Seventy-three years (1951–2024) looking for trigeminal neuralgia therapy and peripheral nerve stimulation as a niche theme

Data collection

We used the following terms to do a search on the Scopus website, taking into consideration that this website contains research that is considered to be valid: TITLE – ABS – KEY (“trigeminal neuralgia”) AND TITLE – ABS – KEY (current) AND TITLE – ABS – KEY (therapy) are the titles of the products that are under consideration. One hundred and eighty nine documents were received by us. We then save the document from Scopus in the form of a file with the extension.csv file following this step.

Data analysis

Both the Biblioshiny and Vosviewer software packages were utilised in the analysis process.

Quantitative analysis

Documents by year

Based on Figure 1, it appears that there has been an increase in the number of documents, until in 2021 there were 15 documents. The oldest document in 1951 was entitled Selective low frequency currents in 1951 0 therapy of trigeminus neuralgia.|Die Behandlung der Trigeminusneuralgie mit selektiven niederirequenten Stromformen., written by Henssge, E., Meanwhile, the latest document in 2024 is entitled Trigeminal Postherpetic Neuralgia: From Pathophysiology to Treatment, written by Niemeyer, C.S., Harlander-Locke, M., Bubak, A.N., Rzasa-Lynn, R. Birlea, M., selanjutnya artikel berjudul SUNCT, SUNA and short-lasting unilateral neuralgiform headache attacks: Debates and an update, written by Kang, M.-K., Cho, S.-J., artikel selanjutnya berjudul Trigeminal Neuralgia as a Primary Demyelinating Disease: Potential Multimodal Evidence and Remaining Controversies, ditulis oleh Mousavi, S.H., Lindsey, J.W., Westlund, K.N., and Alles, S.R.A., and the next article is entitled An extract of phase II and III trials on recent developments in managing neuropathic pain syndromes: diabetic peripheral neuropathy, trigeminal neuralgia, and postherpetic neuralgia, yang ditulis oleh Upshaw, W.C., et al.

Figure 1. Documents by year.

Most global cited document

Based on Figure 2. The document that received the most citations, with 269 citations, was the document written by Antal A., in 2010 with the title Anodal Transcranial Direct Current Stimulation of the Motor Cortex Ameliorates Chronic Pain and Reduces Short Intracortical Inhibition. Which was published in Journal of Pain and Symptom Management. In the next position, with 194 citations, is the journal written by Skirving D.J., and Dan N.G., in 2001 was published in Journal of Neurosurgery entitled A 20-year review of percutaneous balloon compression of the trigeminal ganglion. In third place with 156 citations are written documents by Levy R., Deer T.R., and Henderson J., in 2010 was published in the Journal Pain Physician entitled Intracranial neurostimulation for pain control: A review.

Figure 2. Most global cited documents.

Most relevant sources

Based on Figure 3. Here are the journals that publish the most important documents. Journal of Neurosurgery is a journal that has been indexed by Scopus since 1945. This journal is published by the American Association of Neurological Surgeons. Although the exact location of the center is not mentioned in the search results, the American Association of Neurological Surgeons is based in the United States. The SJR (SCImago Journal Rank) value for 2022 is 1,138. The impact factor for Journal of Neurosurgery in 2022 is 4.1. The journal accepts a wide range of articles, including clinical and laboratory studies, technical notes about instruments or equipment that are innovative or useful to clinicians and researchers in the field of neuroscience, as well as reviews, papers about historical figures or events related to neurosurgery, and letters to the editor.

Figure 3. Most relevant sources.

Next is the journal Current Pain and Headache Reports, a journal that has been indexed by Scopus since 2001. This journal is published by Current Science, Inc. Although the exact location of the center is not mentioned in the search results, Current Science, Inc. based in the United States. The SJR (SCImago Journal Rank) value for 2022 is 0.796. The impact factor for “Current Pain and Headache Reports” in 2022 is 3.86. The journal accepts a wide range of articles, including in-depth reviews contributed by international experts on the most important developments in the field.

