{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:08:36Z","timestamp":1777489716992,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the Shandong Provincial Medical and Health Science and Technology Development Plan Project","award":["(202109010812)"],"award-info":[{"award-number":["(202109010812)"]}]},{"name":"the Shandong Provincial Natural Science Foundation","award":["(ZR2021QH060)"],"award-info":[{"award-number":["(ZR2021QH060)"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Trigeminal zoster-associated neuralgia (TZAN) is a refractory intractable craniofacial neuropathic pain with a high risk of progressing to postherpetic neuralgia. Abnormal T2-weighted magnetic resonance imaging (MRI) hyperintensity in the spinal trigeminal nucleus (STN) has been reported in TZAN patients, but its diagnostic value, influencing factors and association with prognosis remain insufficiently explored. This study aimed to investigate the correlation between STN lesions and TZAN and identify factors affecting STN signal characteristics and TZAN therapeutic efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 105 TZAN patients, 105 non-TZAN normal controls (NC) and 287 classical trigeminal neuralgia (CTN) patients who underwent cranial MRI at Shandong Provincial Hospital Affiliated to Shandong First Medical University between September 2018 and March 2024. Propensity score matching (1:1, caliper = 0.1) was used to balance baseline differences between the TZAN and CTN groups. STN lesions were evaluated in a blinded manner by two radiologists, and clinical data (pain Numeric Rating Scale scores, pregabalin dosage) were collected via medical records and 6-month telephone follow-up. Multivariate logistic regression analyzed factors associated with STN hyperintensity and TZAN efficacy (pain relief \u2265\u200980% defined as \u201cexcellent response\u201d).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      STN lesion detection rate was significantly higher in TZAN than in NC (62.9% vs. 1.0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and matched CTN (68.9% vs. 0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with 62.9% sensitivity, 99.0% specificity and 81.0% accuracy for TZAN diagnosis. Age (odds ratio (OR)\u2009=\u20091.06, 95% confidence interval (CI)\u2009=\u20091.006\u20131.116,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.030) and subacute phase (vs. acute: OR\u2009=\u200932.01; vs. chronic: OR\u2009=\u200946.40, both\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) independently predicted STN hyperintensity. STN-normal patients had better short-term efficacy (discharge Numeric Rating Scale\u2009=\u20092 (1, 3) vs. 3 (2, 4),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.042; excellent response rate: 38.5% vs. 19.7%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.036) but no long-term difference (3 and 6\u2005months post-discharge,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Chronic phase predicted poor prognosis (vs. acute: OR\u2009=\u20096.55,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.005; vs. subacute: OR\u2009=\u20095.39,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>STN lesions are highly specific for TZAN and may serve as an auxiliary diagnostic indicator. STN hyperintensity is most prominent in elderly TZAN patients in the subacute phase, potentially acting as a subacute-phase imaging marker. Early intervention in subacute TZAN may be critical for improving prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024261435927","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:37:51Z","timestamp":1776040671000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Spinal trigeminal nucleus lesions in trigeminal zoster-associated neuralgia: A retrospective cohort study on diagnostic value and prognostic factors"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9679-5666","authenticated-orcid":false,"given":"Lina","family":"Wang","sequence":"first","affiliation":[{"name":"Shandong Provincial Hospital Affiliated to Shandong First Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8252-3742","authenticated-orcid":false,"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Shandong Provincial Hospital Affiliated to Shandong First Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingrui","family":"Li","sequence":"additional","affiliation":[{"name":"Shandong Provincial Hospital Affiliated to Shandong First Medical University"},{"name":"Shandong Provincial Third Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Dong","sequence":"additional","affiliation":[{"name":"Shandong Provincial Hospital Affiliated to Shandong First Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-nan","family":"Wang","sequence":"additional","affiliation":[{"name":"Shandong Provincial Hospital Affiliated to Shandong First Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0880-6394","authenticated-orcid":false,"given":"Tao","family":"Sun","sequence":"additional","affiliation":[{"name":"Shandong Provincial Hospital Affiliated to Shandong First Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-023-01209-z"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms252011306"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0118-2024"},{"key":"e_1_3_2_6_2","first-page":"161","article-title":"Trigeminal herpes zoster presenting with high-intensity signals for the spinal trigeminal nucleus and tract on diffusion-weighted image: a case report of stroke mimic","volume":"70","author":"Himeno T","year":"2018","unstructured":"Himeno T, Takeshima S, Kubo S, et al. Trigeminal herpes zoster presenting with high-intensity signals for the spinal trigeminal nucleus and tract on diffusion-weighted image: a case report of stroke mimic. Brain Nerve 2018; 70: 161\u2013164. Japanese..","journal-title":"Brain Nerve"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.21037\/qims.2016.01.07"},{"key":"e_1_3_2_8_2","first-page":"1","article-title":"The International Classification of Headache Disorders. 3rd ed","volume":"38","author":"Headache Classification Committee of the International Headache Society (IHS)","year":"2018","unstructured":"Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders. 3rd ed. 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Analysis of the risk factors and a prediction model for postherpetic trigeminal neuralgia recurrence after extracranial nonsemilunar ganglion radiofrequency thermocoagulation. Pain Physician 2023; 26: E719\u2013E724.","journal-title":"Pain Physician"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/1992483"},{"key":"e_1_3_2_23_2","article-title":"Comparative long-term efficacy of short-term spinal cord stimulation versus bipolar pulsed radiofrequency for refractory postherpetic neuralgia: a 24 month prospective study","volume":"30","author":"Li Yun","year":"2025","unstructured":"Li Yun, Wang Junnan, Chen Yang, et al.. Comparative long-term efficacy of short-term spinal cord stimulation versus bipolar pulsed radiofrequency for refractory postherpetic neuralgia: a 24 month prospective study. 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