{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:56:18Z","timestamp":1790571378941,"version":"4.1.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Subacute herpes zoster neuralgia is a clinically important transitional stage before pain becomes fully established as persistent postherpetic neuralgia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center retrospective cohort study, patients with subacute thoracic herpes zoster neuralgia treated between January 2024 and December 2025 were identified from routine clinical records. Patients were classified according to the treatment received as PRP\u202f+\u202fPRF or PRF alone. The primary outcome was the Numerical Rating Scale (NRS) score at 3\u202fmonths after treatment. Repeated NRS and Pittsburgh Sleep Quality Index (PSQI) measurements were analyzed longitudinally. Secondary outcomes included pregabalin requirement and persistent clinically meaningful zoster-related pain, defined as NRS\u202f&amp;gt;\u202f3 at the 3-month post-treatment follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy patients were analyzed, including 36 in the PRP\u202f+\u202fPRF group and 34 in the PRF group. At 3\u202fmonths, the observed mean NRS score was lower in the PRP\u202f+\u202fPRF group than in the PRF group (1.39\u202f\u00b1\u202f1.44 vs. 2.56\u202f\u00b1\u202f1.02). In the prespecified ANCOVA adjusted for baseline NRS, PRP\u202f+\u202fPRF was associated with a lower 3-month NRS score than PRF alone (adjusted mean difference, \u22121.13; 95% confidence interval [CI], \u22121.71 to \u22120.54;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The association remained directionally consistent in additional multivariable and change-score sensitivity analyses. Significant group-by-time interactions were observed for NRS and PSQI, with lower NRS and PSQI scores in the PRP\u202f+\u202fPRF group from 1\u202fweek through 3\u202fmonths. Pregabalin requirement at 3\u202fmonths was lower in the PRP\u202f+\u202fPRF group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001). Persistent clinically meaningful zoster-related pain at 3\u202fmonths occurred in 4 of 36 patients (11.1%) in the PRP\u202f+\u202fPRF group and 7 of 34 patients (20.6%) in the PRF group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.336).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this retrospective cohort, PRP combined with DRG-targeted PRF was associated with faster early improvement in pain and sleep and with lower post-treatment pregabalin use than PRF alone. Further prospective studies are needed to confirm these findings and determine whether this approach influences progression to persistent pain and PHN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1833755","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:29:20Z","timestamp":1790569760000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of platelet-rich plasma combined with dorsal root ganglion-targeted pulsed radiofrequency with outcomes in subacute thoracic herpes zoster neuralgia: a retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaolong","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Pain Medicine, The Second Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, The Second Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenghua","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, The Second Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengrong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, The Second Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruilin","family":"He","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, The Second Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongbin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, The Second Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"192","DOI":"10.3390\/v14020192","article-title":"Herpes zoster: a review of clinical manifestations and management","volume":"14","author":"Patil","year":"2022","journal-title":"Viruses"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1111\/j.1365-2990.2011.01167.x","article-title":"Review: the neurobiology of varicella zoster virus infection","volume":"37","author":"Gilden","year":"2011","journal-title":"Neuropathol Appl Neurobiol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1007\/s11940-001-0028-3","article-title":"Shingles (herpes zoster) and post-herpetic neuralgia","volume":"3","author":"Davis","year":"2001","journal-title":"Curr Treat Options Neurol"},{"key":"ref4","first-page":"656","article-title":"Herpes zoster and postherpetic neuralgia: prevention and management","volume":"96","author":"Saguil","year":"2017","journal-title":"Am Fam Physician"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1016\/j.jpain.2010.02.020","article-title":"Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study","volume":"11","author":"Drolet","year":"2010","journal-title":"J Pain"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1001\/archneur.1986.00520080074027","article-title":"Postherpetic neuralgia. 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herpes zoster-related pain: a study protocol","volume":"14","author":"Wang","year":"2025","journal-title":"Pain Ther"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1006\/viro.1999.9745","article-title":"Latent Varicella-zoster virus in human dorsal root ganglia","volume":"258","author":"Kennedy","year":"1999","journal-title":"Virology"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1111\/j.1526-4637.2012.01453.x","article-title":"Pulsed radiofrequency application reduced mechanical hypersensitivity and microglial expression in neuropathic pain model","volume":"13","author":"Park","year":"2012","journal-title":"Pain Med"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1111\/papr.12766","article-title":"Sleep shortage is associated with postherpetic neuralgia development through hyperesthesia and acute pain intensity: a community-based prospective cohort 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