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Impact of Multiple Sclerosis Subtypes on Pain Management in Patients With Trigeminal Neuralgia After Stereotactic Radiosurgery: An International Multicenter Analysis.
De Nigris Vasconcellos, Fernando; Mashiach, Elad; Alzate, Juan Diego; Bernstein, Kenneth; Rotman, Lauren; Levy, Sarah; Qu, Tanxia; Wegner, Rodney E; Shepard, Matthew J; Patel, Samir; Warnick, Ronald E; Moreno, Nuria Martínez; Martínez Álvarez, Roberto; Picozzi, Piero; Franzini, Andrea; Peker, Selçuk; Samanci, Yavuz; Elguindy, Ahmed N; Palmer, Joshua D; Lunsford, L Dade; Jose, Shalini G; Wei, Zhishuo; Niranjan, Ajay; Blagui, Sarra; Iorio-Morin, Christian; Mathieu, David; Briggs, Robert G; Yu, Cheng; Zada, Gabriel; Dayawansa, Samantha; Sheehan, Jason; Schulder, Michael; Goenka, Anuj; Begley, Sabrina; Khilji, Hamza; Urgosík, Dusan; Liscák, Roman; Kondziolka, Douglas.
Afiliación
  • De Nigris Vasconcellos F; Department of Neurological Surgery, NYU Langone Health, New York University, New York , New York , USA.
  • Mashiach E; Department of Neurological Surgery, NYU Langone Health, New York University, New York , New York , USA.
  • Alzate JD; Department of Neurological Surgery, NYU Langone Health, New York University, New York , New York , USA.
  • Bernstein K; Department of Radiation Oncology, NYU Langone Health, New York University, New York , New York , USA.
  • Rotman L; Department of Neurological Surgery, NYU Langone Health, New York University, New York , New York , USA.
  • Levy S; Department of Neurology, Mount Sinai Corinne Goldsmith Dickinson Center for MS, Mount Sinai , New York , USA.
  • Qu T; Department of Radiation Oncology, NYU Langone Health, New York University, New York , New York , USA.
  • Wegner RE; Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Allegheny Health Network, Pittsburgh , Pennsylvania , USA.
  • Shepard MJ; Department of Neurosurgery, Allegheny Health Network, Pittsburgh , Pennsylvania , USA.
  • Patel S; Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton , Canada.
  • Warnick RE; Department of Neurosurgery, Gamma Knife Center, Jewish Hospital, Mayfield Clinic, Cincinnati , Ohio , USA.
  • Moreno NM; Radiosurgery Unit, Hospital Ruber Internacional, Madrid , Spain.
  • Martínez Álvarez R; Radiosurgery Unit, Hospital Ruber Internacional, Madrid , Spain.
  • Picozzi P; Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano , Italy.
  • Franzini A; Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano , Italy.
  • Peker S; Department of Neurosurgery, Koc University School of Medicine, Istanbul , Turkey.
  • Samanci Y; Department of Neurosurgery, Koc University School of Medicine, Istanbul , Turkey.
  • Elguindy AN; Department of Radiation Oncology, The James Cancer Hospital at The Ohio State University, Columbus , Ohio , USA.
  • Palmer JD; Department of Radiation Oncology, The James Cancer Hospital at The Ohio State University, Columbus , Ohio , USA.
  • Lunsford LD; Department of Neurological Surgery, UPMC, Pittsburgh , Pennsylvania , USA.
  • Jose SG; Department of Neurological Surgery, UPMC, Pittsburgh , Pennsylvania , USA.
  • Wei Z; Department of Neurological Surgery, UPMC, Pittsburgh , Pennsylvania , USA.
  • Niranjan A; Department of Neurological Surgery, UPMC, Pittsburgh , Pennsylvania , USA.
  • Blagui S; Department of Neurosurgery, Centre de recherche du CHUS, Université de Sherbrooke, Sherbrooke , Canada.
  • Iorio-Morin C; Department of Neurosurgery, Centre de recherche du CHUS, Université de Sherbrooke, Sherbrooke , Canada.
  • Mathieu D; Department of Neurosurgery, Centre de recherche du CHUS, Université de Sherbrooke, Sherbrooke , Canada.
  • Briggs RG; Department of Neurosurgery, University of Southern California, Los Angeles , California , USA.
  • Yu C; Department of Neurosurgery, University of Southern California, Los Angeles , California , USA.
  • Zada G; Department of Neurosurgery, University of Southern California, Los Angeles , California , USA.
  • Dayawansa S; Department of Neurosurgery, UVA, Charlottesville , Virginia , USA.
  • Sheehan J; Department of Neurosurgery, UVA, Charlottesville , Virginia , USA.
  • Schulder M; Department of Neurosurgery, North Shore University Hospital (Northwell), Manhasset , New York , USA.
  • Goenka A; Department of Neurosurgery, North Shore University Hospital (Northwell), Manhasset , New York , USA.
  • Begley S; Department of Neurosurgery, North Shore University Hospital (Northwell Zucker School of Medicine), Hempstead , New York , USA.
  • Khilji H; Department of Neurosurgery, North Shore University Hospital, SUNY Downstate College of Medicine, Brooklyn , New York , USA.
  • Urgosík D; Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague , Czechia.
  • Liscák R; Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague , Czechia.
  • Kondziolka D; Department of Neurological Surgery, NYU Langone Health, New York University, New York , New York , USA.
Neurosurgery ; 94(4): 838-846, 2024 Apr 01.
Article en En | MEDLINE | ID: mdl-38051068
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Trigeminal neuralgia affects approximately 2% of patients with multiple sclerosis (MS) and often shows higher rates of pain recurrence after treatment. Previous studies on the effectiveness of stereotactic radiosurgery (SRS) for trigeminal neuralgia did not consider the different MS subtypes, including remitting relapsing (RRMS), primary progressive (PPMS), and secondary progressive (SPMS). Our objective was to investigate how MS subtypes are related to pain control (PC) rates after SRS.

