ReviewPain reports2018
Rethinking the causes of pain in herpes zoster and postherpetic neuralgia: the ectopic pacemaker hypothesis.
Review in Pain reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
51 citing papers in PubMed, 74 citations in OpenAlex.
- Ultrasound-Guided Liposomal vs. Conventional Bupivacaine Erector Spinae Plane Block Plus Gabapentin for Postherpetic Neuralgia.The Kaohsiung journal of medical sciences · 2026Trial
- Pain Fluctuations of Women with Subacute Herpetic Neuralgia During Local Methylcobalamin in Combination with Lidocaine Treatment: A Single-Blinded Randomized Controlled Trial.Journal of pain research · 2023Trial
- Analgesic Characteristics of NanoBEO Released by an Airless Dispenser for the Control of Agitation in Severe Dementia.Molecules (Basel, Switzerland) · 2022Trial
- Ultrasound-Guided Stellate Ganglion Block Combined with Extracorporeal Shock Wave Therapy on Postherpetic Neuralgia.Journal of healthcare engineering · 2022Trial
- Efficacy and Safety of Botulinum Toxin A and Pulsed Radiofrequency on Postherpetic Neuralgia: A Randomized Clinical Trial.Contrast media & molecular imaging · 2022Trial
- OnabotulinumtoxinA in refractory postherpetic neuralgia: a case report.British journal of pain · 2026Article
- Pain outcomes and safety of dorsal root ganglion-targeted transforaminal injection for postherpetic neuralgia: a retrospective single-center cohort study.BMC neurology · 2026Observational
- A European Delphi Consensus to Support the Diagnosis, Management, and Appropriate Positioning of Topical Treatments for Postherpetic Neuralgia (PHN).Pain and therapy · 2026Article
- Varicella Zoster Virus Infection: Clinical Features, Molecular Pathogenesis, Treatment, and Prevention.MedComm · 2026Review
- A Study on the Efficacy and Safety of Intravenous Lidocaine Infusion Combined with Pulsed Radiofrequency in Preventing Postherpetic Neuralgia: A Randomized, Double-Blind, Controlled Trial.Journal of pain research · 2026Article
- 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.Frontiers in neurology · 2026Article
- Post-Herpetic Neuralgia: Review of Pathophysiology, Mechanisms, and Drug Treatment.Current neuropharmacology · 2026Review
- Spinal Cord Stimulation and DREZ Lesioning for Refractory Postherpetic Neuralgia: An Exploratory Case Series.Journal of pain research · 2026Article
- Developing a Core Outcome Set for Herpes Zoster-Associated Neuralgia in Clinical Trials of Traditional Chinese Medicine: A Study Protocol.Journal of multidisciplinary healthcare · 2026Article
- Cell-free DNA Levels in Herpes Zoster: A Cross-sectional Longitudinal Study.Acta dermato-venereologica · 2025Article
- Fire Acupuncture Combined with Pulse Radiofrequency Relieves Tactile Allodynia in Rats with Postherpetic Neuralgia.International journal of general medicine · 2025Article
- Exploring the causal relationship between plasma proteins and postherpetic neuralgia: a Mendelian randomization study.Frontiers in neurology · 2025Article
- Article
- Satellite Glial Cells in Human Disease.Cells · 2024Review
- CDDO regulates central and peripheral sensitization to attenuate post-herpetic neuralgia by targeting TRPV1/PKC-δ/p-Akt signals.Journal of cellular and molecular medicine · 2024Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPain in herpes zoster (HZ) and postherpetic neuralgia (PHN) is traditionally explained in terms of 2 processes: irritable nociceptors in the rash-inflamed skin and, later, deafferentation due to destruction of sensory neurons in one virally infected dorsal root ganglion. OBJECTIVES AND
methodsConsideration of the evidence supporting this explanation in light of contemporary understanding of the pain system finds it wanting. An alternative hypothesis is proposed as a replacement.
resultsThis model, the ectopic pacemaker hypothesis of HZ and PHN, proposes that pain in both conditions is driven by hyperexcitable ectopic pacemaker sites at various locations in primary sensory neurons affected by the causative varicella zoster virus infection. This peripheral input is exacerbated by central sensitization induced and maintained by the ectopic activity.
conclusionsThe shift in perspective regarding the pain mechanism in HZ/PHN has specific implications for clinical management.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.