The journal that published the next most important document was the Pain Physician journal. This journal was indexed by Scopus starting in 1999. This journal is published by the Association of Pain Management Anesthesiologists. The center of this journal is located at 81 Lakeview Drive, Paducah, KY, United States. Pain Physician's SJR (SCImago Journal Rank) value in 2022 is 0.824. The Impact Factor of this journal is 4.396. This journal accepts various types of writing, including but not limited to: Systematic Review, Meta-Analysis, Randomized Controlled Trial, Retrospective Analysis, Observational Study, and Prospective Study.

Factorial map of the documents with the highest contributes

In Figure 4, Based on factorial analysis, the most contributing document is a document entitled Gamma Knife Radiosurgery on the Trigeminal Root Entry Zone for Idiopathic Trigeminal Neuralgia with Authors: So Hee Park, Jin Woo Chang Published in Yonsei Medical Journal February 2020.

Figure 4. Factorial map of the documents with the highest contributes.

The summary of the article is that Trigeminal Neuralgia (TN) is a chronic disorder of the trigeminal nerve which is characterized by a sensation like repeated electric shocks on one side of the face. It can cause severe pain in the face and disrupt or impair the patient's quality of life. Options for managing TN consist of pharmacological treatment and surgical treatment, including Gamma Knife Radiosurgery (GKRS). GKRS has been used for TN for a long time because of its low complication rate and high success rate.

Documents by author

Based on Figure 5. the most authors with 4 documents are Obermann, M., with the title of the article: Update on the challenges of treating trigeminal neuralgia., Botolinum toxin for headache|Botulinumtoxin bei Kopfschmerzen., Treatment options in trigeminal neuralgia., and Update on trigeminal neuralgia.

Figure 5. Documents by author.

The next most author with 4 documents is Slavin, K.V., with the title of the article: Gasserian Ganglion Stimulation for Facial Pain., Motor Cortex Stimulation for Deafferentation Pain., Peripheral Nerve Stimulation for Facial Pain, and Microsurgical Pontine Descending Tractotomy in Cases of Intractable Trigeminal Neuralgia.

The next most author with 3 documents is Benoliel, R., with the title of the article: Persistent idiopathic facial pain., Painful traumatic trigeminal neuropathy: An open study on the pharmacotherapeutic response to stepped treatment., and Management of neuropathic orofacial pain.

Documents by country or territory

Based on Figure 6. United States is the country with the largest number of document producers 69 documents. Followed by China with 18 documents, Germany with 17 documents, and United Kingdom with 14 documents.

Figure 6. Documents by country or territory.

Documents by affiliation

Based on Figure 7. For Affiliates that produced the most documents, Harvard Medical School produced 6 documents. Followed by Universität Duisburg-Essen which produced 4 documents. Furthermore, Sapienza Università di Roma with 3 documents and the University of Pittsburgh School of Medicine produced 3 documents.

Figure 7. Documents by affiliation.

Documents by subject area

Based on Figure 8, most of the documents were produced in the medicine field, 64.7 percent, and 11.1 percent in the neuroscience field. It appears that more research is being conducted in an effort to find ways to improve the management of trigeminal neuralgia.

Figure 8. Documents by subject area.

Network visualization

Based on Figure 9, it can be seen that the areas studied are still not related to other areas that are divided into edges. That field is: decompression surgery, postoperative complication, nerve surgery, pathogenesis, microsurgery, short survey, surgery, conservative treatment, electrocoagulation, english abstract, rash, tocainide, tizanidine, constipation, gastrointestinal symptom, nerve decompression, confusion, fatigue, diabetic, neuropathy, drug safety, analgesic, backache, epilepsy, allodyna, nociception, pain threshold, hyperalgesia, metabolism, and physiology.

Figure 9. Network visualization.

