Submited on: 28 May 2012 08:29:15 AM GMT
Published on: 28 May 2012 12:23:28 PM GMT
 

  • What are the main claims of the paper and how important are they?

    The author claims that ultrasound-guided autologous platelet rich plasma injections can alleviate the symptoms of trigeminal neuralgia.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes.


  • Are the claims properly placed in the context of the previous literature?

    Yes.


  • Do the results support the claims? If not, what other evidence is required?

    Yes.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    This was a single case study.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    A video of the procedure would be helpful.


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    A case series on the topic would be helpful.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes, I would consider giving a lecture on this intersting topic.


  • Other Comments:

    The paper should have an abstract.  It is however an interesting case report and the proposed mechasims are plausible.  This is a hot topic in the orthopedic-sports-musculoskeletal literaure, with quite a few publications and many clinics (at least in the USA) offering it.  There is a recent good review:  Phys Sportsmed. 2011 Sep;39(3):94-9.  Once concern that I have with it's use in trigeminal neurlagia is the relapsing-remitting natural history if the disorder and any co-treatment with membrane stabilizers (that may cloud the efficacy of PRP).  None the less, this field is ripe for more growth and I would be interested to see a case series of TN patients treated with PRP in the futire.

  • Competing interests:
    No.
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    General neurology.

  • How to cite:  Rison R A.Autologous platelet rich plasma for trigeminal neuralgia[Review of the article 'Trigeminal Neuralgia Treatment: A Case Report on Short-Term Follow up After Ultrasound Guided Autologous Platelet Rich Plasma Injections. ' by Doss A].WebmedCentral 2012;3(11):WMCRW002361
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  • What are the main claims of the paper and how important are they?

    The author claims that a patient (his family member) showed relief in trigeminal neuralgia symptoms upon being injected with platelet rich plasma via ultrasound


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    These findings are novel and support additional studies


  • Are the claims properly placed in the context of the previous literature?

    Yes. PRP has been used in instances of neural damage.


  • Do the results support the claims? If not, what other evidence is required?

    Results are at best, reflective of a single case study and needs to be followed up by similar experimental paradigms in affected patients


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Protocol for the injection is sufficent to understand how it was provided for this single patient.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Statistically, this study might be invalid. However, increasing the number of patients will strengthen this study. Further, what are the sources and doses of vitamins and omega 3 in this study?


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    It is probably sufficient to highlight a new method, though as the authors mention, it is not be adopted as a standard method of curing the patient.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes, it is an interesting report. I wonder where the benefit is coming from. Is it from the PRP consisting of IGF-1 and VEGF and perhaps other unknown factors? Is it coming from the natural supplements (omega 3 and vitamins)? Perhaps a mouse model to study TN will be a an interesting aspect in terms of a follow up.


  • Other Comments:

    The article is quite though provoking.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I have published in neuropathogenesis and peripheral neuropathy

  • How to cite:  Antony J M.A New Treatment Method for Trigeminal Neuralgia-Are We There Yet?[Review of the article 'Trigeminal Neuralgia Treatment: A Case Report on Short-Term Follow up After Ultrasound Guided Autologous Platelet Rich Plasma Injections. ' by Doss A].WebmedCentral 2012;3(6):WMCRW002006
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  • What are the main claims of the paper and how important are they?

    NA


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    NA


  • Are the claims properly placed in the context of the previous literature?

    NA


  • Do the results support the claims? If not, what other evidence is required?

    NA


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    NA


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    NA


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    NA


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    NA


  • Other Comments:

    This is a well written and interesting case report that provides some indication that Autologous Platelet Rich Plasma injections could have some beneficial effects in a patient with trigeminal neuralgia. The author presents some ideas as to how this may occur, and sheds some thoughts on potential mechanistic insights. It would strengthen the article if there were some more discussion as to the potential mechanisms through which PNP may promote nerve regeneration and/or remyelination. There is only one reference that addresses this (ref 16). Perhaps that's all there is?

     

    The author is careful to not over-interpret the result, and points out this is a case report. It is especially impressive that the patient reports substantial improvement 6 months after treatment, suggesting a beneficial long-term effect. Further investigations with similar results may spur true randomized, blinded clinical studies to evaluate and possibly vaidate this approach to Trigeminal Neuralgia

     

    The link in reference one is either broken, or no longer valid.

