Evidence map›Paper›PMID 40067404›Full record

SynthesisNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025

Efficacy of neuromodulation and rehabilitation approaches on pain relief in patients with spinal cord injury: a systematic review and meta-analysis.

Simona Portaro, Angelo Alito, Giulia Leonardi, Nicola Marotta, Adriana Tisano, Daniele Bruschetta, Umile Giuseppe Longo, Antonio Ammendolia, Demetrio Milardi, Alessandro de Sire

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Simona PortaroDepartment of Physical and Rehabilitation Medicine, University Hospital "G. Martino", Messina, Italy.ORCID http://orcid.org/0000-0002-6379-1642
Angelo AlitoDepartment of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.ORCID http://orcid.org/0000-0002-6609-579X
Giulia LeonardiDepartment of Physical and Rehabilitation Medicine, University Hospital "G. Martino", Messina, Italy.ORCID http://orcid.org/0000-0002-9532-0220
Nicola MarottaPhysical Medicine and Rehabilitation Unit, Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy.ORCID http://orcid.org/0000-0002-5568-7909
Adriana TisanoDepartment of Clinical and Experimental Medicine, University of Messina, Messina, Italy.ORCID http://orcid.org/0000-0001-6550-9543
Daniele BruschettaDepartment of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.ORCID http://orcid.org/0000-0003-1211-362X
Umile Giuseppe LongoFondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.ORCID http://orcid.org/0000-0003-4063-9821
Antonio AmmendoliaResearch Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy.ORCID http://orcid.org/0000-0002-2828-2455
Demetrio MilardiDepartment of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.ORCID http://orcid.org/0000-0001-7311-2757
Alessandro de SireResearch Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy. alessandro.desire@unicz.it.ORCID http://orcid.org/0000-0002-5541-8346

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSpinal cord injury (SCI) is a debilitating neurological condition that causes physical dependency, psychological distress, and financial burden. Pain is a common consequence of SCI, significantly impacting quality of life. Effective pain management in SCI is challenging and requires multifaceted approaches. Among rehabilitation methods, non-invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS), theta burst stimulation (TBS), transcranial direct current stimulation (tDCS), transcutaneous electrical nerve stimulation (TENS), and virtual reality (VR) have been explored. This study aims to evaluate the efficacy of rehabilitation and non-invasive brain stimulation techniques on pain relief in SCI patients.

methodsA systematic review of the literature was conducted using PubMed, Scopus, and ScienceDirect with the formula ("spinal cord injury") AND ("pain"). Risk of bias was assessed using the Cochrane Risk of Bias Tool.

resultsSixteen studies involving 319 patients were included. Patients in the control groups received: rTMS in seven trials, tDCS in seven trials, TBS in one trial, and TENS combined with VR in one trial. The trials analyzed were of poor methodological quality, characterized by small sample sizes, weak power analyses, varying clinical scores, and non-comparable follow-up periods. No major complications or serious adverse events were reported.

conclusionResults were inconsistent, with no solid evidence supporting the superiority of rehabilitation techniques over comparator treatments. However, the favorable safety profile and positive outcomes in some measures suggest potential benefits for pain management and quality of life. Further studies are necessary to better understand SCI-related pain and optimize treatment strategies.

Indexed as

Pain ManagementSpinal Cord InjuriesTranscutaneous Electric Nerve StimulationHumansTranscranial Direct Current StimulationTranscranial Magnetic StimulationNon-invasive brain stimulationPainRehabilitationSpinal cord injury

Identifiers

PMID40067404
PMCPMC12152033

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.