The use of cellular therapies for trigeminal neuralgia: a systematic review of behavioral and molecular outcomes.

Trigeminal neuralgia (TN) is a neuropathic pain disorder characterized by severe orofacial pain. The underlying pathophysiological nuances remain under study, and their understanding is key to developing new and more effective therapies for this debilitating disease. The field of cellular therapies for neurological diseases is continuously evolving. This systematic review was performed after the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We sought studies on the preclinical and clinical uses of cellular therapies for trigeminal neuralgia. We included 8 studies encompassing 1 clinical and 7 preclinical applications. Of the preclinical studies, four used Stem Cells from Human Exfoliated Deciduous Teeth (SHED), two used Olfactory Ensheathing Cells (OECs), and one used Bone Marrow Mesenchymal Stem Cells (BMSCs). All preclinical studies showed a statistically significant behavioral improvement in groups receiving cellular therapies compared to controls (p < 0.05), with either local or systemic delivery. In addition, cellular therapies have the potential to mitigate TN by promoting myelin repair, reducing neuroinflammation, and modulating pain-related pathways. The only clinical report in the literature described the incidental use of Adipose-Derived Stem Cells (ADSCs) during a facial cosmetic procedure in a 60-year-old female with a long history of TN, who remained pain-free at 2-year follow-up. These findings highlight the promising role of cellular therapies in the treatment of TN, demonstrating significant behavioral and molecular benefits in preclinical models and a compelling clinical case. Further rigorous clinical studies are necessary to establish their safety, efficacy, and long-term therapeutic impact.