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The goal was to compare the effectiveness of different stimulation therapies in diabetic neuropathy.
TENS is the most effective non-invasive stimulation technique for pain and sleep issues in diabetic neuropathy.
The goal was to compare the effectiveness of different stimulation therapies in diabetic neuropathy.
Researchers systematically searched electronic databases for randomized controlled trials (RCTs) involving non-invasive brain or nerve stimulation in individuals with diabetic neuropathy. The key focus was pain relief, while secondary endpoints encompassed changes in quality of life and sleep impairment. Evaluation of acceptability was done via dropout rates. For quantifying treatment effects, a frequentist NMA framework was applied, utilizing odds ratios (ORs) and standardized mean differences (SMDs) along with 95% confidence intervals (CIs).
In this systematic review and network meta-analysis (NMA), 15 RCTs involving 1,139 volunteers (mean age: 61.2 years; 53.8% women) were included, comparing 10 intervention arms: 1 control, 4 brain stimulation, and 5 nerve stimulation techniques. Among them, transcutaneous electrical nerve stimulation (TENS) emerged as the most effective—yielding marked reductions in pain (SMD = –1.67) and sleep disruption (SMD = –1.63) versus control. No vital differences were observed across groups for dropout rates or all-cause mortality.
The findings revealed TENS as a front-runner among non-invasive stimulation therapies for diabetic neuropathy, demonstrating superior pain and sleep-related benefits. Additionally, rigorously designed RCTs with longer-term follow-up are crucial.
Journal of NeuroEngineering and Rehabilitation
The comparative evidence of efficacy of non-invasive brain and nerve stimulation in diabetic neuropathy: a systematic review and network meta-analysis
Ping-Tao Tseng et al.
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