Alterations in local activity and functional connectivity in patients with postherpetic neuralgia after short-term spinal cord stimulation

Abstract

IntroductionThe efficacy of short-term spinal cord stimulation (stSCS) as a treatment for neuropathic pain in patients with postherpetic neuralgia (PHN) has already been validated. However, the potential alterations in brain functionality that are induced by such treatment have yet to be completely elucidated.MethodsThis study use resting-state functional magnetic resonance imaging (rs-fMRI) to detect the changes in regional homogeneity (ReHo) and degree centrality (DC) related to stimulator-induced pain relief in patients with PHN. A total of 10 patients with PHN underwent an MRI protocol at baseline and after stSCS. Alterations in ReHo and DC were then compared between baseline and after stSCS. We investigated the relationship between clinical parameters and functional changes in the brain.ResultsClinical parameters on pain, emotion, and sleep quality were correlated with ReHo and DC. ReHo and DC were significantly altered in the middle temporal gyrus, precuneus, superior frontal gyrus, supramarginal gyrus, inferior parietal lobule, rolandic operculum, middle occipital gyrus, superior parietal gyrus, and the precentral gyrus after stSCS. A significant correlation was detected between ReHo changes in the middle occipital gyrus, precuneus, inferior parietal gyrus, and changes in pain, emotion, and sleep quality. A significant negative correlation was detected between DC changes in the middle temporal gyrus, rolandic operculum, supramarginal gyrus, precuneus, inferior parietal gyrus, and changes in pain, emotion, and sleep quality.ConclusionThis study found that stSCS is able to induce ReHo and DC changes in patients with PHN, thus suggesting that stSCS can change brain function to alleviate pain, sleep, and emotional disorder.

Altered Regional Spontaneous Brain Activity and Default Mode Network Functional Connectivity in Herpes Zoster-related Pain Patients with High Anxiety

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“…A brain structure study via experimental induction of low back pain found that asymptomatic participants had greater grey matter density at MOG_L than participants with pain [ 48 ]. A study on alterations in local activity and functional connectivity in patients with postherpetic neuralgia after short-term spinal cord stimulation found patients with increased ReHo values at the MOG [ 49 ]. The visual system plays a prominent role in migraine, especially migraine with aura [ 50 ].…”

Bidirectional two-sample Mendelian randomization analysis reveals a causal effect of interleukin-18 levels on postherpetic neuralgia risk

“…Another possible mechanism underlying PHN is immune activation, whereby the immune system produces cytokines and other inflammatory molecules that can damage nerve cells and lead to persistent pain. Furthermore, chronic inflammation can alter the way pain signals are processed in the central nervous system, thereby allowing pain to persist even after the initial injury has healed ( 47 , 49 , 50 ). Lastly, genetic factors may also influence the development of PHN.…”