Percutaneous Balloon Compression Exerts Multidimensional Efficacy in Trigeminal Neuralgia via Neuroinflammation and Neurotransmitter Regulation.

Abstract

This real-world study evaluated the multidimensional efficacy of percutaneous balloon compression (PBC) in trigeminal neuralgia (TN), focusing on pain relief, psychological comorbidities, quality of life, and neuroinflammation modulation. A retrospective analysis included 140 TN patients (68 PBC vs. 72 pharmacotherapy controls), with 57 propensity score-matched pairs. Outcomes comprised visual analog scale (VAS), Hamilton Depression/Anxiety Scales, Short Form-36 Health Survey quality of life scores, and serum biomarkers (5-hydroxytryptamine, Substance P, interleukin 1β, and tumor necrosis factor-alpha). Difference-in-differences (DID) models quantified net treatment effects; generalized estimating equations identified predictors of efficacy. PBC demonstrated superior outcomes versus controls (all P < 0.05): greater VAS reduction (net DID: -0.97; 95% confidence interval: -1.41 to -0.53), Hamilton Depression Scale/Hamilton Anxiety Scale improvements, and Short Form-36 Health Survey gains (DID: +2.03). Biomarker analysis revealed significant declines in PBC-treated patients for 5-hydroxytryptamine, Substance P, interleukin 1β, and tumor necrosis factor-alpha (DID interactions P < 0.01). Total efficacy was higher with PBC (98.08% vs. 84.62%) with lower complications. Generalized estimating equation confirmed PBC intervention (β = 3.21, P = 0.002), pain reduction (βVAS_diff = -1.21, P = 0.003), and cytokine modulation as independent predictors of efficacy. Beyond analgesia, PBC attenuates affective disorders and normalizes neuroinflammatory signaling in TN. Its modulation of the pain-neuroimmune axis supports integrated neuropsychiatric management strategies.