Evidence map›Paper›PMID 40322588›Full record

ArticleJournal of pain research2025

High Prevalence of Small-Fiber Neuropathy in Patients with Tarlov Cysts: Toward a More Comprehensive Clinical Understanding.

Mieke Hulens, Peter Zajonc, Frans Bruyninckx, Ricky Rasschaert, Peter De Mulder, Chris Bervoets, Wim Dankaerts

Abstract read
In one paragraph

Article in Journal of pain research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mieke HulensDepartment of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Leuven, Belgium.ORCID 0000-0002-2335-8772
Peter ZajoncPinpoint Targeting, LLC, New York City, NY, USA.
Frans BruyninckxDepartment of Physical Medicine & Rehabilitation, University Hospitals of Leuven, Leuven, Belgium.ORCID 0000-0001-7731-2086
Ricky RasschaertDepartment of Neurosurgery, AZ Rivierenland, Bornem, Belgium.ORCID 0000-0001-6690-7666
Peter De MulderDepartment of Anesthesiology and Pain Therapy, Imelda Hospital, Bonheiden, Belgium.ORCID 0009-0009-2339-3779
Chris BervoetsDepartment of Neurosciences, KU Leuven, Leuven, Belgium.ORCID 0000-0001-9842-2823
Wim DankaertsDepartment of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Leuven, Belgium.ORCID 0000-0001-6616-9341

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To explore the prevalence of small-fiber neuropathy (SFN) and the clinical characteristics of patients with Tarlov cysts (PTCs), focusing on symptoms related to SFN and increased cerebrospinal pressure. Patients and Methods: In this retrospective study, 126 surveys assessing symptoms in women (30-69 years) with Tarlov cysts (TCs) ≥ 7 mm seeking treatment for chronic back, pelvic or leg pain and skin biopsy results from 75 patients assessing intraepidermal nerve fiber density (IENFD) were reviewed. Results: IENFD < 5th percentile was documented in 80% of PTCs according to the normative reference data of Collongues et al and 72% according to the worldwide dataset of Lauria et al Questionnaires revealed high incidences of neuropathic pain (80%), allodynia (76%), pain while sitting (93%), anal sphincter (11%) and urinary sphincter (66%) problems, persistent genital arousal (27%), and restless legs (54%). Autonomic dysfunctions included early satiety (41%), bladder (93%) and bowel (88%) dysfunction, increased sweating (51%), and Raynaud's phenomenon (45%). Other symptoms potentially associated with increased cerebrospinal fluid pressure (CSFP) were headaches (57%), fatigue (86%), cognitive issues (86%), and pulsatile tinnitus (59%). Conclusion: This study revealed a high prevalence of SFN in PTCs (72-80%). Although the TCs may not cause radicular pain in the corresponding dermatomes directly, individuals with TCs frequently report a range of symptoms that have previously been linked to symptomatic TCs, including bladder, bowel, sphincter, and sexual symptoms, as well as local pain. Additionally, seemingly unrelated symptoms, such as headaches, fatigue, cognitive difficulties, neuropathic pain localized in other parts of the body, and autonomic dysfunctions, are commonly reported. These symptoms may be associated with elevated CSFP within the nerve root sheath. Elevated pulsatile CSFP underlies the formation of TCs at the dorsal root ganglion and may gradually contribute to small-fiber dysfunction by irritating, compressing and damaging small nerve fibers within the dorsal root ganglion.

Indexed as

dysautonomiahEDSintracranial hypertensionmeningeal cystsneuropathic painPGAD

Identifiers

PMID40322588
PMCPMC12050039

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Registered trials

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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.