendations for the use of noninvasive brain stimulation in clinical practice. Methods: Systematic review of the literature searching for randomized clinical trials followed by consensus panel. Recommendations also involved a cost-estimation study. Results: The systematic review wielded 24 transcranial direct current stimulation (tDCS) and 22 repetitive transcranial magnetic stimulation (rTMS) studies. The following recommendations were provided: (1) Level A for anodal tDCS over the primary motor cortex (M1) in fibromyalgia, and level B for peripheral neuropathic pain, abdominal pain, and migraine; bifrontal (F3/F4) tDCS and M1 high-definition (HD)-tDCS for fibromyalgia; Oz/Cz tDCS for migraine and for secondary benefits such as improvement in quality of life, decrease in anxiety, and increase in pressure pain threshold; (2) level A recommendation for high-frequency (HF) rTMS over M1 for fibromyalgia and neuropathic pain, and level B for myofascial or musculoskeletal pain, complex regional pain syndrome, and migraine; (3) level A recommendation against the use of anodal M1 tDCS for low back pain; and (4) level B recommendation against the use of HF rTMS over the left dorsolateral prefrontal cortex in the control of pain. Conclusion: Transcranial DCS and rTMS are recommended techniques to be used in the control of CP conditions, with low to moderate analgesic effects, and no severe adverse events. These recommendations are based on a systematic review of the literature and a consensus made by experts in the field. Readers should use it as part of the resources available to decision-making.
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U2 - 10.1097/PR9.0000000000000692
DO - 10.1097/PR9.0000000000000692
M3 - Article
C2 - 30801041
AN - SCOPUS:85061476557
SN - 2471-2531
VL - 4
JO - Pain Reports
JF - Pain Reports
IS - 1
M1 - e692
ER -