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ORIGINAL RESEARCH article

Front. Neurosci.
Sec. Brain Imaging Methods
Volume 19 - 2025 | doi: 10.3389/fnins.2025.1552961

Altered White Matter Microstructural Integrity in Patients with Postherpetic Neuralgia: A Combined DTI and DTI-NODDI Study

Provisionally accepted
Wei Qian Wei Qian 1Xiaopei Xu Xiaopei Xu 1Ying Wu Ying Wu 2Lina Yu Lina Yu 2Chao Wang Chao Wang 1*Min Yan Min Yan 2*Risheng Yu Risheng Yu 1*
  • 1 Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • 2 Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    Background: Postherpetic neuralgia (PHN) is a debilitating condition resulting from herpes zoster infection, characterized by persistent pain that significantly impacts quality of life. This study aimed to investigate the white matter microstructural alterations associated with PHN and to assess the relationship between diffusion metrics and clinical symptoms.Methods: A total of 29 patients with PHN, 28 patients recovering from herpes zoster (RHZ), and 27 healthy controls (HC) were recruited, and clinical assessments were obtained to evaluate pain intensity and psychological distress. Diffusion tensor imaging (DTI) data was collected, followed by analysis of diffusion and neurite orientation dispersion and density imaging (NODDI) metrics. Statistical analyses included ANOVA to compare groups and Pearson correlation coefficients to assess relationships between imaging metrics and clinical outcomes.Results: PHN patients exhibited significantly altered white matter integrity, specifically in neurite density index (NDI) and orientation dispersion index, compared to both RHZ patients and HC. Significant correlations were also found between altered imaging metrics and clinical assessments of pain and emotional distress, with lower fractional anisotropy (FA) and NDI associated with higher pain scores and psychological symptoms.Conclusions: Our study highlights significant microstructural changes in white matter tracts in patients with PHN, indicating compromised neural integrity that correlates with increased pain perception and emotional distress. NODDI demonstrated superior sensitivity in detecting these alterations compared to traditional DTI metrics, underscoring its potential for enhancing diagnostic and therapeutic approaches in managing chronic pain conditions like PHN.

    Keywords: Herpes Zoster, postherpetic neuralgia, Diffusion Tensor Imaging, Neurite orientation dispersion and density imaging, white matter microstructure

    Received: 29 Dec 2024; Accepted: 04 Feb 2025.

    Copyright: © 2025 Qian, Xu, Wu, Yu, Wang, Yan and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Chao Wang, Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
    Min Yan, Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
    Risheng Yu, Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.