Central effects of short-term spinal cord stimulation in postherpetic neuralgia: a longitudinal fMRI and DTI study

These findings suggest that stSCS's early clinical benefits in PHN are mediated by rapid functional reorganization rather than immediate microstructural changes. This reorganization appears prominent within fronto-striatal circuits: specifically, mOFC functional changes correlate with analgesia, while baseline cingulum integrity predicts subsequent striatal plasticity. This provides initial mechanistic insights into stSCS and suggest that baseline brain structure could be explored as a potential biomarker for treatment response, warranting validation in larger, controlled cohorts.