Percutaneous trigeminal ganglion radiofrequency thermocoagulation alleviates anxiety and depression disorders in patients with classic trigeminal neuralgia

Abstract

Trigeminal neuralgia (TN) is a neurological condition that presents as excruciating facial pain. Depression and anxiety are commonly associated with TN; however, anxiety and depression disorders in patients with TN and the effects of the various therapeutic strategies for TN on these disorders are not well studied.To evaluate depression and anxiety in patients with trigeminal neuralgia (TN), identify factors that predict their occurrence and study the effect of the percutaneous trigeminal ganglion radiofrequency thermocoagulation (PRT) procedure for alleviating pain on depression and anxiety.Patients with classic TN, who received PRT treatment, were consecutively recruited between October 2014 and October 2015. Severity of pain was determined using the visual analogue scale (VAS) score. Beck Depression Inventory-II (BDI) and Beck anxiety Inventory (BAI) were used to evaluate depression and anxiety disorders pre- and post-PRT. Medical, demographic, and psychosocial backgrounds were also assessed as predictive factors. A BDI score of ≥14 represented depression and BAI score of ≥45 represented anxiety. VAS, BDI, and BAI scores were collected at the time of admission and on the day of discharge.Of the 167 patients who participated in the study, 121 (72.5%) had depression and 34 (20.4%) suffered anxiety. Pre-PRT procedure, female sex, age >50 years, ineffective treatment, and high pain intensity (VAS ≥7) predicted the development of depression and anxiety. Post-PRT procedure, all patients who experienced pain relief also reported amelioration of depression and anxiety.A considerable percentage of patients with TN developed depression and anxiety. Patients who were female, older than 50 years, or suffered from failure treatment and severe pain (VAS>7), were at higher risk of depression and anxiety development. Complete alleviation of pain by using surgical PRT could immediately attenuate depressive and anxiety disorders associated with TN.

Proteomic Analysis of the Hippocampus in Mouse Models of Trigeminal Neuralgia and Inescapable Shock-Induced Depression

“…As far as we know, this is the first animal evidence that only 2 weeks of TN can induce behavioral despair. In line with this, some clinical studies have revealed that treatment of TN can immediately attenuate depressive disorders [40], and conversely, when a comorbid patient was treated with the antidepressant duloxetine, the TN was unexpectedly and rapidly relieved [41]. Together, these findings point out that neuralgia and depression might be modulated similarly.…”

Effects of Supraorbital Foramen Variations on the Treatment Efficacy of Radiofrequency Therapy for V1 Trigeminal Neuralgia: A Retrospective Study

“…Active damaging of the nerves for the treatment of some diseases has been highly accepted by the patients. e definition of "effective" for the treatment of trigeminal neuralgia varied in different studies [21][22][23]. For instance, some studies have defined "effective" as pain remission by >50% after treatment [24,25].…”

Trigeminal Neuralgia: Etiology, Diagnosis, and Treatment

“…Mechanical rhizotomy can be achieved through the use of trigeminal ganglion balloon compression [52]. Lastly, the causative sensory nerve fibers can be selectively destroyed by heat formed by percutaneous radiofrequency rhizotomy [53]. These various surgical procedures often provide immediate pain relief [54].…”