ArticleFrontiers in neurology2025
Trigeminal somatosensory evoked potentials for intraoperative monitoring and prognostic prediction in microvascular decompression for trigeminal neuralgia: a prospective cohort study.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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10 authors.
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Abstract
Objective: This study aims to explore the monitoring techniques of trigeminal somatosensory evoked potentials (TSEP) and investigate their clinical significance in microvascular decompression (MVD) for primary trigeminal neuralgia (PTN). By analyzing the relationship between changes in TSEP waveforms during surgery and postoperative outcomes of MVD, a prognostic prediction model based on electrophysiological and clinical features will be constructed to provide a basis for individualized assessment of surgical risks and efficacy. Methods: This study included 74 patients diagnosed with PTN and used statistical methods to analyze and optimize the waveform characteristics of TSEP. The amplitude change rate of TSEP before and after MVD surgery was calculated, and combined with postoperative pain scores, Spearman correlation analysis and ROC curves were used to determine the optimal cut-off value for predicting prognosis. Finally, univariate and multivariate Cox regression analyses were conducted to identify independent risk factors affecting poor prognosis of MVD surgery in PTN patients, a nomogram model was established, and the model's performance was validated through Kaplan-Meier survival analysis and ROC curves. Results: (1) In this study, there was no statistically significant difference in the amplitudes of V1w1 and V1w2 between the healthy and affected sides in TSEP ( Conclusion: The TSEP technique used in this study is simple to operate (only requiring puncture around the muscle groups near the puncture point), provides stable waveform results, and is convenient for intraoperative interpretation (only needing to observe changes in waveform amplitude). In addition, intraoperative monitoring of TNW2 amplitude change rate (≥60% indicates good prognosis) can provide real-time guidance during decompression and predict efficacy. The combination of hypertension, PTN duration ≥2.5 years, and TNW2 amplitude change rate <60% are independent risk factors for poor prognosis after MVD; patients with PTN who have hypertension, longer PTN duration, or TNW2 amplitude change rate <60% during microvascular decompression experience slower postoperative pain relief. The nomogram model based on TSEP waveforms, hypertension, and PTN duration has high accuracy and can individually assess recurrence risk, providing a tool for clinically identifying high-risk patients.
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