White Matter Microstructure Abnormalities In Patients With Herpes Zoster And Postherpetic Neuralgia: A DTI Study

Objectives:To explore white matter microstructure abnormalities of HZ and PHN,by studying the abnormal diffusion of the brain white matter in patients with herpes zoster and postherpetic neuralgia using a tract-based spatial statistics.Methods:Forty-eight HZ patients,Forty PHN patients and twenty-eight well-matched healthy controls?HC?were included in the study and examined with a routine 3.0T magnetic resonance imaging scanner,All data were processed automatically by a software called FSL,the FA,MD,RD,AD values were analyzed with track-based spatial statistics among the PHN,HZ and HC groups.In addition,the pearson correlation coefficient was calculated to compare various clinical indices with the diffusion property.Result:?1?Compared with the HC,HZ patients showed significantly decreased FA in corpus callosum,right cerebral peduncle,left uncinate fasciculus and two sides of corticospinal tract,internal capsule,corona radiata,posterior thalamic radiation,anterior thalamic radiation,inferior longitidinal fasciculus,inferior fronto-occipital fasciculus,external capsule,fornix/Stria terminali,anterior cingulate cortexsuperior longitudinal fasciculus,superior fronto-occipital fasciculus;significantly increased MD,RD and AD in corpus callosum,cerebral peduncle,inferior fronto-occipital fasciculus,inferior longitidinal fasciculus,superior longitu-dinal fasciculus,superior fronto-occipital fasciculus,fornix/stria terminali,cortico-spinal tract,internl capsule,corona radiata,posterior thalamic radiation,anterior thalamic radiation,external capsule,uncinate fasciculus?p<0.01,TFCE corrected?.?2?Compared with the HC,PHN patients showed significantly decreased FA in corpus callosum,and two sides of anterior cingulate cortex,cerebral peduncle,inferior fronto-occipital fasciculus,superior longitudinal fasciculus,inferior longitidinal fasciculus,fornix/stria terminali,internal capsule,corona radiata,posterior thalamic radiation,anterior thalamic radiation,external capsule,uncinate fasciculus,corticospinal tract;significantly increased MD,RD and AD in corpus callosum,middle cerebellar peduncle,and two sides of anterior cingulate cortex,cerebral peduncle,inferior fronto-occipital fasciculus,superior longitudinal fasciculus,inferior longitidinal fasciculus,fornix/stria terminali,internal capsule,corona radiata,posterior thalamic radiation,anterior thalamic radiation,external capsule,uncinate fasciculus,posterior cingulate cortex,corticospinal tract?p<0.01,TFCE corrected?.?3?Compared with the HZ,PHN patients showed significantly increased MD,RD and AD in corpus callosum,corona radiata,internal capsule,external capsule,inferior fronto-occipital fasciculus,inferior longitidinal fasciculus superior fronto-occipital fasciculus,superior longitudinal fasciculus,anterior thalamic radiation,posterior thalamic radiation,fornix/stria,anterior cingulate cortex,posterior cingulate cortex,uncinate fasciculus,cerebral peduncle,middle cerebellar pedunclecorticospinal tract?p<0.01,TFCE corrected?.?4?The results of partial correlation analysis showed that the disease duration were positively correlated with the changed MD,AD and RD of the PHN patients compared with HZ(p<0.05,R_MD=0.344,R_AD=0.390,R_RD=0.333),VAS score had no significant correlationship with FA,MD,AD,RD?p>0.05?.Conclusion:There was a significant difference in brain white matter microstructure of PHN patients and HZ patients compaired with healthy controls,which not only involved pain-related regions.And PHN patients showed broader abnormalities in white matter microstructure compaired with HZ patients.The main mechanism of white matter microstructure abnormalities may be white matter demyelination,nerve inflammation and axonal degeneration.There was a difference in white matter microstructure between PHN and HZ patients,which were positively correlated with the disease duration,suggesting that all these abnormal brain regions may participate in the generation of PHN.