Altered Regional Spontaneous Brain Activity and Default Mode Network Functional Connectivity in Herpes Zoster-related Pain Patients with High Anxiety

Abstract

Abstract Pain and psychological disorders are two common symptom clusters in patients with herpes zoster-related pain (HZ-RP). Numerous neuroimaging studies have revealed abnormal brain structure and function in patients with HZ-RP. However, very few studies have focused on the functional characteristics of the brain in HZ-RP patients with different levels of anxiety. Fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo) and functional connectivity (FC) were compared between HZ-RP patients with high anxiety (HZ-RP with HA n = 25) and HZ-RP patients with low anxiety (HZ-RP with LA, n = 26). Multivariable linear regression models were used to investigate the impact of clinical characteristics on the significant abnormalities, and moderation analysis was used to examine the interaction between pain and anxiety. The two groups showed significant differences in regional spontaneous brain activity in the right Rolandic operculum (RO), left middle temporal gyrus (MTG) and right precentral gyrus (PrCG). The left anterior prefrontal cortex showed significantly decreased FC with the left medial superior frontal gyrus while the left occipital cortex showed increased FC with the right fusiform, right MTG and left precuneus in the HZ-RP with HA group compared with that in the LA group. The degree of pain and anxiety contributed to explaining the variance in the fALFF of the right RO. However, the abnormal ReHo in the right PrCG was solely related to the degree of anxiety. The abnormal brain dysfunctional pattern may be an indicator of underlying pathophysiological mechanisms linking HZ-RP and anxiety. The right PrCG plays a vital role in regulating anxiety in HZ-RP patients.