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Article ; Online: Author's Reply to the Letter of Van Boxem, Van Gaag, Van Zundert, and Kallewaard, Entitled 'Response to Ter Meulen et al. Effect of Transforaminal Epidural Corticosteroid Injections in Acute Sciatica'.

Ter Meulen, Bastiaan C / van Dongen, Johanna M / Maas, Esther / van de Vegt, Marinus H / Haumann, Johan / Weinstein, Henry C / Ostelo, Raymond

The Clinical journal of pain

2024 Volume 40, Issue 3, Page(s) 197–198

MeSH term(s)	Humans ; Sciatica/drug therapy ; Adrenal Cortex Hormones/therapeutic use ; Injections, Epidural
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2024-03-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	632582-8
ISSN	1536-5409 ; 0749-8047
ISSN (online)	1536-5409
ISSN	0749-8047
DOI	10.1097/AJP.0000000000001185
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Article ; Online: Effect of Transforaminal Epidural Corticosteroid Injections in Acute Sciatica: A Randomized Controlled Trial.

Ter Meulen, Bastiaan C / van Dongen, Johanna M / Maas, Esther / van de Vegt, Marinus H / Haumann, Johan / Weinstein, Henry C / Ostelo, Raymond

The Clinical journal of pain

2023 Volume 39, Issue 12, Page(s) 654–662

Abstract: Objective: Transforaminal epidural steroid injections (TESIs) are widely administered for sciatica. The aim of this trial was to evaluate the effectiveness of TESIs in patients with acute sciatica (<8 wk).: Methods: This study was conducted in 2 ... ...

Abstract	Objective: Transforaminal epidural steroid injections (TESIs) are widely administered for sciatica. The aim of this trial was to evaluate the effectiveness of TESIs in patients with acute sciatica (<8 wk). Methods: This study was conducted in 2 Dutch hospitals. Participants (n=141) were randomly assigned to (1) usual care and TESI of 1 ml of 40 mg/ml Methylprednisolone plus 1 ml of 0.5% Levobupivacaine (intervention 1); (2) usual care and transforaminal epidural injection with 1 ml of 0.5% Levobupivacaine and 1 ml NaCl 0.9% (intervention 2); (3) usual care consisting of oral pain medication with or without physiotherapy (control). Co-primary outcomes were back pain and leg pain intensity, physical functioning, and recovery measured during 6-month follow-up. Results: There were no statistically significant mean differences in co-primary outcomes between groups during follow-up, except for leg pain when comparing intervention group 1 with control (-0.96 95%CI:-1.83 to -0.09). For secondary outcomes, some statistical significant between-group differences were found for treatment satisfaction and surgery, but only when comparing intervention group 2 to control. Post hoc analyses showed a statistically significant difference in response [50% improvement of leg pain (yes/no)] between intervention 1 and the control group at 3 months and that both intervention groups used less opioids. Discussion: Except for a statistically significant effect of TESI on leg pain for patients with acute sciatica compared with usual care, there were no differences in co-primary outcomes. Nonetheless, transforaminal epidural injections seem to be associated with less opioid use, which warrants further exploration.
MeSH term(s)	Humans ; Sciatica/drug therapy ; Levobupivacaine/therapeutic use ; Adrenal Cortex Hormones/therapeutic use ; Pain/drug therapy ; Injections, Epidural ; Treatment Outcome
Chemical Substances	Levobupivacaine (A5H73K9U3W) ; Adrenal Cortex Hormones
Language	English
Publishing date	2023-12-01
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	632582-8
ISSN	1536-5409 ; 0749-8047
ISSN (online)	1536-5409
ISSN	0749-8047
DOI	10.1097/AJP.0000000000001155
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Article ; Online: Cost-effectiveness of Transforaminal epidural steroid injections for patients with ACUTE sciatica: a randomized controlled trial.

Ter Meulen, Bastiaan C / Maas, Esther T / van der Vegt, Rien / Haumann, Johan / Weinstein, Henry C / Ostelo, Raymond W J G / van Dongen, Johanna M

BMC musculoskeletal disorders

2024 Volume 25, Issue 1, Page(s) 247

Abstract: Background: Transforaminal epidural injections with steroids (TESI) are increasingly being used in patients sciatica. The STAR (steroids against radiculopathy)-trial aimed to evaluate the (cost-) effectiveness of TESI in patients with acute sciatica (< ... ...

