Li Zihan, Gu Lili, Jiang Xiaofeng, Liu Jiaqi, Li Jiahao, Xie Yangyang, Xiong Jiaxin, Lv Huiting, Zou Wanqing, Qin Suhong, Lu Jing, Jiang Jian
Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, China.
Neuroimaging Laboratory, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, China.
Brain Topogr. 2025 Feb 6;38(2):28. doi: 10.1007/s10548-025-01104-3.
PHN is one of the most common clinical complications of herpes zoster (HZ), the pathogenesis of which is unclear and poorly treated clinically, and many studies now suggest that postherpetic neuralgia (PHN) pain may be related to central neurologic mechanisms. This study aimed to investigate the white matter structural networks and changes in the organization of the rich-club in HZ and PHN. Diffusion imaging (DTI) data from 89 PHN patients, 76 HZ patients, and 66 healthy controls (HCs) were used to construct corresponding structural networks. Using graph-theoretic analysis, changes in the overall and local characteristics of the structural networks and rich-club organization were analyzed, and their correlations with clinical scales were analyzed. Compared with HCs, PHN patients had reduced global efficiency (Eg), reduced local efficiency (Eloc), a reduced clustering coefficient (Cp), a longer characteristic path length (Lp), and reduced nodal efficiency (Ne) in several brain regions, including the right posterior cingulate gyrus, the right supraoccipital gyrus, the bilateral postcentral gyrus, and the right precuneus; HZ patients had reduced Eg, a longer Lp, and reduced right orbital frontalis suprachiasmatic Ne. Moreover, HZ and PHN patients showed a significant reduction in the strength of rich-club connections. Compared with HZ patients, the intensities of the rich-club and feeder connections were lower in the PHN patients. Moreover, the changes in the structural networks and rich-club organization topology indices of the patients in the HZ and PHN patients were significantly correlated with disease duration, pain scores, and emotional changes. The structural networks of HZ and PHN patients exhibited reduced network transmission efficiency and rich-club connectivity, possibly due to structural damage to the white matter, and this was more obvious in PHN patients. The rich-club connectivity of HZ patients showed incomplete compensation in the acute pain stage.
带状疱疹后神经痛（PHN）是带状疱疹（HZ）最常见的临床并发症之一，其发病机制尚不清楚，临床治疗效果不佳，目前许多研究表明，带状疱疹后神经痛（PHN）疼痛可能与中枢神经机制有关。本研究旨在探讨HZ和PHN患者的白质结构网络及富俱乐部组织的变化。利用89例PHN患者、76例HZ患者和66例健康对照（HCs）的扩散成像（DTI）数据构建相应的结构网络。采用图论分析方法，分析结构网络和富俱乐部组织的整体及局部特征变化，并分析其与临床量表的相关性。与HCs相比，PHN患者在包括右侧后扣带回、右侧枕上回、双侧中央后回和右侧楔前叶在内的几个脑区的全局效率（Eg）降低、局部效率（Eloc）降低、聚类系数（Cp）降低、特征路径长度（Lp）延长和节点效率（Ne）降低；HZ患者的Eg降低、Lp延长和右侧眶额上视交叉Ne降低。此外，HZ和PHN患者的富俱乐部连接强度显著降低。与HZ患者相比，PHN患者的富俱乐部连接和馈线连接强度较低。此外，HZ和PHN患者结构网络和富俱乐部组织拓扑指数的变化与病程、疼痛评分和情绪变化显著相关。HZ和PHN患者的结构网络表现出网络传输效率和富俱乐部连通性降低，可能是由于白质结构损伤所致，这在PHN患者中更为明显。HZ患者的富俱乐部连通性在急性疼痛阶段表现出不完全代偿。
