CSF biomarkers of inflammation in trigeminal neuralgia patients operated with microvascular decompression

Hans Ericson, Sami Abu Hamdeh, Eva Freyhult, Fredrik Stiger, Emmanuel Bäckryd, Anders Svenningsson, Torsten Gordh, Kim Kultima
Pain 2019 August 1
Compression of the trigeminal root entry zone by a blood vessel can cause trigeminal neuralgia (TN). However, a neurovascular conflict does not explain all cases of TN and TN can exist without a neurovascular contact. A common observation during microvascular decompression (MVD) surgery to treat TN is arachnoiditis in the region of the trigeminal nerve. Thus, aberrant inflammatory mechanisms may be involved in the pathophysiology of TN but information about the role of inflammation in TN is scarce. We used Proximity Extension Assay technology (PEA) to analyse the levels of 92 protein biomarkers related to inflammation in lumbar CSF from patients with TN (n=27) before and after MVD compared to individuals without TN. We aimed to analyse the pattern of inflammation-related proteins in order to improve our understanding of the pathophysiology of TN. The main finding was that immunological protein levels in the CSF from patients with TN decreased after surgery towards levels observed in healthy controls. Two proteins appeared to be of specific interest for TN; TRAIL and TNF-β. Thus, inflammatory activity might be one important mechanism in TN.

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