Abstract	Background: Transforaminal epidural injections with steroids (TESI) are increasingly being used in patients sciatica. The STAR (steroids against radiculopathy)-trial aimed to evaluate the (cost-) effectiveness of TESI in patients with acute sciatica (< 8 weeks). This article contains the economic evaluation of the STAR-trial. Methods: Participants were randomized to one of three study arms: Usual Care (UC), that is oral pain medication with or without physiotherapy, n = 45); intervention group 1: UC and transforaminal epidural steroid injection (TESI) 1 ml of 0.5% Levobupivacaine and 1 ml of 40 mg/ml Methylprednisolone and intervention group 2: UC and transforaminal epidural injection (TEI) with 1 ml of 0,5% Levobupivacaine and 1 ml of 0.9% NaCl (n = 50). The primary effect measure was health-related quality of life. Secondary outcomes were pain, functioning, and recovery. Costs were measured from a societal perspective, meaning that all costs were included, irrespective of who paid or benefited. Missing data were imputed using multiple imputation, and bootstrapping was used to estimate statistical uncertainty. Results: None of the between-group differences in effects were statistically significant for any of the outcomes (QALY, back pain, leg pain, functioning, and global perceived effect) at the 26-weeks follow-up. The adjusted mean difference in total societal costs was €1718 (95% confidence interval [CI]: - 3020 to 6052) for comparison 1 (intervention group 1 versus usual care), €1640 (95%CI: - 3354 to 6106) for comparison 2 (intervention group 1 versus intervention group 2), and €770 (95%CI: - 3758 to 5702) for comparison 3 (intervention group 2 versus usual care). Except for the intervention costs, none of the aggregate and disaggregate cost differences were statistically significant. The maximum probability of all interventions being cost-effective compared to the control was low (< 0.7) for all effect measures. Conclusion: These results suggest that adding TESI (or TEI) to usual care is not cost-effective compared to usual care in patients with acute sciatica (< 8 weeks) from a societal perspective in a Dutch healthcare setting. Trial registration: Dutch National trial register: NTR4457 (March, 6th, 2014).
MeSH term(s)	Humans ; Sciatica/drug therapy ; Sciatica/complications ; Cost-Benefit Analysis ; Levobupivacaine/therapeutic use ; Intervertebral Disc Displacement/complications ; Quality of Life ; Back Pain/complications ; Steroids ; Injections, Epidural
Chemical Substances	Levobupivacaine (A5H73K9U3W) ; Steroids
Language	English
Publishing date	2024-04-01
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2041355-5
ISSN	1471-2474 ; 1471-2474
ISSN (online)	1471-2474
ISSN	1471-2474
DOI	10.1186/s12891-024-07366-5
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: On Perception and Consciousness in HPPD: A Systematic Review.

Vis, Pieter J / Goudriaan, Anneke E / Ter Meulen, Bastiaan C / Blom, Jan Dirk

Frontiers in neuroscience

2021 Volume 15, Page(s) 675768

Abstract: Hallucinogen-persisting perception disorder (HPPD) features as a diagnostic category in the DSM-5, ICD-11, and other major classifications, but our knowledge of the phenomenology of the perceptual symptoms involved and the changes in consciousness during ...

Abstract	Hallucinogen-persisting perception disorder (HPPD) features as a diagnostic category in the DSM-5, ICD-11, and other major classifications, but our knowledge of the phenomenology of the perceptual symptoms involved and the changes in consciousness during the characteristic "flashbacks" is limited. We systematically evaluated original case reports and case series on HPPD to define its phenomenology, associated (psycho)pathology, and course. Our search of PubMed and Embase yielded 66 relevant publications that described 97 people who, together, experienced 64 unique symptoms of HPPD. Of these, 76% concerned symptoms characteristic of Alice in Wonderland syndrome, over 50% non-visual symptoms, and 38% perceptual symptoms not clearly linked to prior intoxication states. This is in contrast with the DSM-5 diagnostic criteria for HPPD. Even though less than half of the patients showed a protracted disease course of over a year, a third achieved remission. However, in patients with co-occurring depression (with or without anxiety) HPPD symptoms persisted longer and treatment outcomes were more often negative. Thus, unlike the acute stages of psychedelic drug intoxication, which may be accompanied by altered states of consciousness, HPPD is rather characterized by changes in the
Language	English
Publishing date	2021-08-11
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2411902-7
ISSN	1662-453X ; 1662-4548
ISSN (online)	1662-453X
ISSN	1662-4548
DOI	10.3389/fnins.2021.675768
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Article ; Online: A century of prosopometamorphopsia studies.

Blom, Jan Dirk / Ter Meulen, Bastiaan C / Dool, Jitze / Ffytche, Dominic H

Cortex; a journal devoted to the study of the nervous system and behavior

2021 Volume 139, Page(s) 298–308

Abstract: Prosopometamorphopsia is an extremely rare disorder of visual perception characterised by facial distortions. We here review 81 cases (eight new ones and 73 cases published over the past century) to shed light on the perception of face gestalts. Our ... ...

