Liu J, et al. - Researchers measured brain alterations in patients with herpes zoster (HZ) and postherpetic neuralgia (PHN). In addition, they compared their differences using a voxel-based morphometry (VBM) technique. They recruited 33 patients with HZ, 22 patients with PHN, and 28 well-matched healthy controls (HCs). Compared with HCs, the HZ group displayed decreased gray matter volume (GMV) in the bilateral insular lobes and increased GMV in the bilateral thalamus. The PHN group displayed GMV decrease in the bilateral insula lobes, right middle frontal gyrus, bilateral precentral gyrus, and left postcentral gyrus and GMV increase in the left cerebellar posterior lobe, right parahippocampal gyrus, and right lentiform nucleus. These observations suggest broader abnormalities in nonpain-related regions in the brains of PHN patients, suggesting the complexity of a central mechanism. On comparing PHN patients with HZ patients, the left cerebellar tonsil, culmen, and left lentiform nucleus corresponded to greater area under the curve. This suggests that abnormalities in these regions are risk factors for HZ patients’ transformation to PHN.