METHODS:

We conducted a retrospective multicenter analysis of prospectively collected databases. Pain status was assessed using the Barrow National Institute Pain Intensity Scales. Time to recurrence was estimated through the Kaplan-Meier method and compared groups using log-rank tests. Logistic regression was used to calculate the odds ratio (OR).

RESULTS:

Two hundred and fifty-eight patients, 135 (52.4%) RRMS, 30 (11.6%) PPMS, and 93 (36%) SPMS, were included from 14 institutions. In total, 84.6% of patients achieved initial pain relief, with a median time of 1 month; 78.7% had some degree of pain recurrence with a median time of 10.2 months for RRMS, 8 months for PPMS, 8.1 months for SPMS ( P = .424). Achieving Barrow National Institute-I after SRS was a predictor for longer periods without recurrence ( P = .028). Analyzing PC at the last available follow-up and comparing with RRMS, PPMS was less likely to have PC (OR = 0.389; 95% CI 0.153-0.986; P = .047) and SPMS was more likely (OR = 2.0; 95% CI 0.967-4.136; P = .062). A subgroup of 149 patients did not have other procedures apart from SRS. The median times to recurrence in this group were 11.1, 9.8, and 19.6 months for RRMS, PPMS, and SPMS, respectively (log-rank, P = .045).

CONCLUSION:

This study is the first to investigate the relationship between MS subtypes and PC after SRS, and our results provide preliminary evidence that subtypes may influence pain outcomes, with PPMS posing the greatest challenge to pain management.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neuralgia del Trigémino / Radiocirugia / Esclerosis Múltiple Límite: Humans Idioma: En Revista: Neurosurgery Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neuralgia del Trigémino / Radiocirugia / Esclerosis Múltiple Límite: Humans Idioma: En Revista: Neurosurgery Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos