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带状疱疹后神经痛患者在疼痛缓解前及缓解后六个月大脑的功能和结构变化

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

作者信息

Zhang Yi, Cao Song, Yuan Jie, Song Ganjun, Yu Tian, Liang Xiaoli

机构信息

Department of Anesthesiology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563002, Guizhou, People's Republic of China.

Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical University, Zunyi, People's Republic of China.

出版信息

J Pain Res. 2020 May 4;13:909-918. doi: 10.2147/JPR.S246745. eCollection 2020.

Abstract

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.

摘要

目的

采用多模态磁共振成像(MRI)检测带状疱疹后神经痛(PHN)患者疼痛缓解6个月后,其大脑的结构和功能异常是否会发生变化。

方法

纳入15例成功治疗的PHN患者;在治疗前和治疗6个月后检测并比较大脑活动和结构异常情况。采用静息态功能MRI技术评估功能参数,即局部一致性(ReHo)和低频振幅分数(fALFF)。采用基于体素的形态学测量(VBM)和扩散峰度成像(DKI)检测结构变化。

结果

疼痛缓解6个月后,PHN患者大脑在额叶、尾状核、缘上回、前扣带回皮质(ACC)、楔叶、颞中回和小脑表现出不同的ReHo和fALFF值。此外,成功治疗后小脑的VBM强度增加;丘脑的DKI值降低,颞叶的DKI值增加。

结论

疼痛缓解6个月后,PHN患者大脑存在功能和结构变化。PHN患者大脑中一些差异区域的变化,如ACC、额叶、丘脑和颞叶,表明慢性疼痛缓解后中枢可塑性可能是可逆的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d804/7210030/386c040a780c/JPR-13-909-g0001.jpg

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