Resting State Functional Connectivity Study Of Pain Matrix In Patients With Herpes Zoster And Postherpetic Neuralgia

Objective: The purpose of this study was to explore the resting-state functional connectivity(FC)changes among pain matrix and other brain regions in herpes zoster(HZ)and postherpetic neuralgia(PHN)patients,and measured its association with patients’ disease duration and clinical scores.Materials and methods: 54 PHN,52 HZ patients and 54 healthy controls(HCs)underwent resting-state functional magnetic resonance imaging(rs-f MRI)scans.We utilized seed-based FC analysis to investigate whether HZ and PHN patients exhibited abnormal functional connectivity between pain matrix and other brain regions compared with HCs.Based on the FC characteristics of different brain regions,a random forest(RF)model was constructed to explore the feasibility of potential neuroimaging indicators to distinguish the HZ and PHN patients.Results: PHN patients exhibited decreased functional connectivity between the pain matrix and the putamen,superior temporal gyrus,middle frontal gyrus,middle cingulate gyrus,amygdala,precuneus,and supplementary motor area compared with HCs.The durations of disease in PHN patients were negatively correlated with these impaired FCs.Compared with HCs,HZ patients decreased FC between the right thalamus and bilateral putamen,the left insula and right putamen,and the right middle cingulate gyrus.The duration of disease in HZ patients was positively correlated with FC between the right thalamus and right putamen.In addition,the results of machine learning experiments showed that the random forest model combined with FC features achieved a classification accuracy of 75% when distinguishing between HZ and PHN patients.Conclusion: Disrupted functional connectivity among pain matrix and other regions in HZ and PHN patients may affect multiple dimensions of pain processing.