Analgesic effect of non-invasive neuromodulation approaches among patients with diabetic peripheral neuropathy: A systematic review
Abstract
Diabetic peripheral neuropathy (DPN), a complication of Diabetes Mellitus, is increasingly contributing to global morbidity and mortality. Non-invasive neuromodulation (NINM) approaches have become popular as safe, effective, and non-intrusive methods for managing persistent neuropathic pain. A key strategy for addressing DPN symptoms, neuromodulation modifies nerve function and encourages plastic changes in the central nervous system, aiding pain relief. This review aims to systematically assess scientific literature on the safety and effectiveness of NINM in reducing pain and improving physical function in DPN patients. Using PRISMA guidelines, searches were conducted across electronic databases such as MEDLINE (via PubMed), Web of Science, ScienceDirect, Cochrane, and PEDro, with study quality assessed using the PEDro scale. Fourteen studies with 436 participants were analyzed, revealing that NINM approaches can access deeper cortical regions without invasion, causing beneficial changes in the primary motor cortex (M1) that promote adaptive responses and activate pain control mechanisms without significant side effects. NINM shows promise in reducing neuropathic pain, evidenced by improved pain scores and physical function, leading to enhanced quality of life for patients suffering from chronic DPN-related pain.