Overlay visualization of scopus, database using vosviewer

Based on Figure 10. In the overlay visualization, it appears that the keywords that are being researched a lot approaching 2014 are the parts colored yellow, namely: stereotactic radiosurgery, follow up, microvascula decompression, steroid, rash, oxcarbazepine, pregabalin, multiple sclerosis, humans, quality of life, pathology, analgesia, prospective study, pain management, botulinum toxin, cluster headache, controlled study, depression, clinical effectiveness, animals, nonhuman, animal model, hyperalgesia, allodynia, meta analysis, neuropathic pain, cluster headache, and duloxetine.

Figure 10. Overlay visualization of scopus, database using vosviewer.

Density visualization

Based on Figure 11. In the visual circulation density, it appears that the part that is already saturated with research is yellow, while the part that is not yet saturated is slightly yellow and dominantly green, namely keywords.: diagnosis, differential, short survey, postoperative complication, microsurgery, stereoactic radiosurgery, decompression surgery, nerve surgery, pathogenesis, retrospective study, retrospective studies, surgery, electrocoagulation, middle age, peripheral nervous system, english abstract, major clinical study, trigeminal ganglion, conservative treatment, surgical technique, radiofrequency, differential diagnosis, phenytoin, primozide, clonazepam, nerve decompression, rash, ataxia, tocainide, tizanidine, add on therapy, constipation, muscle relaxant agent, gastrointestinal symptom, drowsiness, nausea, confusion, fatigue, side effect, muscle relaxant agent, diabetic neuropathy, drug safety, analgesic, barkache, physiology, acupuntute, physiotherapy, cluster headache, multiple sclerosis, facial pain, steroid, botulinum toxin, electrotherapy, depression, therapy effect, electric stimulation therapy, controlled study, pain measurement, clinical effectiveness, nociception, epilepsy, nonhuman, animal, animals, metabolism, animal experiment, animal model, pain threshold, hyperalgesiam, epilepsy and allodynia.

Figure 11. Density visualization.

Thematic map

Based on Figure 12, In the thematic map description obtained in the motor theme area, three keywords are ganglion, de, and radiofrequency. This shows that themes related to therapy using radio frequency for trigeminal neuralgia are starting to become saturated with various research, and researchers are starting to move towards niche areas with new themes. In the motor theme, the keywords stimulation, nerve, and peripheral are also found, which shows that researchers are continuing to research this area on emerging research themes. Meanwhile, in the niche area, the keywords del, application, and common appear, which show that there has been quite a big change in the management of trigeminal neuralgia in research themes that include good times. Apart from that, in the niche theme, the keyword option, carbamazepine, also appears. This shows that in the niche theme, researchers are still using carbamazepine as an option for therapy. Carbamazepine is an old therapy for trigeminal neuralgia, but it appears that researchers are interested in examining this classic therapy more deeply.

Figure 12. Thematic map.

Thematic evolution

Based on Figure 13, There was an evolution of changes in themes in research in 1951–2012 with the keywords clinical, ganglion, trigeminal, headache, pain, therapy, and radiosurgery. The theme then changed in 2013–2024 to clinical, brain, trigeminal, review, pain, stimulation, report, and study.

Figure 13. Thematic evolution.

It appears that there has been a change in therapy from nerve stimulation to no longer using radiofrequency or surgery.

Cluster analysis

Table 1 (Extended data). The result of cluster analysis

From Table 1 above, there are 5 clusters based on keywords.

Cluster 1, dominated by Carbamazepine, Review and Gabapentine

Cluster 2, dominated by Article, Male and Adult

Cluster 3, dominated by Humans, Pain and Chronic pain

Cluster 4, dominated Human, Trigeminus neuralgia, and Trigeminal neuralgia

Cluster 5, dominated Priority journal, Neuropathic pain and Neuralgia

Qualitative analysis

Table 2 (Extended data). Diseases with the use of trigeminal neuralgia therapy in the clinic: