TY - JOUR
T1 - Trigeminal neuralgia and its comorbidities
T2 - A nationwide disease trajectory study
AU - Worm, Jacob
AU - Jørgensen, Isabella Friis
AU - Davídsson, Ólafur Birgir
AU - Hjalgrim, Henrik
AU - Röder, Timo
AU - Ostrowski, Sisse Rye
AU - Pedersen, Ole Birger
AU - Erikstrup, Christian
AU - Bruun, Mie Topholm
AU - Jensen, Bitten Aagaard
AU - Sørensen, Erik
AU - Ullum, Henrik
AU - Björnsdóttir, Gyða
AU - Thorgeirsson, Thorgeir
AU - Stefánsson, Hreinn
AU - Sveinsson, Ólafur Árni
AU - Stefansson, Kari
AU - Schytz, Henrik Winther
AU - Bendtsen, Lars
AU - Brunak, Søren
AU - Hansen, Thomas Folkmann
AU - Maarbjerg, Stine
AU - Banasik, Karina
AU - Bay, Jacob
AU - Boldsen, Jens Kjærgaard
AU - Brodersen, Thorsten
AU - Brunak, Søren
AU - Burgdorf, Kristoffer
AU - Chalmer, Mona Ameri
AU - Didriksen, Maria
AU - Dinh, Khoa Manh
AU - Dowsett, Joseph
AU - Erikstrup, Christian
AU - Fenstraa, Bjarke
AU - Geller, Frank
AU - Gudbjartsson, Daniel
AU - Hansen, Thomas Folkmann
AU - Hindhede, Lotte
AU - Hjalgrim, Henrik
AU - Jacobsen, Rikke Louise
AU - Jemec, Gregor
AU - Jensen, Bitten Aagaard
AU - Kaspersen, Katrine
AU - Kjerulff, Bertram Dalskov
AU - Kogelman, Lisette
AU - Larsen, Margit Anita Hørup
AU - Louloudis, Ioannis
AU - Lundgard, Agnete
AU - Mikkelsen, Susan
AU - Mikkelsen, Christina
AU - Nissen, Ioanna
AU - Nyegaard, Mette
AU - Ostrowski, Sisse Rye
AU - Pedersen, Ole Birger
AU - Henriksen, Alexander Pil
AU - Rohde, Palle Duun
AU - Rostgaard, Klaus
AU - Schwinn, Michael
AU - Stefansson, Kari
AU - Stefánsson, Hreinn
AU - Sørensen, Erik
AU - Porsteinsdóttir, Unnur
AU - Thørner, Lise Wegner
AU - Brun, Mie Topholm
AU - Ullum, Henrik
AU - Werge, Thomas
AU - Westergaard, David
N1 - Publisher Copyright:
© 2024 International Association for the Study of Pain.
PY - 2025/4
Y1 - 2025/4
N2 - There is a limited understanding of risk factors and comorbidities in trigeminal neuralgia, a disease characterized by paroxysms of severe unilateral facial pain and a higher incidence in women. We aim to identify temporally associated comorbidities involving trigeminal neuralgia by analyzing nationwide disease trajectories. Using data from 7.2 million unique individuals in the Danish National Patient Register between 1994 and 2018, each individual diagnosed with trigeminal neuralgia was compared with 10,000 matched controls to identify co-occurring diseases. The sequential disease associations were identified in sex-stratified disease trajectories. A Cox-regression analysis investigated whether treatment with carbamazepine or oxcarbazepine, as compared with gabapentin, pregabalin, or lamotrigine, was associated with stroke risk. Finally, we investigated the stroke polygenic risk score and its association with stroke incidence in a subset of genotyped individuals with trigeminal neuralgia. We included 7141 individuals with trigeminal neuralgia (64.2% female, mean age at diagnosis 58.7 years) and identified 18 diseases associated with subsequent trigeminal neuralgia. After diagnosis, trigeminal neuralgia was associated with 9 diseases, including ischemic stroke (relative risk 1.55). Carbamazepine or oxcarbazepine treatment increased the ischemic stroke risk (hazard ratio 1.78; 95% confidence interval 1.47-2.17); however, the polygenic risk of stroke showed no association. In the Danish population, a trigeminal neuralgia diagnosis is temporally associated with 27 diseases revealed in systematic disease trajectories. Trigeminal neuralgia itself and its first-line treatment, but not a stroke polygenic risk score, was associated with an increased risk of ischemic stroke indicating that vascular risk factors should be routinely assessed in individuals with trigeminal neuralgia.
AB - There is a limited understanding of risk factors and comorbidities in trigeminal neuralgia, a disease characterized by paroxysms of severe unilateral facial pain and a higher incidence in women. We aim to identify temporally associated comorbidities involving trigeminal neuralgia by analyzing nationwide disease trajectories. Using data from 7.2 million unique individuals in the Danish National Patient Register between 1994 and 2018, each individual diagnosed with trigeminal neuralgia was compared with 10,000 matched controls to identify co-occurring diseases. The sequential disease associations were identified in sex-stratified disease trajectories. A Cox-regression analysis investigated whether treatment with carbamazepine or oxcarbazepine, as compared with gabapentin, pregabalin, or lamotrigine, was associated with stroke risk. Finally, we investigated the stroke polygenic risk score and its association with stroke incidence in a subset of genotyped individuals with trigeminal neuralgia. We included 7141 individuals with trigeminal neuralgia (64.2% female, mean age at diagnosis 58.7 years) and identified 18 diseases associated with subsequent trigeminal neuralgia. After diagnosis, trigeminal neuralgia was associated with 9 diseases, including ischemic stroke (relative risk 1.55). Carbamazepine or oxcarbazepine treatment increased the ischemic stroke risk (hazard ratio 1.78; 95% confidence interval 1.47-2.17); however, the polygenic risk of stroke showed no association. In the Danish population, a trigeminal neuralgia diagnosis is temporally associated with 27 diseases revealed in systematic disease trajectories. Trigeminal neuralgia itself and its first-line treatment, but not a stroke polygenic risk score, was associated with an increased risk of ischemic stroke indicating that vascular risk factors should be routinely assessed in individuals with trigeminal neuralgia.
KW - Antiseizure medication
KW - Cardiovascular disease
KW - Cohort study
KW - Comorbidity
KW - Epidemiology
KW - Facial pain
KW - Ischemic stroke
KW - Neuropathic pain
KW - Risk factor
UR - http://www.scopus.com/inward/record.url?scp=85206841828&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000003428
DO - 10.1097/j.pain.0000000000003428
M3 - Journal article
C2 - 39365662
AN - SCOPUS:85206841828
SN - 0304-3959
VL - 166
SP - 879
EP - 887
JO - Pain
JF - Pain
IS - 4
ER -