Effects of microvascular decompression on depression and anxiety in trigeminal neuralgia: A prospective cohort study focused on risk factors and prognosis

Objective: Patients with trigeminal neuralgia (TN) often develop a terrible fear of triggering pain, which may lead to depression and anxiety, exerting a negative effect on their quality of life. This study aimed to investigate the prevalence and risk factors of depression and anxiety in TN patients, and further to investigate the effects of microvascular decompression (MVD) on these psychiatric disorders. Patients and methods: A prospective cohort study was conducted, patients with TN who underwent MVD in our department between 2013 and 2015 were included. Visual analogue scale (VAS) score was used to measure the severity of pain: Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to evaluate depression and anxiety disorders before and 6-month after MVD. The clinical data of these patients were collected prospectively and statistically analyzed. Results: A total of 128 study subjects comprising 70 women and 58 men with a mean age of 47.5 +/- 11.2 years were included in this study. The mean VAS score was 7.7 +/- 1.5. Eighty-three patients (64.8%) had depression and 24 patients (18.8%) suffered anxiety. Multivariate logistic regression analysis revealed that female gender (OR = 2.4, P = 0.036), high pain intensity (OR = 3.25, P = 0.027) and ineffective medicine treatment (OR = 1.89, P = 0.041) were associated with depression, and female gender (OR = 3.45, P = 0.034) and high pain intensity (OR = 2.88, P = 0.022) were also associated with anxiety. There were significant improvements in depression and anxiety symptoms between pre- and postoperative responses. Conclusions: Depression and anxiety are prevalent in patients with idiopathic TN. Female gender, high pain intensity and ineffective medicine treatment are risk factors. MVD not only provides high pain-relief rate, but also leads to significant improvements in the depression and anxiety symptoms.