Alterations in local activity and functional connectivity in patients with postherpetic neuralgia after short-term spinal cord stimulation

Xiaochong Fan; Huan Ren; Chunxiao Bu; Zhongyuan Lu; Yarui Wei; Fuxing Xu; Lijun Fu; Letian Ma; Cunlong Kong; Tao Wang; Yong Zhang; Qingying Liu; Wenqi Huang; Huilian Bu; Jingjing Yuan

doi:10.3389/fnmol.2022.938280

Alterations in local activity and functional connectivity in patients with postherpetic neuralgia after short-term spinal cord stimulation

Front Mol Neurosci. 2022 Aug 11:15:938280. doi: 10.3389/fnmol.2022.938280. eCollection 2022.

Authors

Xiaochong Fan¹, Huan Ren¹, Chunxiao Bu², Zhongyuan Lu¹, Yarui Wei², Fuxing Xu¹, Lijun Fu¹, Letian Ma¹, Cunlong Kong¹, Tao Wang¹, Yong Zhang², Qingying Liu¹, Wenqi Huang³, Huilian Bu¹, Jingjing Yuan⁴

Affiliations

¹ Department of Pain Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
² Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
³ Department of Anesthesiology, The First Affiliated Hospital Sun Yat-sen University, Guangzhou, China.
⁴ Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Abstract

Introduction: The efficacy of short-term spinal cord stimulation (stSCS) as a treatment for neuropathic pain in patients with postherpetic neuralgia (PHN) has already been validated. However, the potential alterations in brain functionality that are induced by such treatment have yet to be completely elucidated.

Methods: This study use resting-state functional magnetic resonance imaging (rs-fMRI) to detect the changes in regional homogeneity (ReHo) and degree centrality (DC) related to stimulator-induced pain relief in patients with PHN. A total of 10 patients with PHN underwent an MRI protocol at baseline and after stSCS. Alterations in ReHo and DC were then compared between baseline and after stSCS. We investigated the relationship between clinical parameters and functional changes in the brain.

Results: Clinical parameters on pain, emotion, and sleep quality were correlated with ReHo and DC. ReHo and DC were significantly altered in the middle temporal gyrus, precuneus, superior frontal gyrus, supramarginal gyrus, inferior parietal lobule, rolandic operculum, middle occipital gyrus, superior parietal gyrus, and the precentral gyrus after stSCS. A significant correlation was detected between ReHo changes in the middle occipital gyrus, precuneus, inferior parietal gyrus, and changes in pain, emotion, and sleep quality. A significant negative correlation was detected between DC changes in the middle temporal gyrus, rolandic operculum, supramarginal gyrus, precuneus, inferior parietal gyrus, and changes in pain, emotion, and sleep quality.

Conclusion: This study found that stSCS is able to induce ReHo and DC changes in patients with PHN, thus suggesting that stSCS can change brain function to alleviate pain, sleep, and emotional disorder.

Keywords: emotion; functional magnetic resonance imaging; mechanisms of action; pain; postherpetic neuralgia; spinal cord stimulation.