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Neuromodulatory treatments for chronic pain: efficacy and mechanisms.

Nature reviews. Neurology
March 1, 2014
Mark P Jensen et al. (3 authors)
Journal ArticleResearch Support, N.I.H., ExtramuralReviewHuman Study
Study Details

Study Goal

The researchers aimed to summarize the efficacy and mechanisms of noninvasive neuromodulatory treatments, including mindfulness meditation, for chronic pain.

Results Summary

The study found limited evidence for the potential efficacy of mindfulness meditation, noting both immediate and long-term effects on cortical structures related to attention, emotional responding, and pain. However, more definitive research is needed before recommending it for chronic pain treatment.

Population

Patients with chronic pain

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
hypnosis
decrease
chronic pain
patients with chronic pain
-
provide support for the efficacy and positive side-effect profile
#1
meditation training
decrease
chronic pain
patients with chronic pain
-
limited evidence for the potential efficacy
#2
noninvasive electrical stimulation procedures
decrease
chronic pain
patients with chronic pain
-
limited evidence for the potential efficacy
#3
neurofeedback procedures
decrease
chronic pain
patients with chronic pain
-
limited evidence for the potential efficacy
#4
hypnosis
neutral
multiple neurophysiological processes involved in the experience of pain
-
-
influences
#5
mindfulness meditation
neutral
cortical structures and activity involved in attention, emotional responding and pain
-
-
has both immediate and long-term effects
#6
Abstract

Chronic pain is common, and the available treatments do not provide adequate relief for most patients. Neuromodulatory interventions that modify brain processes underlying the experience of pain have the potential to provide substantial relief for some of these patients. The purpose of this Review is to summarize the state of knowledge regarding the efficacy and mechanisms of noninvasive neuromodulatory treatments for chronic pain. The findings provide support for the efficacy and positive side-effect profile of hypnosis, and limited evidence for the potential efficacy of meditation training, noninvasive electrical stimulation procedures, and neurofeedback procedures. Mechanisms research indicates that hypnosis influences multiple neurophysiological processes involved in the experience of pain. Evidence also indicates that mindfulness meditation has both immediate and long-term effects on cortical structures and activity involved in attention, emotional responding and pain. Less is known about the mechanisms of other neuromodulatory treatments. On the basis of the data discussed in this Review, training in the use of self-hypnosis might be considered a viable 'first-line' approach to treat chronic pain. More-definitive research regarding the benefits and costs of meditation training, noninvasive brain stimulation and neurofeedback is needed before these treatments can be recommended for the treatment of chronic pain.

Medical Subject Headings (MeSH)
Autogenic TrainingBrainChronic PainElectric Stimulation TherapyHumansMeditationNeurotransmitter AgentsPain Management
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Citation Metrics
Total Citations111
Citations/Year10.1
Relative Citation Ratio4.70
NIH Percentile92.3%
Research Impact Scores
APT Score0.95
Weight Score1.77
Normalized Score0.61
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