Department of Radiology, Peking University First Hospital, Beijing, China Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China Department of Anesthesiology, Peking University First Hospital, Beijing, China College of Engineering, Peking University, Beijing, China Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Pain. 2013 Jan;154(1):110-118. doi: 10.1016/j.pain.2012.09.016. Epub 2012 Oct 5.
This article investigates the effects of postherpetic neuralgia (PHN) on resting-state brain activity utilizing arterial spin labeling (ASL) techniques. Features of static and dynamic cerebral blood flow (CBF) were analyzed to reflect the specific brain response to PHN pain. Eleven consecutive patients suffering from PHN and 11 age- and gender-matched control subjects underwent perfusion functional magnetic resonance imaging brain scanning during the resting state. Group comparison was conducted to detect the regions with significant changes of CBF in PHN patients. Then we chose those regions that were highly correlated with the self-reported pain intensity as "seeds" to calculate the functional connectivity of both groups. Absolute CBF values of these regions were also compared across PHN patients and control subjects. Significant increases in CBF of the patient group were observed in left striatum, right thalamus, left primary somatosensory cortex (S1), left insula, left amygdala, left primary somatomotor cortex, and left inferior parietal lobule. Significant decreases in CBF were mainly located in the frontal cortex. Regional CBF in the left caudate, left insula, left S1, and right thalamus was highly correlated with the pain intensity, and further comparison showed that the regional CBF in these regions is significantly higher in PHN groups. Functional connectivity results demonstrated that the reward circuitry involved in striatum, prefrontal cortex, amygdala, and parahippocampal gyrus and the circuitry among striatum, thalamus, and insula were highly correlated with each element in PHN patients. In addition, noninvasive brain perfusion imaging at rest may provide novel insights into the central mechanisms underlying PHN pain.
本文利用动脉自旋标记（ASL）技术研究了疱疹后神经痛（PHN）对静息态脑活动的影响。分析了静态和动态脑血流（CBF）的特征，以反映特定的大脑对 PHN 疼痛的反应。11 名连续的 PHN 患者和 11 名年龄和性别匹配的对照组在静息状态下接受了灌注功能磁共振成像脑扫描。进行组间比较以检测 PHN 患者 CBF 变化明显的区域。然后，我们选择那些与自我报告的疼痛强度高度相关的区域作为“种子”，计算两组的功能连接。还比较了 PHN 患者和对照组这些区域的绝对 CBF 值。患者组的 CBF 显著增加区域为左侧纹状体、右侧丘脑、左侧初级体感皮层（S1）、左侧岛叶、左侧杏仁核、左侧初级运动皮层和左侧下顶叶。CBF 显著降低区域主要位于额叶。左侧尾状核、左侧岛叶、左侧 S1 和右侧丘脑的 CBF 与疼痛强度高度相关，进一步比较显示，这些区域的 CBF 在 PHN 组中显著升高。功能连接结果表明，涉及纹状体、前额叶皮质、杏仁核和海马旁回的奖励回路以及纹状体、丘脑和岛叶之间的回路与 PHN 患者的每个元素高度相关。此外，静息时的无创脑灌注成像可能为 PHN 疼痛的中枢机制提供新的见解。
