Impact of Multiple Sclerosis Subtypes on Pain Management in Patients With Trigeminal Neuralgia After Stereotactic Radiosurgery: An International Multicenter Analysis

Author:

De Nigris Vasconcellos Fernando1ORCID,Mashiach Elad1,Alzate Juan Diego1,Bernstein Kenneth2,Rotman Lauren1,Levy Sarah3,Qu Tanxia2,Wegner Rodney E.4,Shepard Matthew J.5,Patel Samir6,Warnick Ronald E.7,Moreno Nuria Martínez8,Martínez Álvarez Roberto8,Picozzi Piero9,Franzini Andrea9,Peker Selçuk10,Samanci Yavuz10,Elguindy Ahmed N.11,Palmer Joshua D.11,Lunsford L. Dade12,Jose Shalini G.12,Wei Zhishuo12,Niranjan Ajay12,Blagui Sarra13,Iorio-Morin Christian13,Mathieu David13,Briggs Robert G14,Yu Cheng14,Zada Gabriel14,Dayawansa Samantha15,Sheehan Jason15,Schulder Michael16,Goenka Anuj16,Begley Sabrina17,Khilji Hamza18,Urgošík Dušan19,Liščák Roman19,Kondziolka Douglas1

Affiliation:

1. Department of Neurological Surgery, NYU Langone Health, New York University, New York, New York, USA;

2. Department of Radiation Oncology, NYU Langone Health, New York University, New York, New York, USA;

3. Department of Neurology, Mount Sinai Corinne Goldsmith Dickinson Center for MS, Mount Sinai, New York, USA;

4. Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA;

5. Department of Neurosurgery, Allegheny Health Network, Pittsburgh, Pennsylvania, USA;

6. Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Canada;

7. Department of Neurosurgery, Gamma Knife Center, Jewish Hospital, Mayfield Clinic, Cincinnati, Ohio, USA;

8. Radiosurgery Unit, Hospital Ruber Internacional, Madrid, Spain;

9. Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Italy;

10. Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey;

11. Department of Radiation Oncology, The James Cancer Hospital at The Ohio State University, Columbus, Ohio, USA;

12. Department of Neurological Surgery, UPMC, Pittsburgh, Pennsylvania, USA;

13. Department of Neurosurgery, Centre de recherche du CHUS, Université de Sherbrooke, Sherbrooke, Canada;

14. Department of Neurosurgery, University of Southern California, Los Angeles, California, USA;

15. Department of Neurosurgery, UVA, Charlottesville, Virginia, USA;

16. Department of Neurosurgery, North Shore University Hospital (Northwell), Manhasset, New York, USA;

17. Department of Neurosurgery, North Shore University Hospital (Northwell Zucker School of Medicine), Hempstead, New York, USA;

18. Department of Neurosurgery, North Shore University Hospital, SUNY Downstate College of Medicine, Brooklyn, New York, USA;

19. Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czechia

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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical),Surgery

Reference32 articles.

1. Defining the clinical course of multiple sclerosis: the 2013 revisions;Lublin;Neurology.,2014

2. The natural history of primary progressive MS in British Columbia, Canada;Tremlett;Neurology.,2005

3. Treatment of multiple sclerosis: a review;Hauser;Am J Med.,2020

4. Multiple sclerosis—a review;Dobson;Eur J Neurol.,2019

5. Multiple sclerosis: pathogenesis, symptoms, diagnoses and cell-based therapy;Ghasemi;Cell J.,2017

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3