Herpes Zoster Chronification to Postherpetic Neuralgia Induces Brain Activity and Grey Matter Volume Change

Overview

Journal Am J Transl Res

Specialty General Medicine

Date 2018 Feb 10

PMID 29423004

Citations 25

Authors

Song Cao

Bangyong Qin

Yi Zhang

Jie Yuan

Bao Fu

Peng Xie

Ganjun Song

Ying Li

Tian Yu

Affiliations

Soon will be listed here.

Abstract

Objective: Herpes zoster (HZ) can develop into postherpetic neuralgia (PHN), which is a chronic neuropathic pain (NP). Whether the chronification from HZ to PHN induced brain functional or structural change is unknown and no study compared the changes of the same brains of patients who transited from HZ to PHN. We minimized individual differences and observed whether the chronification of HZ to PHN induces functional and pain duration dependent grey matter volume (GMV) change in HZ-PHN patients.

Methods: To minimize individual differences induced error, we enrolled 12 patients with a transition from HZ to PHN. The functional and structural changes of their brains between the two states were identified with resting-state functional MRI (rs-fMRI) technique (i.e., the regional homogeneity (ReHo) and fractional aptitude of low-frequency fluctuation (fALFF) method) and the voxel based morphometry (VBM) technology respectively. The correlations between MRI parameters (i.e., ΔReHo, ΔfALFF and ΔVBM) and Δpain duration were analyzed too.

Results: Compared with HZ brains, PHN brains exhibited abnormal ReHo, fALFF and VBM values in pain matrix (the frontal lobe, parietal lobe, thalamus, limbic lobe and cerebellum) as well as the occipital lobe and temporal lobe. Nevertheless, the activity of vast area of cerebellum and frontal lobe significantly increased while that of occipital lobe and limbic lobe showed apparent decrease when HZ developed to PHN. In addition, PHN brain showed decreased GMV in the frontal lobe, the parietal lobe and the occipital lobe but increased in the cerebellum and the temporal lobe. Correlation analyses showed that some of the ReHo, fALFF and VBM differential areas (such as the cerebellum posterior lobe, the thalamus extra-nuclear and the middle temporal gyrus) correlated well with Δpain duration.

Conclusions: HZ chronification induced functional and structural change in cerebellum, occipital lobe, temporal lobe, parietal lobe and limbic lobe. These changes may be correlated with HZ-PHN chronification. In addition, these changes could be reasons of refractory chronic pain of PHN.

Citing Articles

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References

Snedecor S, Sudharshan L, Cappelleri J, Sadosky A, Desai P, Jalundhwala Y . Systematic review and meta-analysis of pharmacological therapies for pain associated with postherpetic neuralgia and less common neuropathic conditions. Int J Clin Pract. 2014; 68(7):900-18. DOI: 10.1111/ijcp.12411. View

Rocca M, Ceccarelli A, Falini A, Colombo B, Tortorella P, Bernasconi L . Brain gray matter changes in migraine patients with T2-visible lesions: a 3-T MRI study. Stroke. 2006; 37(7):1765-70. DOI: 10.1161/01.STR.0000226589.00599.4d. View

Huang T, Zhao Z, Yan C, Lu J, Li X, Tang C . Altered Spontaneous Activity in Patients with Persistent Somatoform Pain Disorder Revealed by Regional Homogeneity. PLoS One. 2016; 11(3):e0151360. PMC: 4792417. DOI: 10.1371/journal.pone.0151360. View

Mansour A, Baliki M, Huang L, Torbey S, Herrmann K, Schnitzer T . Brain white matter structural properties predict transition to chronic pain. Pain. 2013; 154(10):2160-2168. PMC: 3799881. DOI: 10.1016/j.pain.2013.06.044. View

Kim C, Kim Y, Chung G, Im H, Lee D, Kim J . Identifying neuropathic pain using (18)F-FDG micro-PET: a multivariate pattern analysis. Neuroimage. 2013; 86:311-6. DOI: 10.1016/j.neuroimage.2013.10.001. View

