Biological mechanism of post-herpetic neuralgia

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Biological mechanism of post-herpetic neuralgia

Post-herpetic neuralgia (PHN) is an exceptionally drug-resistant neuropathic pain, which arises as a result of a herpes zoster eruption. The deplorable PHN management partly results from the trouble in dissecting out its contributing factors due to the complexity of PHN mechanism.

Pen WW et al comprehensively investigated the contributions of multiple factors to PHN severity to elaborate their understanding of the PHN mechanism and to establish a basis for effective therapeutic schemes. In this study, the comparison of somatosensory detection thresholds (C, Aδ and Aβ fibre thresholds) between affected and unaffected sides, 16 PHN patients with significant sensory deficits and 13 PHN patients without significant sensory deficits were identified and assigned to different groups. The laser-evoked brain responses were used to confirm the different extents of lesions in the nociceptive system between patients with and without sensory deficits. Besides, patients with sensory deficits had more severe pain and psychological disorders, for instance anxiety and depression. Most significantly, chronic pain severity was highly influenced by various psychophysiological factors (sleep disturbances, psychological disorders and hypothalamic-pituitary-adrenal axis dysfunction) for patients with sensory deficits.

It was thus concluded that  the contribution of multiple patho-psychophysiological factors to PHN severity, could help establish a basis for the development of a rational, patient-centred therapeutic strategy. It was also implicated that the knowledge of multiple patho-psychophysiological factors to PHN severity, could  expand our understanding of the underlying PHN mechanism, and can aid in developing a rational, patient-centred therapeutic strategy targeting towards the corresponding etiology and psychophysiological disorders for individual patient.

Source:

Eur J Pain. 2016 Dec 15

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/27977069

Original title of article:

Biological mechanism of post-herpetic neuralgia: Evidence from multiple patho-psychophysiological measures.

Authors:

Peng WW et al.

Eur J Pain. 2016 Dec 15
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