{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:00:47Z","timestamp":1793235647015,"version":"4.5.0"},"reference-count":68,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2015,11,26]],"date-time":"2015-11-26T00:00:00Z","timestamp":1448496000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Varicella zoster virus (VZV) is a ubiquitous, exclusively human alphaherpesvirus. Primary infection usually results in varicella (chickenpox), after which VZV becomes latent in ganglionic neurons along the entire neuraxis. As VZV-specific cell-mediated immunity declines in elderly and immunocompromised individuals, VZV reactivates and causes herpes zoster (shingles), frequently complicated by postherpetic neuralgia. VZV reactivation also produces multiple serious neurological and ocular diseases, such as cranial nerve palsies, meningoencephalitis, myelopathy, and VZV vasculopathy, including giant cell arteritis, with or without associated rash. Herein, we review the clinical, laboratory, imaging, and pathological features of neurological complications of VZV reactivation as well as diagnostic tests to verify VZV infection of the nervous system. Updates on the physical state of VZV DNA and viral gene expression in latently infected ganglia, neuronal, and primate models to study varicella pathogenesis and immunity are presented along with innovations in the immunization of elderly individuals to prevent VZV reactivation.<\/ns4:p>","DOI":"10.12688\/f1000research.7153.1","type":"journal-article","created":{"date-parts":[[2015,11,26]],"date-time":"2015-11-26T06:10:03Z","timestamp":1448518203000},"page":"1356","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":59,"title":["Varicella Zoster Virus in the Nervous System"],"prefix":"10.12688","volume":"4","author":[{"given":"Don","family":"Gilden","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Nagel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Cohrs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Mahalingam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Baird","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2015,11,26]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"787-94","DOI":"10.4065\/84.9.787","article-title":"Health care utilization and cost burden of herpes zoster in a community population.","volume":"84","author":"B 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.7707.r11349, Kamel Khalili, Department of Neuroscience and Center for Neurovirology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, 19140, USA, 26 Nov 2015, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/4-1356\/v1#referee-response-11349","order":0,"name":"referee-response-11349","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.7707.r11350, Ann Arvin, Departments of Pediatrics, Stanford University, Stanford, California, 94025, USA, 26 Nov 2015, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/4-1356\/v1#referee-response-11350","order":1,"name":"referee-response-11350","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.7707.r11351, Howard Lipton, Department of Microbiology & Immunology, University of Illinois School of Medicine, Chicago, Illinois, 60612-7344, USA, 26 Nov 2015, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/4-1356\/v1#referee-response-11351","order":2,"name":"referee-response-11351","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported in part by Public Health Service grants AG032958 (MAN, RJC, RM, and DG), NS093716 (DG), NS067070 (MAN), and NS082228 (RJC) from the National Institutes of Health. NLB was supported by training grant NS007321 to DG from the National Institutes of Health. The authors thank Marina Hoffman for editorial assistance and Cathy Allen for word processing and formatting of the manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}