Abstract	Prosopometamorphopsia is an extremely rare disorder of visual perception characterised by facial distortions. We here review 81 cases (eight new ones and 73 cases published over the past century) to shed light on the perception of face gestalts. Our analysis indicates that the brain systems underlying the perception of face gestalts have genuine network properties, in the sense that they are widely disseminated and built such that spatially normal perception of faces can be maintained even when large parts of the network are compromised. We found that bilateral facial distortions were primarily associated with right-sided and bilateral occipital lesions, and unilateral facial distortions with lesions ipsilateral to the distorted hemifield and with the splenium of the corpus callosum. We also found tentative evidence for the involvement of the left frontal regions in the fusing of vertical hemi-images of faces, and of right parietal regions in the fusing of horizontal hemi-images. Evidence supporting the remarkable adaptability of the network comes from the relatively high recovery rates that we found, from the ipsilateral hemifield predominance of hemi-prosopometamorphopsia, and from a phenomenon called cerebral asthenopia (heightened visual fatigability) which points to the dynamic nature of compensatory mechanisms maintaining normal face perception, even in chronic cases of prosopometamorphopsia. Finally, our analysis suggests that specialised networks for the representation of face gestalts in familiar-versus-unfamiliar faces and for own-versus-other face may be present, although this is in need of further study.
Language	English
Publishing date	2021-03-12
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	280622-8
ISSN	1973-8102 ; 0010-9452
ISSN (online)	1973-8102
ISSN	0010-9452
DOI	10.1016/j.cortex.2021.03.001
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Zs.A 687: Show issues

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Article ; Online: Oliver Sacks and migraine.

Haan, Joost / Kaptein, Ad A / Ter Meulen, Bastiaan C

Cephalalgia : an international journal of headache

2017 Volume 37, Issue 10, Page(s) 990–997

Abstract: Background Oliver Sacks (1933-2015) published a large number of books on a variety of neurological topics. Of these, numerous copies have been sold and they probably serve as the only or main source of information on neurological diseases for many ... ...

Abstract	Background Oliver Sacks (1933-2015) published a large number of books on a variety of neurological topics. Of these, numerous copies have been sold and they probably serve as the only or main source of information on neurological diseases for many persons without a medical background. His first book was on migraine and in his subsequent books many descriptions of migraine can be found, mainly those of auras. Methods We explored the descriptions of migraine in Sacks' work in order to evaluate the image of migraine offered to the readers. Conclusion Oliver Sacks gave wonderful descriptions of migraine auras, but hardly any of migraine headache. Furthermore, he described rare auras such as 'amusia' and olfactory auras. Overall, this makes his descriptions of migraine not very useful to serve as medical information for laypersons. Oliver Sacks, however, wrote great literature.
Language	English
Publishing date	2017-09
Publishing country	England
Document type	Journal Article
ZDB-ID	604567-4
ISSN	1468-2982 ; 0333-1024
ISSN (online)	1468-2982
ISSN	0333-1024
DOI	10.1177/0333102416663460
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Article ; Online: STeroids Against Radiculopathy (STAR) trial: a statistical analysis plan.

Ter Meulen, Bastiaan C / van Dongen, Johanna M / van der Vegt, Marinus / Weinstein, Henry C / Ostelo, Raymond W J G

Trials

2021 Volume 22, Issue 1, Page(s) 80

Abstract: Background: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However, their safety, effectiveness, and cost-effectiveness are still a matter of debate. This a priori statistical analysis plan ... ...

