Implantable Peripheral Nerve Stimulation for Trigeminal Neuropathic Pain: A Systematic Review and Meta-Analysis

Ni, Yuncheng; Yang, Liuqing; Han, Rui; Guo, Gangwen; Sheng, Huang; Weng, Lili; Wang, Xun; Liu, Zhenxing; Huang, Dong; Hu, Rong; Zhou, Haocheng

doi:10.1111/ner.13421

Cited by 19 publications

(11 citation statements)

References 49 publications

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“…A considerable amount of evidence has demonstrated that the implantable electrical nerve stimulation (ENS) device can provide sufficient relief from HZ-related pain ( Harke et al, 2002 ; Vannemreddy and Slavin, 2011 ; Deer et al, 2014 ; Chen et al, 2017 ; Ni et al, 2021 ). For pain management, ENS can be classified into two approaches according to the site of the herpetic lesion: spinal cord and peripheral nerve stimulation.…”

Section: Introductionmentioning

confidence: 99%

Effect of Implantable Electrical Nerve Stimulation on Cortical Dynamics in Patients With Herpes Zoster–Related Pain: A Prospective Pilot Study

Zhou

Han

Chen

et al. 2022

Front. Bioeng. Biotechnol.

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Implantable electrical nerve stimulation (ENS) can be used to treat neuropathic pain caused by herpes zoster. However, little is known about the cortical mechanism underlying neuromodulation therapy. Here, we recorded a 16-channel resting-state electroencephalogram after the application of spinal cord stimulation (n = 5) or peripheral nerve stimulation (n = 3). The neuromodulatory effect was compared between specific conditions (active ENS versus rest). To capture the cortical responses of ENS, spectral power and coherence analysis were performed. ENS therapy achieved satisfactory relief from pain with a mean visual analog scale score reduction of 5.9 ± 1.1. The spectral analysis indicated that theta and alpha oscillations increased significantly during active neuromodulation compared with the resting state. Furthermore, ENS administration significantly increased frontal-frontal coherence in the alpha band. Our findings demonstrate that, despite methodological differences, both spinal cord and peripheral nerve stimulation can induce cortical alpha oscillation changes in patients with zoster-related pain. The dynamic change may, in part, mediate the analgesic effect of ENS on herpes zoster–related pain.

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Section: Introductionmentioning

confidence: 99%

Effect of Implantable Electrical Nerve Stimulation on Cortical Dynamics in Patients With Herpes Zoster–Related Pain: A Prospective Pilot Study

Zhou

Han

Chen

et al. 2022

Front. Bioeng. Biotechnol.

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“…A recent meta-analysis covering the same topic included data from studies of mixed diagnoses, as well as multiple treatment modalities. 31 Despite such wide inclusion criteria, the study was limited by a poor choice of search parameters and was missing more than half of the studies included in our meta-analysis. For peripheral nerve branch stimulation of multiple etiologies (trigeminal pain + headaches), they reported only binarized data (subjects with pain relief ≥ 50% were responders) rather than mean difference of pain scores.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes and complications of peripheral nerve field stimulation in the management of refractory trigeminal pain: a systematic review and meta-analysis

Sarica

Iorio-Morin

Aguirre-Padilla

et al. 2022

Journal of Neurosurgery

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OBJECTIVE Peripheral nerve field stimulation (PNFS) is a tool in the armamentarium of treatment options for trigeminal pain. The efficacy of this modality in mitigating trigeminal pain remains unclear. The aim of this study was to examine the existing literature on PNFS and elucidate pain score outcomes associated with its use in patients with trigeminal pain. METHODS A systematic review and meta-analysis was performed in accordance with the PRISMA framework. The PubMed, Web of Science, and Scopus databases were queried on June 10, 2020. Studies reporting pain outcomes in more than 5 adult patients treated with PNFS for facial pain were included. The primary outcome of the study was the mean difference in the visual analog scale (VAS) score from the last follow-up to baseline, and it was analyzed by an inverse-variance, random-effect model. The risk of bias was assessed using the Newcastle-Ottawa Scale and a funnel plot. RESULTS Of the 4597 studies screened for inclusion, 46 relevant full-text articles were assessed for eligibility. Eleven observational cohort studies from the 46 articles were found to be eligible, and reported on a total of 109 patients. In 86% (94/109) of cases, trial stimulation was successful and followed by a permanent system implantation. VAS scores improved by 75% (mean difference 6.32/10 points, 95% CI 5.38–7.27 points) compared to baseline. Seventy-six percent (42/55) of patients became medication free or required lower doses of medications. The complication rate necessitating surgical revision was estimated at 32% per procedure. CONCLUSIONS These findings support the belief that PNFS provides effective, long-term pain control for trigeminal pain. Statistical heterogeneity was considerable across all studies. Future work should be aimed at conducting double-blind randomized controlled trials to determine the utility of PNFS for treating various forms of trigeminal pain for which limited therapeutic options exist.

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“…10,11 A recent meta-analysis by has also indicated utility of peripheral intervention in the management of trigeminal neuropathic pain from both peripheral and central causes. 12 The underlying mechanisms of this pain relief remain unclear but may include blockade of afferent nociceptive transduction and reduction in neurogenic inflammation through inhibition of neural substances and neurotransmitters. 12 Although central post-stroke facial pain, including secondary trigeminal neuralgia, is commonly reported, the current literature remains limited and lacks standard treatment guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…12 The underlying mechanisms of this pain relief remain unclear but may include blockade of afferent nociceptive transduction and reduction in neurogenic inflammation through inhibition of neural substances and neurotransmitters. 12 Although central post-stroke facial pain, including secondary trigeminal neuralgia, is commonly reported, the current literature remains limited and lacks standard treatment guidelines. As the use of anticonvulsants or tricyclic antidepressants may be limited in stroke patients due to undesirable neurological side effects, an earlier consideration of interventional treatment options should be carefully considered.…”

Section: Discussionmentioning

confidence: 99%

A case of secondary trigeminal neuralgia due to lateral medullary syndrome treated with trigeminal ganglion radiofrequency ablation

2022

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Implantable Peripheral Nerve Stimulation for Trigeminal Neuropathic Pain: A Systematic Review and Meta-Analysis

Cited by 19 publications

References 49 publications

Effect of Implantable Electrical Nerve Stimulation on Cortical Dynamics in Patients With Herpes Zoster–Related Pain: A Prospective Pilot Study

Effect of Implantable Electrical Nerve Stimulation on Cortical Dynamics in Patients With Herpes Zoster–Related Pain: A Prospective Pilot Study

Clinical outcomes and complications of peripheral nerve field stimulation in the management of refractory trigeminal pain: a systematic review and meta-analysis

A case of secondary trigeminal neuralgia due to lateral medullary syndrome treated with trigeminal ganglion radiofrequency ablation

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