Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
Department of Anesthesiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
Brain Res. 2021 Feb 1;1752:147219. doi: 10.1016/j.brainres.2020.147219. Epub 2020 Dec 20.
In recent decades, an increasing number of neuroimaging studies utilizing magnetic resonance imaging (MRI) have explored the differential effects of postherpetic neuralgia (PHN) on brain structure and function. We systematically reviewed and integrated the findings from relevant neuroimaging studies in PHN patients. A total of 15 studies with 16 datasets were ultimately included in the present study, which were categorized by the different neuroimaging modalities. The results revealed that PHN was closely associated with structural/microstructural and functional abnormalities of the brain mainly located in the 'pain matrix', including the thalamus, insula, parahippocampus, amygdala, dorsolateral prefrontal cortex, precentral gyrus and inferior parietal lobe, as well as other regions, such as the precuneus, lentiform nucleus and brainstem. Furthermore, a disruption of multiple networks, including the default-mode network, salience network and limbic system, may contribute to the neurophysiological mechanisms underlying PHN. The findings indicate that the cerebral abnormalities of PHN were not restricted to the pain matrix but extended to other regions, profoundly affecting the regulation and moderation of pain processing in PHN. Future prospective and longitudinal neuroimaging studies with larger samples will elucidate the progressive trajectory of neural changes in the pathophysiological process of PHN.
在最近几十年中，越来越多的利用磁共振成像（MRI）的神经影像学研究探讨了带状疱疹后神经痛（PHN）对大脑结构和功能的不同影响。我们系统地回顾和整合了 PHN 患者相关神经影像学研究的结果。共有 15 项研究和 16 个数据集最终被纳入本研究，这些研究按不同的神经影像学方式进行了分类。结果表明，PHN 与大脑的结构/微观结构和功能异常密切相关，这些异常主要位于“疼痛矩阵”中，包括丘脑、脑岛、海马旁回、杏仁核、背外侧前额叶皮层、中央前回和下顶叶，以及其他区域，如楔前叶、豆状核和脑干。此外，多个网络（包括默认模式网络、突显网络和边缘系统）的中断可能有助于解释 PHN 背后的神经生理机制。这些发现表明，PHN 的大脑异常不仅局限于疼痛矩阵，还扩展到其他区域，深刻影响了 PHN 中疼痛处理的调节和缓和。未来具有更大样本量的前瞻性和纵向神经影像学研究将阐明 PHN 病理生理过程中神经变化的进展轨迹。
