{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:47:06Z","timestamp":1792176426838,"version":"4.4.0"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Trigeminal neuralgia (TN) is characterized by recurrent, unilateral episodes of electric shock-like facial pain, frequently triggered by routine activities, that can significantly impair quality of life. Although interventions such as microvascular decompression, stereotactic radiosurgery, and minimally invasive percutaneous procedures often provide rapid pain relief, recurrence remains a clinical challenge. Psychological comorbidities, particularly depressive disorder, may play a role in predicting outcomes after surgical intervention. This study aimed to determine whether a preexisting diagnosis of depressive disorder was independently associated with earlier recurrence of pain after surgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This single-center retrospective study included patients with TN who underwent surgical intervention between March 30, 2017, and March 30, 2024. Exposure variables consisted of demographic data, comorbidities, preprocedural characteristics of TN, procedure type, and total number of interventions. Primary outcomes were defined as &gt; 50% pain relief at the last follow-up and recurrence of pain during the follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 150 patients with TN who underwent 193 procedures were included in this retrospective analysis. The mean follow-up duration was 11.4 months. Among these cases, 54 patients had a clinical diagnosis or were being treated for depressive disorder. Female sex (74.1%) and comorbid migraine (44.4%) were significantly more prevalent in the depressed cohort. Patients with depressive disorder also underwent balloon compression rhizotomy (52.1%) and radiosurgery (32.4%) at higher rates compared with those without depressive disorder. No other significant differences were observed between the two groups. Postoperatively, recurrence of any level of facial pain was significantly more common in patients with depressive disorder (70.4% vs 51.6%, p = 0.011). In a multivariable mixed-effects Cox regression model, depressive disorder emerged as an independent predictor of earlier pain recurrence during follow-up, alongside type of surgical intervention received.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Depressive disorder is a common psychiatric comorbidity among patients with TN. This study demonstrated that depressive disorder also serves as an independent predictor of earlier pain recurrence after surgical intervention. Recognizing depressive disorder alongside other preexisting conditions may aid clinicians in setting realistic expectations of surgical outcomes and guiding clinical decision-making. Further studies are necessary to validate the observed associations and further clarify the impact of psychological comorbidities on pain outcomes after surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.6.focus25463","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:16:26Z","timestamp":1756728986000},"page":"E11","source":"Crossref","is-referenced-by-count":6,"title":["A double burden: depression and early pain recurrence following surgical management of trigeminal neuralgia"],"prefix":"10.3171","volume":"59","author":[{"given":"Omid","family":"Shoraka","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Botros","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Taussky","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beth Israel Deaconess, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy L.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T.","family":"Couldwell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Rolston","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Brigham, Harvard Medical School, Boston, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shervin","family":"Rahimpour","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"},{"name":"Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"9","key":"b1","series-title":"Lancet Neurol","first-page":"784","article-title":"Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia","volume":"19","author":"Bendtsen L","year":"2020","unstructured":"Bendtsen L, Zakrzewska JM, Heinskou TB,  Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia. Lancet Neurol. 2020;19(9):784\u2013796."},{"issue":"5","key":"b2","series-title":"J Korean Neurosurg Soc","first-page":"615","article-title":"Surgical treatment for trigeminal neuralgia","volume":"65","author":"Park CK","year":"2022","unstructured":"Park CK, Park BJ. Surgical treatment for trigeminal neuralgia. J Korean Neurosurg Soc. 2022;65(5):615\u2013621."},{"issue":"3","key":"b3","series-title":"Pain Pract","first-page":"514","article-title":"Comparison of microvascular decompression, percutaneous radiofrequency rhizotomy, and stereotactic radiosurgery in the treatment of trigeminal neuralgia: a long term quasi-experimental study","volume":"24","author":"Altamirano JM","year":"2024","unstructured":"Altamirano JM, Jimenez-Olvera M, Moreno-Jimenez S,  Comparison of microvascular decompression, percutaneous radiofrequency rhizotomy, and stereotactic radiosurgery in the treatment of trigeminal neuralgia: a long term quasi-experimental study. Pain Pract. 2024;24(3):514\u2013524."},{"issue":"6","key":"b4","series-title":"Cleve Clin J Med","first-page":"355","article-title":"Guidelines for the management of trigeminal neuralgia","volume":"90","author":"Chong MS","year":"2023","unstructured":"Chong MS, Bahra A, Zakrzewska JM. Guidelines for the management of trigeminal neuralgia. Cleve Clin J Med. 2023;90(6):355\u2013362."},{"issue":"5","key":"b5","series-title":"Pract Neurol","first-page":"392","article-title":"Trigeminal neuralgia: a practical guide","volume":"21","author":"Lambru G","year":"2021","unstructured":"Lambru G, Zakrzewska J, Matharu M. Trigeminal neuralgia: a practical guide. Pract Neurol. 2021;21(5):392\u2013402."},{"issue":"7","key":"b6","series-title":"Cephalalgia","first-page":"648","article-title":"Trigeminal neuralgia \u2013 diagnosis and treatment","volume":"37","author":"Maarbjerg S","year":"2017","unstructured":"Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G. Trigeminal neuralgia \u2013 diagnosis and treatment. Cephalalgia. 2017;37(7):648\u2013657."},{"issue":"1","key":"b7","series-title":"J Headache Pain","first-page":"64","article-title":"Risk of psychiatric disorders following trigeminal neuralgia: a nationwide population-based retrospective cohort study","volume":"16","author":"Wu TH","year":"2015","unstructured":"Wu TH, Hu LY, Lu T,  Risk of psychiatric disorders following trigeminal neuralgia: a nationwide population-based retrospective cohort study. J Headache Pain. 2015;16(1):64."},{"issue":"7","key":"b8","series-title":"Medicina (Kaunas)","first-page":"386","article-title":"Associations between chronic pain and depressive symptoms in patients with trigeminal neuralgia","volume":"47","author":"Ma\u010dianskyt\u0117 D","year":"2011","unstructured":"Ma\u010dianskyt\u0117 D, Janu\u017eis G, Kubilius R, Adomaitien\u0117 V, \u0160\u010diupokas A. 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Clinical depression and anxiety are relieved by microvascular decompression in patients with trigeminal neuralgia\u2014a prospective patient-reported outcome study. J Clin Med. 2024;13(8):2329."},{"key":"b14","series-title":"Clin Neurol Neurosurg","first-page":"59","article-title":"Effects of microvascular decompression on depression and anxiety in trigeminal neuralgia: a prospective cohort study focused on risk factors and prognosis","volume":"161","author":"Cheng J","year":"2017","unstructured":"Cheng J, Long J, Hui X, Lei D, Zhang H. Effects of microvascular decompression on depression and anxiety in trigeminal neuralgia: a prospective cohort study focused on risk factors and prognosis. 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