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The role of biomarkers in drug-resistant trigeminal neuralgia: a prospective study in patients submitted to surgical treatment

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Abstract

Background

Molecular mechanisms underlying trigeminal neuralgia (TN) have been poorly understood. Recently, different biomarkers have been studied in several chronic neuropathic diseases or in neuronal damage, but their role in TN has not yet been investigated. Here, we firstly analyzed the serum levels of the neuron-specific enolase (NSE) (as an index of neuronal tissue damage) in TN patients submitted to surgical treatment. Different cytokines and interleukins related to inflammation were also studied.

Methods

Blood samples from 40 patients were prospectively collected preoperatively and after the surgical procedure, namely microvascular decompression (MVD) and percutaneous balloon compression (PBC). Serum levels of uric acid, NSE, ferritin, CRP, IL-2R, and IL-6 were studied. The acute pain relief (APR) and the pre- and postoperative BNI were used to evaluate the clinical outcome.

Results

Overall, we obtained an APR in 87.5% of patients and a significant reduction of BNI after surgery (p < 0.0001). We observed a significant reduction of postoperative NSE values in the group of patients undergoing MVD (p = 0.0055) and a significant increase of postoperative NSE values in patients undergoing PBC (p < 0.05). Furthermore, in the group of patients undergoing MVD, we found a significant postoperative increase of CRP (p < 0.0001), ferritin (p = 0.001), and IL-6 (p = 0.01) values. The only patient who did not respond to MVD had NSE levels unchanged.

Conclusion

Our results suggest the hypothesis that TN would be related to the neural damage instead of the systemic inflammatory status and indicate NSE as a possible biomarker of response in patients submitted to MVD.

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Authors and Affiliations

  1. Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Alessandro Rapisarda, Benedetta Burattini, Alessandro Olivi & Nicola Montano

  2. Department of Neuroscience, Neurosurgery Section, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Alessandro Rapisarda, Benedetta Burattini, Alessandro Olivi & Nicola Montano

  3. Department of Diagnostic and Laboratory Medicine, Unity of Chemistry, Biochemistry and Clinical Molecular Biology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Silvia Baroni, Giacomo Moretti & Andrea Urbani

  4. Department of Basic Biotechnological Sciences, Intensive Care and Perioperative Clinics Research, Catholic University of the Sacred Heart, Università Cattolica del Sacro Cuore, Rome, Italy

    Silvia Baroni, Vanessa Gentili, Francesca Sarlo & Andrea Urbani

Authors
  1. Alessandro Rapisarda
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  2. Silvia Baroni
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  3. Vanessa Gentili
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  4. Giacomo Moretti
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  5. Benedetta Burattini
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  7. Alessandro Olivi
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  8. Andrea Urbani
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  9. Nicola Montano
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Corresponding author

Correspondence to Nicola Montano.

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Ethical approval

The present study was approved by Fondazione IRCCS Policlinico A. Gemelli’s ethical committee and was conducted in accordance with the ethical standards reported in the 1964 Declaration of Helsinki.

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Informed consent to the study has been provided to all participants and authorization for anonymous publication of personal data was obtained.

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Rapisarda, A., Baroni, S., Gentili, V. et al. The role of biomarkers in drug-resistant trigeminal neuralgia: a prospective study in patients submitted to surgical treatment. Neurol Sci 43, 4425–4430 (2022). https://doi.org/10.1007/s10072-022-05971-7

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  • DOI: https://doi.org/10.1007/s10072-022-05971-7

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