Cheng Jian, Long Jiang, Hui Xuhui, Lei Ding, Zhang Heng
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China.
Clin Neurol Neurosurg. 2017 Oct;161:59-64. doi: 10.1016/j.clineuro.2017.08.011. Epub 2017 Aug 24.
Patients with trigeminal neuralgia (TN) often develop a terrible fear of triggering pain, which may lead to depression and anxiety, exerting a negative effect on their quality of life. This study aimed to investigate the prevalence and risk factors of depression and anxiety in TN patients, and further to investigate the effects of microvascular decompression (MVD) on these psychiatric disorders.
A prospective cohort study was conducted, patients with TN who underwent MVD in our department between 2013 and 2015 were included. Visual analogue scale (VAS) score was used to measure the severity of pain. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to evaluate depression and anxiety disorders before and 6-month after MVD. The clinical data of these patients were collected prospectively and statistically analyzed.
A total of 128 study subjects comprising 70 women and 58 men with a mean age of 47.5±11.2years were included in this study. The mean VAS score was 7.7±1.5. Eighty-three patients (64.8%) had depression and 24 patients (18.8%) suffered anxiety. Multivariate logistic regression analysis revealed that female gender (OR=2.4, P=0.036), high pain intensity (OR=3.25, P=0.027) and ineffective medicine treatment (OR=1.89, P=0.041) were associated with depression, and female gender (OR=3.45, P=0.034) and high pain intensity (OR=2.88, P=0.022) were also associated with anxiety. There were significant improvements in depression and anxiety symptoms between pre- and postoperative responses.
Depression and anxiety are prevalent in patients with idiopathic TN. Female gender, high pain intensity and ineffective medicine treatment are risk factors. MVD not only provides high pain-relief rate, but also leads to significant improvements in the depression and anxiety symptoms.
三叉神经痛（TN）患者常对触发疼痛产生极度恐惧，这可能导致抑郁和焦虑，对其生活质量产生负面影响。本研究旨在调查TN患者抑郁和焦虑的患病率及危险因素，并进一步研究微血管减压术（MVD）对这些精神障碍的影响。
进行了一项前瞻性队列研究，纳入2013年至2015年在我科接受MVD的TN患者。采用视觉模拟量表（VAS）评分来衡量疼痛的严重程度。使用贝克抑郁量表（BDI）和贝克焦虑量表（BAI）在MVD术前及术后6个月评估抑郁和焦虑障碍。前瞻性收集这些患者的临床资料并进行统计分析。
本研究共纳入128例研究对象，其中女性70例，男性58例，平均年龄47.5±11.2岁。平均VAS评分为7.7±1.5。83例患者（64.8%）有抑郁，24例患者（18.8%）有焦虑。多因素逻辑回归分析显示，女性（OR=2.4，P=0.036）、高疼痛强度（OR=3.25，P=0.027）和药物治疗无效（OR=1.89，P=0.041）与抑郁相关，女性（OR=3.45，P=0.034）和高疼痛强度（OR=2.88，P=0.022）也与焦虑相关。术前和术后反应之间，抑郁和焦虑症状有显著改善。
特发性TN患者中抑郁和焦虑很常见。女性、高疼痛强度和药物治疗无效是危险因素。MVD不仅提供高止痛率，还能显著改善抑郁和焦虑症状。
