ORIGINAL RESEARCH article
Front. Neurol.
Sec. Headache and Neurogenic Pain
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1614981
This article is part of the Research TopicInnovative Approaches to Neuralgia: Mechanisms and Treatment DevelopmentView all 19 articles
Differential Impact of Biologically Effective Dose in Distal Versus Proximal Gamma Knife Targets for Trigeminal Neuralgia
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
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We report the results of a long-term follow-up series in our center to verify the impact of biologically effective dose (BED) on the efficacy and safety of Gamma Knife radiosurgery (GKS) in the treatment of primary trigeminal neuralgia (TN). A total of 138 consecutive cases of primary TN receiving GKS were included. A 4-mm collimator was used for all cases, and a median central dose of 85 Gy (range 70-90 Gy) was prescribed. The Barrow Neurological Institute Pain Scale was adopted to evaluate the severity of TN. The median follow-up period was 65.5 months (range 12-147 months). Overall, 123 (89.1%) patients eventually achieved effective relief. The influence of BED on treatment outcomes varied by target location. For patients with distal targets, BED was a significant predictor of treatment failure (OR: 0.996, 95% CI: 0.992-0.999, p=0.02) and post-GKS complications (OR: 1.002, 95% CI: 1.000-1.004, p=0.01). However, BED did not significantly influence outcomes in the proximal target subgroup, either for treatment failure or complications. No significant association was found between BED and long-term outcomes in the entire cohort or in any subgroup analysis. Adjusting GKS doses according to BED for the distal target may optimize clinical outcomes in TN patients.
Keywords: Biologically effective dose, gamma knife radiosurgery, Primary trigeminal neuralgia, pain relief, Recurrence
Received: 20 Apr 2025; Accepted: 30 Jul 2025.
Copyright: © 2025 Deng, Gao, Wu, Wang, Xiao, Chen, Zhang, Pan and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wei Wang, West China Hospital, Sichuan University, Chengdu, China
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