AI Article Synopsis
- The study explores the use of an anterior selective target (AST) for radiosurgical treatment of trigeminal neuralgia, contrasting it with conventional targets like the Retrogasserian Zone (RGZ) and the Root Entry Zone (REZ).
- It analyzed the outcomes of 66 patients over various time frames for pain relief, medication dependence, and side effects, finding similar effectiveness across all groups but shorter treatment times and lower brainstem doses for the AST group.
- The results suggest that AST is a viable alternative to classical methods for select patients, warranting further investigation in larger studies.
Article Abstract
Objective: Before commonly used targets such as the Retrogasserian Zone (RGZ) and the Root Entry Zone (REZ) were adopted for the radiosurgical treatment of trigeminal neuralgia (TN), a more anterior target involving the Gasserian ganglion was used. Thanks to advancements in imaging technology, it is now possible to identify and target separate nerve divisions in Meckel's Cave as desired. Although this approach has been mentioned previously, no clinical study has investigated it until now. This study aims to fill this gap in the literature.
Methods: Trigeminal neuralgia patients who received radiosurgical treatment between February 2019 and June 2022 in a single centre were included in the study. Pain relief, medication dependency and side effect profiles of the investigated anterior selective target (AST) were compared to those of the classical targets at 1 week, 1-3-6 months, and 1 year.
Results: A total of 66 patients were included in the study. Effectiveness, safety and application convenience parameters were compared between; the REZ (n = 21), RGZ (n = 20) and AST (n = 25) groups. All groups showed significant improvement in pain with similar results to each other. AST treatments were performed in significantly shorter beam-on-times and with significantly lower brainstem doses.
Conclusions: The investigated AST showed comparable results to the classical targets without any indication of superiority or inferiority in terms of efficacy and safety in this preliminary investigation. As no blocks were needed to protect the brainstem with this method, it can be used for select patients as needed and could even be investigated in larger studies as an alternative approach.
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| http://dx.doi.org/10.1007/s00701-024-06365-8 | DOI Listing |
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