Bauer Marlies, Krigers Aleksandrs, Schoen Victoria, Thomé Claudius, Freyschlag Christian F
Department of Neurosurgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
J Clin Med. 2024 Apr 17;13(8):2329. doi: 10.3390/jcm13082329.
Patients with idiopathic trigeminal neuralgia (TN) live in constant fear of triggering shock-like pain episodes, which may cause symptoms of depression and a reduction in quality of life. Microvascular decompressive surgery has been demonstrated to achieve satisfactory and stable results. With this study, we wanted to investigate prevalence and risk factors for depression and perceived stress in correlation with symptom relief after surgical treatment. In this prospective study, patients undergoing microvascular decompression (MVD) for TN were included. The Barrow Neurological Institute Pain Score (BNI), Beck Depression Inventory (BDI), Chronic Pain Acceptance Questionnaire (CPAQ), Perceived Stress Questionnaire (PSQ) and McGill questionnaire were used to evaluate depression, stress and anxiety disorders before and 3 months after MVD. A total of 35 patients (16 male (46%)) with a mean age of 55.4 (SD 15) years were included in this study. The BDI revealed that 24 (68.8%) patients harbored mild-to-extreme depression preoperatively (2.4 ± 1.4), which improved to 1.2 (±0.6, < 0.0001). Pain acceptance also changed from 64 (±11.3) to 67.7 (±9.3, = 0.006). Perceived stress decreased from 46.9 (±21.9) to 19.6 (±18.6) ( < 0.0001) postoperatively, and pain decreased from 31.0 (±11.7) to 9.4 (±12.9, < 0.0001). Microvascular decompression reduced the mean BNI pain score significantly from 4.6 to 1.8 postoperatively ( < 0.00001). Depression and perceived stress are prevalent in patients with idiopathic TN. Adequate treatment not only provides a high rate of satisfaction through pain relief, but also leads to immediate and significant improvements in depression and stress. Thus, in patients with TN who do not reach an adequate and timely pain reduction through medical management and develop signs of depression, early treatment with microvascular decompression should be considered.
特发性三叉神经痛（TN）患者一直生活在对引发电击样疼痛发作的恐惧之中，这可能导致抑郁症状并降低生活质量。微血管减压手术已被证明能取得满意且稳定的效果。通过这项研究，我们想调查与手术治疗后症状缓解相关的抑郁和感知压力的患病率及危险因素。在这项前瞻性研究中，纳入了接受微血管减压术（MVD）治疗TN的患者。使用巴罗神经学研究所疼痛评分（BNI）、贝克抑郁量表（BDI）、慢性疼痛接受问卷（CPAQ）、感知压力问卷（PSQ）和麦吉尔问卷来评估MVD术前及术后3个月的抑郁、压力和焦虑障碍情况。本研究共纳入35例患者（16例男性（46%）），平均年龄55.4（标准差15）岁。BDI显示，24例（68.8%）患者术前存在轻度至重度抑郁（2.4±1.4），术后改善至1.2（±0.6，<0.0001）。疼痛接受度也从64（±11.3）变为67.7（±9.3，=0.006）。术后感知压力从46.9（±21.9）降至19.6（±18.6）（<0.0001），疼痛从31.0（±11.7）降至9.4（±12.9，<0.0001）。微血管减压术后平均BNI疼痛评分从4.6显著降至1.8（<0.00001）。抑郁和感知压力在特发性TN患者中很普遍。充分的治疗不仅通过缓解疼痛提供高满意度，还能立即显著改善抑郁和压力。因此，对于经药物治疗未能及时充分减轻疼痛并出现抑郁迹象的TN患者，应考虑早期进行微血管减压治疗。
