{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T02:14:41Z","timestamp":1775700881314,"version":"3.50.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Postherpetic neuralgia (PHN) is a chronic neuropathic pain condition in elderly patients following herpes zoster infection. Conventional treatments often have inconsistent efficacy and significant side effects. Combining spinal cord stimulation (SCS) with lidocaine patches may enhance pain relief by targeting central and peripheral pain mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This randomized, controlled, single-blind trial enrolled 97 patients aged \u226560\u202fyears with PHN lasting \u22656\u202fmonths. Participants were assigned to SCS with a 5% lidocaine patch (<jats:italic>n<\/jats:italic>\u202f=\u202f49) or SCS with a placebo patch (<jats:italic>n<\/jats:italic>\u202f=\u202f48). Both groups received oral pregabalin. The placebo patch was identical in appearance to ensure blinding. Pain intensity (VAS) and sleep quality (PSQI) were assessed at baseline and on days 1, 3, 7, 30, and 90 post-interventions. Subgroup analyses by age and PHN duration were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At day 90, the experimental group had greater reductions in VAS scores (1.6\u202f\u00b1\u202f1.1) than the control group (2.7\u202f\u00b1\u202f1.3, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.01). Clinically significant pain relief (\u226550% VAS reduction) was achieved by 72.3% in the experimental group versus 45.8% in the control group (<jats:italic>p<\/jats:italic>\u202f=\u202f0.038). PSQI scores improved more in the experimental group (5.3\u202f\u00b1\u202f2.1) than in the control group (8.2\u202f\u00b1\u202f2.7, <jats:italic>p<\/jats:italic>\u202f=\u202f0.021). Patients with PHN duration &amp;lt;60\u202fdays benefited more from combination therapy. Adverse events were minimal and similar between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combining SCS with lidocaine patches significantly enhances pain relief and sleep quality in elderly PHN patients compared to SCS alone. Further multicenter studies are recommended to validate these findings and assess long-term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.chictr.org.cn\/searchprojEN.html<\/jats:ext-link>, ChiCTR2000039059.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1529673","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T14:39:37Z","timestamp":1737643177000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly: a controlled study"],"prefix":"10.3389","volume":"16","author":[{"given":"Yun","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunhui","family":"Hao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengtao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuli","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1038\/s41541-023-00757-0","article-title":"Healthy ageing: herpes zoster infection and the role of zoster vaccination","volume":"8","author":"Curran","year":"2023","journal-title":"NPJ Vaccines"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"103852","DOI":"10.1016\/j.ebiom.2022.103852","article-title":"Primary immune responses are negatively impacted by persistent herpesvirus infections in older people: results from an observational study on healthy subjects and a vaccination trial on subjects aged more than 70 years old","volume":"76","author":"Nicoli","year":"2022","journal-title":"EBioMedicine"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"12","DOI":"10.4103\/2045-9912.372666","article-title":"Ozonated autohemotherapy combined with pulsed radiofrequency in the treatment of thoracic postherpetic neuralgia in older adults: a retrospective study","volume":"14","author":"Li","year":"2023","journal-title":"Med Gas Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e263","DOI":"10.1016\/S2666-7568(22)00039-3","article-title":"Post-licensure zoster vaccine effectiveness against herpes zoster and postherpetic neuralgia in older adults: a systematic review and meta-analysis","volume":"3","author":"Mbinta","year":"2022","journal-title":"Lancet Healthy Longev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2176065","DOI":"10.1080\/21645515.2023.2176065","article-title":"Public health impact of herpes zoster vaccination on older adults in Hong Kong","volume":"19","author":"Chan","year":"2023","journal-title":"Hum Vaccin Immunother"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/j.jaad.2020.06.1013","article-title":"Risk of recurrent herpes zoster in a population-based cohort study of older adults","volume":"85","author":"Qian","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"265","DOI":"10.4103\/JCAS.JCAS_45_20","article-title":"Post-herpetic neuralgia: a systematic review of current interventional pain management strategies","volume":"13","author":"Aggarwal","year":"2020","journal-title":"J Cutan Aesthetic Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2003","DOI":"10.1007\/s12325-020-01335-9","article-title":"Postherpetic neuralgia: current evidence on the topical film-forming spray with bupivacaine hydrochloride and a review of available treatment strategies","volume":"37","author":"Ngo","year":"2020","journal-title":"Adv Ther"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"5140","DOI":"10.12669\/pjms.38.3.5140","article-title":"Efficacy of local anaesthetic and steroid combination in prevention of post-herpetic neuralgia: a meta-analysis. 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