Evidence map›Paper›PMID 39489857›Full record

SynthesisNeurosurgical review2024

Pre-treatment DTI markers: predicting clinical outcomes in microvascular decompression for classic trigeminal neuralgia - a systematic review.

Giuseppe Pio Cipollina, Roberta Costanzo, Benedetta Maria Campisi, Gianluca Scalia, Lara Brunasso, Lapo Bonosi, Domenico Gerardo Iacopino, Rosario Maugeri

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Giuseppe Pio CipollinaDepartment of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, "Paolo Giaccone", Palermo, Italy.
Roberta CostanzoDepartment of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, "Paolo Giaccone", Palermo, Italy. roberta.costanzo@unipa.it.
Benedetta Maria CampisiDepartment of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, "Paolo Giaccone", Palermo, Italy.
Gianluca ScaliaDepartment of Head and Neck Surgery, Neurosurgery Unit, Garibaldi Hospital, Piazza Santa Maria di Gesù, 5, Catania, 95123, Italy.
Lara BrunassoDepartment of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, "Paolo Giaccone", Palermo, Italy.
Lapo BonosiDepartment of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, "Paolo Giaccone", Palermo, Italy.
Domenico Gerardo IacopinoDepartment of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, "Paolo Giaccone", Palermo, Italy.
Rosario MaugeriDepartment of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, "Paolo Giaccone", Palermo, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeTrigeminal neuralgia (TN) is a severe chronic pain condition, typically affecting patients over 50-year-old, caused by the compression of the nerve at the root entry zone (REZ) by blood vessels. While the diagnosis is clinical, advanced imaging like diffusion tensor imaging (DTI) is crucial to identify underlying causes and assessing nerve damage. DTI may help develop neuroimaging markers to improve understanding of TN and predict surgical outcomes. The goal of the present systematic review is to evaluate the effectiveness of DTI and tractography in order to better assess treatment planning and outcome prediction through the analysis of trigeminal nerve alterations.

methodsThe authors conducted a systematic review and meta-analysis of the literature to compare radiological parameters identified in pre- and post-operative MRI with DTI sequences, including fractional anisotropy (FA), quantity of anisotropy (QA), radial diffusivity (RD), and to correlate these findings with post-operative clinical outcomes. A comprehensive search of the PubMed and Scopus databases was carried out for studies published between April 2010 and January 2024.

resultsThis review included 11 studies and 603 patients. Of the 363 patients with trigeminal neuralgia (TN), 193 underwent microvascular decompression (MVD), with 72.5% showing clinical improvement and 27.5% not improving, possibly due to chronic nerve damage. Four studies assessed radiological parameters before and after MVD, while two focused only on post-MVD data. The mean fractional anisotropy (FA) in affected nerves increased from 0.328 before MVD to 0.382 afterward. Five studies did not report postoperative outcomes, just comparing radiological parameters in TN patients versus healthy controls.

conclusionsRecent studies show that MRI-DTI parameters, including FA, RD, and QA, are useful for diagnosing trigeminal neuralgia and predicting treatment outcomes. Lower FA and higher RD values indicate better results after surgery. More research is mandatory to guide treatment decisions and enhance patients' care.

Indexed as

Diffusion Tensor ImagingMicrovascular Decompression SurgeryTrigeminal NeuralgiaAnisotropyHumansTreatment Outcome

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.