title: Biological mechanism of post-herpetic neuralgia: Evidence from multiple patho-psychophysiological measures.
abstract: Post-herpetic neuralgia (PHN), which develops after the resolution of a herpes zoster eruption, is an exceptionally drug-resistant neuropathic pain. The unsatisfactory management of PHN partly results from the difficulty in dissecting out its contributing factors due to the complexity of PHN mechanism.
  
  
  
  Here, to elaborate our understanding of the PHN mechanism and to establish a basis for effective therapeutic strategies, we comprehensively investigated the contributions of multiple factors to PHN severity.
  
  
  
  Based on 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 different extents of lesions in the nociceptive system between patients with and without sensory deficits were confirmed using laser-evoked brain responses. Moreover, patients with sensory deficits had more severe pain and psychological disorders, e.g. anxiety and depression. Importantly, chronic pain severity was significantly influenced by various psychophysiological factors (sleep disturbances, psychological disorders and hypothalamic-pituitary-adrenal axis dysfunction) for patients with sensory deficits.
  
  
  
  Our findings demonstrated the contribution of multiple patho-psychophysiological factors to PHN severity, which could help establish a basis for the development of a rational, patient-centred therapeutic strategy.
  
  
  
  This study revealed the contribution of multiple patho-psychophysiological factors to PHN severity, which expanded our understanding of the underlying PHN mechanism, and helped develop a rational, patient-centred therapeutic strategy targeting towards the corresponding etiology and psychophysiological disorders for individual patient.
authors.affiliation: Brain Function and Psychological Science Research Center, Shenzhen University, Shenzhen, China.
authors.forename: W W
authors.initials: WW
authors.lastname: Peng
authors.affiliation: Department of Pain Medicine, Daping Hospital & Research Institute of Surgery, The Third Military Medical University, Chongqing, China.
authors.forename: X L
authors.initials: XL
authors.lastname: Guo
authors.affiliation: Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China.
authors.forename: Q Q
authors.initials: QQ
authors.lastname: Jin
authors.affiliation: Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China.
authors.forename: H
authors.initials: H
authors.lastname: Wei
authors.affiliation: Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China.
authors.forename: X L
authors.initials: XL
authors.lastname: Xia
authors.affiliation: Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Pain Medicine, Daping Hospital & Research Institute of Surgery, The Third Military Medical University, Chongqing, China.
authors.forename: P C
authors.initials: PC
authors.lastname: Huang
authors.affiliation: Department of Pain Medicine, Daping Hospital & Research Institute of Surgery, The Third Military Medical University, Chongqing, China.
authors.forename: W C
authors.initials: WC
authors.lastname: Wang
authors.affiliation: Department of Pain Medicine, Daping Hospital & Research Institute of Surgery, The Third Military Medical University, Chongqing, China.
authors.forename: S L
authors.initials: SL
authors.lastname: Li
authors.affiliation: Department of Pain Medicine, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China.
authors.forename: J S
authors.initials: JS
authors.lastname: Wang
authors.affiliation: Institute for Biomedical Sciences of Pain, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.affiliation: Key Laboratory of Cognition and Personality (Ministry of Education) and School of Psychology, Southwest University, Chongqing, China.|CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Hu
mesh_terms: D000368:Aged; D005260:Female; D014645:Herpesvirus 3, Human; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012720:Severity of Illness Index