Zhang Z, Ferretti V, Guntan I, Moro A, Steinberg E, Ye Z . Neuronal ensembles sufficient for recovery sleep and the sedative actions of α2 adrenergic agonists. Nat Neurosci. 2015; 18(4):553-561. PMC: 4836567. DOI: 10.1038/nn.3957. View

Li Z, Kadivar A, Pluta J, Dunlop J, Wang Z . Test-retest stability analysis of resting brain activity revealed by blood oxygen level-dependent functional MRI. J Magn Reson Imaging. 2012; 36(2):344-54. PMC: 3399952. DOI: 10.1002/jmri.23670. View

Cohen J . Clinical practice: Herpes zoster. N Engl J Med. 2013; 369(3):255-63. PMC: 4789101. DOI: 10.1056/NEJMcp1302674. View

Schmidt-Wilcke T, Hierlmeier S, Leinisch E . Altered regional brain morphology in patients with chronic facial pain. Headache. 2010; 50(8):1278-85. DOI: 10.1111/j.1526-4610.2010.01637.x. View

10.

Rodriguez-Raecke R, Niemeier A, Ihle K, Ruether W, May A . Brain gray matter decrease in chronic pain is the consequence and not the cause of pain. J Neurosci. 2009; 29(44):13746-50. PMC: 6666725. DOI: 10.1523/JNEUROSCI.3687-09.2009. View

11.

Bocci T, Santarcangelo E, Vannini B, Torzini A, Carli G, Ferrucci R . Cerebellar direct current stimulation modulates pain perception in humans. Restor Neurol Neurosci. 2015; 33(5):597-609. DOI: 10.3233/RNN-140453. View

12.

Schmader K . Postherpetic neuralgia in immunocompetent elderly people. Vaccine. 1998; 16(18):1768-70. DOI: 10.1016/s0264-410x(98)00137-6. View

13.

Baliki M, Petre B, Torbey S, Herrmann K, Huang L, Schnitzer T . Corticostriatal functional connectivity predicts transition to chronic back pain. Nat Neurosci. 2012; 15(8):1117-9. PMC: 3411898. DOI: 10.1038/nn.3153. View

14.

Rainville P, Duncan G, Price D, Carrier B, Bushnell M . Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science. 1997; 277(5328):968-71. DOI: 10.1126/science.277.5328.968. View

15.

Zang Y, Jiang T, Lu Y, He Y, Tian L . Regional homogeneity approach to fMRI data analysis. Neuroimage. 2004; 22(1):394-400. DOI: 10.1016/j.neuroimage.2003.12.030. View

16.

Legrain V, Iannetti G, Plaghki L, Mouraux A . The pain matrix reloaded: a salience detection system for the body. Prog Neurobiol. 2010; 93(1):111-24. DOI: 10.1016/j.pneurobio.2010.10.005. View

17.

Jin C, Yuan K, Zhao L, Zhao L, Yu D, von Deneen K . Structural and functional abnormalities in migraine patients without aura. NMR Biomed. 2012; 26(1):58-64. DOI: 10.1002/nbm.2819. View

18.

Haag L, Heba S, Lenz M, Glaubitz B, Hoffken O, Kalisch T . Resting BOLD fluctuations in the primary somatosensory cortex correlate with tactile acuity. Cortex. 2014; 64:20-8. PMC: 5527676. DOI: 10.1016/j.cortex.2014.09.018. View

19.

Keating G . Shingles (Herpes Zoster) Vaccine (Zostavax(®)): A Review in the Prevention of Herpes Zoster and Postherpetic Neuralgia. BioDrugs. 2016; 30(3):243-54. DOI: 10.1007/s40259-016-0180-7. View

20.

Currie S, Wang J . More data on major depression as an antecedent risk factor for first onset of chronic back pain. Psychol Med. 2005; 35(9):1275-82. DOI: 10.1017/S0033291705004952. View