Altered White Matter Microstructure In Herpes Zoster And Postherpetic Neuralgia Determined By Automated Fiber Quantification

Objective: This study aimed to explore changes in the white matter microstructure in herpes zoster(HZ)and postherpetic neuralgia(PHN)patients and to estimate the correlation of these changes with clinical data.Materials and methods: Diffusion tensor magnetic resonance imaging data of HZ patients(n=33),PHN patients(n=32)and healthy controls(n=35)were collected and analyzed by automatic fiber quantification method to accurately locate the segments of white matter fiber bundle changes.The correlation between different segments of fiber tracts and clinical indicators was evaluated.Results: Compared with HCs,HZ and PHN patients both showed a wide range of changes in the diffusion properties of fiber tracts.HZ patients exhibited changes primarily in the left superior longitudinal fasciculus(SLF),whereas PHN patients predominantly exhibited changes in the left inferior fronto-occipital fasciculus.The bilateral SLF and the left corticospinal tract were altered in the PHN patients compared with HZ patients.In addition,PHN patients showed a trend toward more expansive white matter alterations compared with those observed in HZ patients;additionally,in PHN patients,changes in the left cingulum cingulate were significantly correlated with changes in emotion and the duration of disease.Conclusion: Both HZ and PHN patients showed extensive changes in white matter microstructure compared to HCs,and these changes were more prominent in the PHN group than in the HZ group.The results of this study can provide a new perspective on the mechanism of long-term neuropathic pain in PHN patients,and provide theoretical support for early identification and clinical intervention of PHN patients.