게시판
| 21KS-046 |
Longitudinal change in brain functional connectivity with herpes zoster patients: neuroimaging case series
Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Introduction: The clinical course of herpes zoster (HZ) is interesting. The skin symptoms of most patients are recovered within a few weeks, and pain also gets better as skin symptoms improve. However, in some cases, the severe neuropathic pain could be prolonged for a very long period, which is called postherpetic neuralgia (PHN). The exact mechanism of PHN has not been known yet. In these neuroimaging cases, the longitudinal functional connectivity changes of the brain of the HZ patients were evaluated.
Cases: This case study included 5 subjects who were diagnosed with HZ within 14 days after a manifestation of pain and skin symptoms on the dermatome of the right chest or right abdomen. Numeric rating scale (NRS), DN4 (Douleur neuropathique 4), BDI (Beck depression inventory), SF-MPQ (short-form McGill pain questionnaire), CPT (current perception threshold, and brain functional magnetic resonance image (fMRI) were evaluated on enrollment and 3-month. Three among 5 subjects were developed PHN. All patients\' NRS, DN4, BDI, SF-MPQ, and CPT were decreased on 3-month. In the recovered patients, the common activated brain functional connectivity was left postcentral gyrus - right postcentral gyrus and right inferior frontal gyrus (IFG) (opercular part) - right IFG (triangular part). In the PHN subjects, the functional connectivity of the left superior frontal gyrus (SFG) (orbital part) - right IFG (orbital part) was activated.
Conclusions: In this case series, PHN patients were associated with the functional connectivity of left SFG (orbital part) - right IFG (orbital part). Left SFG is known to contribute to higher cognitive functions and working memory, and right IFG (orbital part) is associated with pain processing and empathy for pain. Although a few patients were enrolled in this case series, the development of PHN could be affected by pain itself as well as pain memory and psychological aspects such as empathy for pain.
References
1. du Boisgueheneuc F, Levy R, Volle E, Seassau M, Duffau H, Kinkingnehun S et al. Functions of the left superior frontal gyrus in humens: a lesion study. Brain 2006; 129: 3315-28.
2. Naor N, Rohr C, Schaare LH, Limbachia C, Shamay-Tsoory S, Okon-Singer H. The neural networks underlying reappraisal of empathy for pain. Soc Cogn Affect Neurosci 2020; 15: 733-44.
Cases: This case study included 5 subjects who were diagnosed with HZ within 14 days after a manifestation of pain and skin symptoms on the dermatome of the right chest or right abdomen. Numeric rating scale (NRS), DN4 (Douleur neuropathique 4), BDI (Beck depression inventory), SF-MPQ (short-form McGill pain questionnaire), CPT (current perception threshold, and brain functional magnetic resonance image (fMRI) were evaluated on enrollment and 3-month. Three among 5 subjects were developed PHN. All patients\' NRS, DN4, BDI, SF-MPQ, and CPT were decreased on 3-month. In the recovered patients, the common activated brain functional connectivity was left postcentral gyrus - right postcentral gyrus and right inferior frontal gyrus (IFG) (opercular part) - right IFG (triangular part). In the PHN subjects, the functional connectivity of the left superior frontal gyrus (SFG) (orbital part) - right IFG (orbital part) was activated.
Conclusions: In this case series, PHN patients were associated with the functional connectivity of left SFG (orbital part) - right IFG (orbital part). Left SFG is known to contribute to higher cognitive functions and working memory, and right IFG (orbital part) is associated with pain processing and empathy for pain. Although a few patients were enrolled in this case series, the development of PHN could be affected by pain itself as well as pain memory and psychological aspects such as empathy for pain.
References
1. du Boisgueheneuc F, Levy R, Volle E, Seassau M, Duffau H, Kinkingnehun S et al. Functions of the left superior frontal gyrus in humens: a lesion study. Brain 2006; 129: 3315-28.
2. Naor N, Rohr C, Schaare LH, Limbachia C, Shamay-Tsoory S, Okon-Singer H. The neural networks underlying reappraisal of empathy for pain. Soc Cogn Affect Neurosci 2020; 15: 733-44.