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Functional and Structural Changes in Postherpetic Neuralgia Brain Before and Six Months After Pain Relieving

Authors Zhang Y, Cao S, Yuan J, Song G, Yu T, Liang X

Received 21 January 2020

Accepted for publication 17 April 2020

Published 4 May 2020 Volume 2020:13 Pages 909—918

DOI https://doi.org/10.2147/JPR.S246745

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr E Alfonso Romero-Sandoval


Yi Zhang,1,2 Song Cao,2,3 Jie Yuan,2,3 Ganjun Song,2,4 Tian Yu,2 Xiaoli Liang5

1Department of Anesthesiology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563002, Guizhou, People’s Republic of China; 2Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical University, Zunyi, People’s Republic of China; 3Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, People’s Republic of China; 4Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, People’s Republic of China; 5Department of Anesthesiology, Zunyi Medical University, Zunyi 563002, Guizhou, People’s Republic of China

Correspondence: Xiaoli Liang
Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, People’s Republic of China
Tel +8613648521600
Email 17799870@qq.com

Objective: Multimodal magnetic resonance imaging (MRI) was used to detect whether 6 months after pain relieving, the structural and functional abnormalities in the brain of postherpetic neuralgia (PHN) patients are changeable.
Methods: Fifteen successfully treated PHN patients were enrolled; the brain activity and structural abnormalities were detected and compared before and 6 months after treatment. The functional parameters were evaluated with resting-state functional MRI technique, i.e., the regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF). Structural changes were detected with voxel-based morphometry (VBM) and diffusion kurtosis imaging (DKI).
Results: Six months after pain relieving, PHN brain showed different ReHo and fALFF values in the frontal lobe, caudate, supramarginal gyrus, anterior cingulate cortex (ACC), cuneus, middle temporal gyrus, and cerebellum. In addition, VBM intensity in the cerebellum increased; DKI values decreased in the thalamus and increased in the temporal lobe after successful treatment.
Conclusion: Six months after pain relieving, functional and structural changes exist in PHN brain. Changes in some differential areas in PHN brain, such as ACC, frontal lobe, thalamus, and temporal lobe indicate that the central plasticity may be reversible after chronic pain relieving.

Keywords: postherpetic neuralgia, PHN, functional magnetic resonance imaging, regional homogeneity, ReHo, fractional amplitude of low-frequency fluctuation, fALFF

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