Journal
BRAIN RESEARCH
Volume 1752, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.brainres.2020.147219
Keywords
Postherpetic neuralgia (PHN); Herpes zoster (HZ); Magnetic resonance imaging (MRI); Systematic review
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Funding
- Sichuan Science & Technology Department of China [2019YJ0692]
- Sichuan University & Luzhou Collaborative Foundation [2017CDLZ-G27, 2018CDLZ-11]
- Luzhou Science & Technology Department & Southwest Medical University Collaborative Foundation [2018LZXNYD-ZKO2]
- Project for Doctors of Affiliated Hospital of Southwest Medical University [2018-17129]
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Neuroimaging studies have shown that postherpetic neuralgia (PHN) is closely associated with structural and functional abnormalities in the brain, particularly affecting regions like the thalamus and insula within the pain matrix. Disruption of multiple networks, including the default-mode network and limbic system, may contribute to the neurophysiological mechanisms underlying PHN.
In recent decades, an increasing number of neuroimaging studies utilizing magnetic resonance imaging (MRI) have explored the differential effects of postherpetic neuralgia (PHN) on brain structure and function. We systematically reviewed and integrated the findings from relevant neuroimaging studies in PHN patients. A total of 15 studies with 16 datasets were ultimately included in the present study, which were categorized by the different neuroimaging modalities. The results revealed that PHN was closely associated with structural/microstructural and functional abnormalities of the brain mainly located in the 'pain matrix', including the thalamus, insula, parahippocampus, amygdala, dorsolateral prefrontal cortex, precentral gyrus and inferior parietal lobe, as well as other regions, such as the precuneus, lentiform nucleus and brainstem. Furthermore, a disruption of multiple networks, including the default-mode network, salience network and limbic system, may contribute to the neurophysiological mechanisms underlying PHN. The findings indicate that the cerebral abnormalities of PHN were not restricted to the pain matrix but extended to other regions, profoundly affecting the regulation and moderation of pain processing in PHN. Future prospective and longitudinal neuroimaging studies with larger samples will elucidate the progressive trajectory of neural changes in the pathophysiological process of PHN.
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