The Research Of Postherpetic Neuralgia Patients With Resting State Functional MRI And Voxel Based Morphometry

Purpose: To explore the changes of resting state functional magnetic resonance imaging(rs-fMRI)and voxel-based morphometry(VBM)in patients with postherpetic neuralgia(PHN)compared with healthy volunteers,before and after treatment.Methods: rs-fMRI and VBM images of twelve PHN patients(before and after treatment)and twelve matched healthy volunteers were enrolled.The changes in low frequency amplitude(ALFF),frational low frequency amplitude(fALFF),and the grey matter volume were compared.Results: 1)Compared with healthy volunteers,brain areas in PHN patients,including the brainstem,bilateral frontal lobe,bilateral temporal lobe,right limbic lobe,left insula,right precuneus,and right anterior cingulate,all had increased ALFF values.Brain areas including the bilateral superior frontal gyrus,middle frontal gyrus,bilateral temporal lobe,right fusiform gyrus,and right parahippocampal gyrus,all had decreased ALFF values.Brain areas with increased fALFF were right cerebellum posterior lobe,bilateral frontal lobe,bilateral parietal lobe,left superior parietal lobule.Brain areas with decreased fALFF values included the bilateral frontal lobe,right parietal lobe,and precuneus.2)Increased ALFF was seen in patients with PHN at the left insula,frontal lobe,medial frontal gyrus,bilateral parietal lobe,bilateral inferior parietal lobule,and the right precuneus before and after treatment,whereas decreased ALFF was shown at the left cerebellum posterior lobe,temporal lobe,limbic lobe,and posterior cingulate.Patients with PHN displayed increased fALFF at the left frontal lobe and decreased fALFF at the left postcentral gyrus,parietal lobe,and temporal lobe.3)Compared with healthy volunteers,brain areas with decreased grey matter volumes included the medulla,pons,brainstem,bilateral frontal lobe,left precentral gyrus,and superior temporal gyrus.Conclusion: 1)In theresting state,areas associated with DMN,the frontal lobe,parietal lobe,cerebellum posterior lobe,and insula are greatly significant for painperception and the coding of pain intensity.2)In patients with PHN,the frontal,limbic,and temporal lobemay be restrained or destroyed.And the temporal lobe maybe associated with the cognitive dysfunction in patients with PHN.3)The decreased grey matter volumes of the frontal lobe,temporal lobe,and postcentral gyrus indicate that they maybe associated with the perception of pain and with emotional regulation.