Abstract	Background: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However, their safety, effectiveness, and cost-effectiveness are still a matter of debate. This a priori statistical analysis plan describes the methodology of the analysis for the STAR trial that assesses the (cost-)effectiveness of TESI during the acute stage of sciatica (< 8 weeks). Methods: The STAR trial is a multicentre, randomized controlled, prospective trial (RCT) investigating the (cost-)effectiveness of TESI by making a three-group comparison among patients with acute sciatica due to a herniated lumbar disc (< 8 weeks): (1) TESI combined with levobupivacaine added to oral pain medication (intervention group 1) versus oral pain medication alone (control group), (2) intervention group 1 versus transforaminal epidural injection with levobupivacaine and saline solution added to oral pain medication (intervention group 2), and (3) intervention group 2 versus control group. Co-primary outcomes were physical functioning (Roland Morris Disability Questionnaire), pain intensity (10-point numerical rating scale), and global perceived recovery (7-point Likert scale, dichotomized into 'recovered' and 'not recovered'). For all three comparisons, we defined the following minimal clinically relevant between-group differences: two points for pain intensity (range 0-10), four points for physical functioning (range 0-24) and a 20% difference in recovery rate. Secondary outcomes are health-related quality of life (EQ-5D-5L) and patient satisfaction (7-point Likert scale) and surgery rate. We also collected resource use data to perform an economic evaluation. Analyses will be conducted by intention-to-treat with p < 0.05 (two-tailed) for all three comparisons. Effects will be estimated using mixed models by maximum likelihood. For each comparison, mean differences, or difference in proportions, between groups will be tested per time point and an overall mean difference, or difference in proportions, between groups during the complete duration of follow-up (6 months) will be estimated. In the economic evaluation, Multivariate Imputation by Chained Equations will be used to handle missing data. Cost and effect differences will be estimated using seemingly unrelated regression, and uncertainty will be estimated using bootstrapping techniques. Discussion: This statistical analysis plan provides detailed information on the intended analysis of the STAR trial, which aims to deliver evidence about the (cost-)effectiveness of TESI during the acute phase of sciatica (< 8 weeks). Trial registration: Dutch National trial register NTR4457 (6 March 2014).
MeSH term(s)	Humans ; Injections, Epidural/adverse effects ; Intervertebral Disc Displacement/drug therapy ; Lumbar Vertebrae ; Prospective Studies ; Quality of Life ; Radiculopathy/diagnosis ; Radiculopathy/drug therapy ; Steroids/adverse effects ; Treatment Outcome
Chemical Substances	Steroids
Language	English
Publishing date	2021-01-22
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1468-6708
ISSN (online)	1745-6215 ; 1468-6694
ISSN	1468-6708
DOI	10.1186/s13063-020-05018-2
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Alice in Wonderland Syndrome as a Presenting Manifestation of Creutzfeldt-Jakob Disease.

Naarden, Tirza / Ter Meulen, Bastiaan C / van der Weele, Sarah I / Blom, Jan Dirk

Frontiers in neurology

2019 Volume 10, Page(s) 473

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2019-05-09
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2019.00473
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Article ; Online: Author's Reply to the Letter of Manchikanti and Hirsch, Entitled 'Evolution of the Epidural Treatment of Sciatica Provides Excellent Historic Review with Incomplete Modern Evidence'.

Ter Meulen, Bastiaan C / Weinstein, Henry / Ostelo, Raymond / Koehler, Peter J

European neurology

2016 Volume 75, Issue 5-6, Page(s) 227–228

Language	English
Publishing date	2016
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	209426-5
ISSN	1421-9913 ; 0014-3022
ISSN (online)	1421-9913
ISSN	0014-3022
DOI	10.1159/000445886
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Zs.A 575: Show issues

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Article ; Online: The Epidural Treatment of Sciatica: Its Origin and Evolution.

Ter Meulen, Bastiaan C / Weinstein, Henry / Ostelo, Raymond / Koehler, Peter J

European neurology

2016 Volume 75, Issue 1-2, Page(s) 58–64

Abstract: Epidural injection with corticosteroids is a common treatment option for patients with lower back pain or sciatica. In this paper we review its origin and evolution. The first injections were given around 1900 in Paris by Jean Sicard (1872-1929) and ... ...

Abstract	Epidural injection with corticosteroids is a common treatment option for patients with lower back pain or sciatica. In this paper we review its origin and evolution. The first injections were given around 1900 in Paris by Jean Sicard (1872-1929) and Fernand Cathelin (1873-1945), who worked independently. They both injected small volumes of cocaine into the sacral hiatus. After a slow start, the epidural treatment of back pain and sciatica gradually spread to other parts of Europe and Northern America. In the early 1950s, corticosteroids were introduced for epidural use. Since the 1970s, there have been numerous clinical trials that show a significant, although small, effect of epidural corticosteroid injections compared with placebo for leg pain in the short term. Despite an ongoing debate about effectiveness and safety, epidural injections remain popular.
MeSH term(s)	Adrenal Cortex Hormones/administration & dosage ; Anti-Inflammatory Agents/administration & dosage ; History, 19th Century ; History, 20th Century ; History, 21st Century ; Humans ; Injections, Epidural/history ; Low Back Pain/drug therapy ; Sciatica/drug therapy
Chemical Substances	Adrenal Cortex Hormones ; Anti-Inflammatory Agents
Language	English
Publishing date	2016
Publishing country	Switzerland
Document type	Historical Article ; Journal Article ; Review
ZDB-ID	209426-5
ISSN	1421-9913 ; 0014-3022
ISSN (online)	1421-9913
ISSN	0014-3022
DOI	10.1159/000443729
Database	MEDical Literature Analysis and Retrieval System OnLINE

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