     

    An image of the technique used would be of interest.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Ossipov MH, Dussor GO, Porreca F. Central modulation of pain. The Journal of clinical investigation 2010;120(11):3779-3787.

  • Experience and credentials in the specific area of science:

    Basic research on underlying mechanisms of neuropathic pain for 20 years.

  • How to cite:  Ossipov M .A Call for Further Investigation of PRP for Trigeminal Neuralgia[Review of the article 'Trigeminal Neuralgia Treatment: A Case Report on Short-Term Follow up After Ultrasound Guided Autologous Platelet Rich Plasma Injections. ' by Doss A].WebmedCentral 2012;3(6):WMCRW002005
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Long-term follow up
Posted by on 25 Jun 2012 02:14:56 PM GMT

  • What are the main claims of the paper and how important are they?

    The authors described the first case of PRP treatment for TN.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes, they seem novel.


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    It will be better to have a long-term follow up of the patient for at least 6 months, since TN can recur. It makes it a bit dubious to correctly state the effect PRP had in this patient, since her improvement can be confounded by the combination of other treatment options she was receiving. Case series can also help clarify issues better.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    In part, yes.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    In part, yes.


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Better to compare results to other options like botox [can be discussed].


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes, it would make it helpful to be presented as novel ways of treating TN, and help reproduce results in a larger series then proceed to randomized controlled trials.


  • Other Comments:

    No other comments

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I treat patients with TN as a neurologist.

  • How to cite:  .Long-term follow up [Review of the article 'Trigeminal Neuralgia Treatment: A Case Report on Short-Term Follow up After Ultrasound Guided Autologous Platelet Rich Plasma Injections. ' by Doss A].WebmedCentral 2012;3(6):WMCRW001976
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Placebo Effect of PRP in TN
Posted by Anonymous Reviewer on 18 Jun 2012 11:02:29 PM GMT

  • What are the main claims of the paper and how important are they?

    The authors present a case of sucessfull pain relief in TN after PRP. Although there are no published studies of PRP in TN, I consider that PRP had a placebo effect in this patient. 


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    In part


  • Are the claims properly placed in the context of the previous literature?

    In part


  • Do the results support the claims? If not, what other evidence is required?

    No


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    NA


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    No


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Because of a high probability of a placeboo effect, case series or small randomized studies would be appropriate.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No


  • Other Comments:

    NA

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Von Campenhausen S, Winter Y, Rodrigues e Silva A, Sampaio C, Ruzicka E, Barone P, Poewe W, Guekht A, Mateus C, Pfeiffer KP, Berger K, Skoupa J, Bötzel K, Geiger-Gritsch S, Siebert U, Balzer-Geldsetzer M, Oertel WH, Dodel R, Reese JP. Costs of illness and care in Parkinson's disease: an evaluation in six countries. Eur Neuropsychopharmacol. 2011 Feb;21(2):180-91.

  • Experience and credentials in the specific area of science:
    None
  • How to cite:  Anonymous.Placebo Effect of PRP in TN[Review of the article 'Trigeminal Neuralgia Treatment: A Case Report on Short-Term Follow up After Ultrasound Guided Autologous Platelet Rich Plasma Injections. ' by Doss A].WebmedCentral 2012;3(6):WMCRW001943
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Creditable endeavor
Posted by Prof. Prasunpriya Nayak on 02 Jun 2012 07:01:41 AM GMT

  • What are the main claims of the paper and how important are they?

    A new approach of treating TN and provide good scope of study. 


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes. 


  • Are the claims properly placed in the context of the previous literature?

    Yes.


  • Do the results support the claims? If not, what other evidence is required?

    Yes. Images of pre and post procedures could have been used as evidence. 


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Not applicable


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Not applicable


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Not applicable


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Needs more data to be outstanding. 


  • Other Comments:

    Author is aware about the shortcomings of the article and provided good justification for so. 

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Working in the field of neurodegenerative disorders.

  • How to cite:  Nayak P .Creditable endeavor[Review of the article 'Trigeminal Neuralgia Treatment: A Case Report on Short-Term Follow up After Ultrasound Guided Autologous Platelet Rich Plasma Injections. ' by Doss A].WebmedCentral 2012;3(6):WMCRW001846
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