{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T12:03:50Z","timestamp":1779710630823,"version":"3.53.1"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":144,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271239"],"award-info":[{"award-number":["82271239"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate the efficacy and safety of high\u2010frequency (HF\u2010SCS) and low\u2010frequency (LF\u2010SCS) spinal cord stimulation for painful diabetic neuropathy (PDN) and to qualitatively explore potential differences between HF\u2010SCS and LF\u2010SCS based on indirect comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis were conducted following PRISMA guidelines. We searched PubMed, Scopus, Embase, Web of Science, and the Cochrane Library for studies published between 2015 and 2024. Inclusion criteria included studies involving adult patients with PDN receiving either HF\u2010SCS or LF\u2010SCS. Eligible studies reported outcomes such as pain relief VAS, EQ\u20105D, and adverse events. Data were analyzed using a random\u2010effects model. Pain intensity outcomes were converted to a 0\u201310 scale and pooled as mean differences (MDs). The EQ\u20105D index was pooled as standardized mean differences (SMDs). Sensitivity and subgroup analyses were performed to assess heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 9 studies, including 416 participants, were eligible. Moderate certainty evidence suggests that both HF\u2010SCS and LF\u2010SCS significantly reduce pain in patients with PDN. In RCTs, SCS reduced pain at 6\u2009months compared with best medical therapy (overall MD on a 0\u201310 scale: \u22123.95, 95% CI \u22125.57 to \u22122.33). In subgroup analyses, the HF\u2010SCS trial showed an MD of \u22125.20 (95% CI \u22125.79 to \u22124.61), and LF\u2010SCS trials showed a pooled MD of \u22123.22 (95% CI \u22124.37 to \u22122.07). Both treatments were associated with low adverse event rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both HF\u2010SCS and LF\u2010SCS were associated with substantial reductions in pain intensity in patients with PDN compared with best medical therapy or baseline, although the overall certainty of evidence was at most moderate. Because no head\u2010to\u2010head trials directly comparing HF\u2010SCS and LF\u2010SCS in PDN were available, comparative effectiveness between modalities remains uncertain; however, these cross\u2010study differences should be interpreted cautiously because the modalities were not compared head\u2010to\u2010head. Improvements in EQ\u20105D were modest and did not consistently exceed the prespecified minimal important difference, and both modalities showed low rates of mainly device\u2010related complications with few serious adverse events reported.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/prm\/9347376","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T11:43:44Z","timestamp":1779709424000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spinal Cord Stimulation for Painful Diabetic Neuropathy: A Systematic Review and Meta\u2010Analysis of High\u2010 and Low\u2010Frequency 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