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. 2024 May 25;13(11):3100.
doi: 10.3390/jcm13113100.

Association of Psoas: Lumbar Vertebral Index (PLVI) with Postherpetic Neuralgia in Patients Aged 60 and Older with Herpes Zoster

Sang-Mee An  1   2 , Ji Seon Chae  1   2 , Hyun Jung Lee  1   2 , Sooyoung Cho  2   3 , Jiwoong Im  3
Affiliations

Association of Psoas: Lumbar Vertebral Index (PLVI) with Postherpetic Neuralgia in Patients Aged 60 and Older with Herpes Zoster

Sang-Mee An et al. J Clin Med. .

Abstract

Background/Objectives: The psoas: lumbar vertebral index (PLVI) is a simple and convenient measure to assess central sarcopenia. Recent studies have utilized the psoas area to indirectly assess sarcopenia and frailty, exploring their associations with various health outcomes. This study aims to investigate the relationship between the PLVI and postherpetic neuralgia (PHN) in patients aged 60 years and above following a herpes zoster (HZ) infection. Methods: We conducted a retrospective analysis of data from 351 patients (≥60 years) who developed HZ between January 2019 and December 2023; the patients were divided into two groups based on the presence or absence of PHN after HZ onset. Results: The analyses using receiver operating characteristic curves revealed a value for the area under the curve of 0.813 for PLVI and 0.769 for the modified frailty index (mFI). In a multivariate logistic regression analysis, numerical rating scale scoring, a low PLVI, and a greater number of categorical mFI variables (adjusted odds ratio: 1.30, 3.27, and 2.46, respectively) were found to be significant independent predictors of PHN. Conclusions: Our findings highlight the association between a low PLVI and PHN in an older population. The PLVI may have potential as a predictive tool for PHN in older patients with HZ, but further research is needed to confirm these results.

Keywords: frailty; herpes zoster; older adults; postherpetic neuralgia; psoas: lumbar vertebral index; sarcopenia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study flowchart. CT, computed tomography; HZ, herpes zoster; MRI, magnetic resonance imaging; PHN, postherpetic neuralgia.
Figure 2
Figure 2
Representative cross-sectional (A) and sagittal (B) MRI images. Measurement of the right and left psoas muscle areas (outlined in yellow) and vertebral body area (outlined in orange) at the L4 level. Cross-sectional image was obtained at the level of the dashed line in (B). (C,D) Representative cross-sectional and sagittal abdominopelvic CT images, respectively. Measurement of the right and left psoas muscle areas (outlined in yellow) and vertebral body area (outlined in orange) at the L4 level. Cross-sectional image was obtained at the level of the dashed line in (D). CT, computed tomography; MRI, magnetic resonance imaging.
Figure 3
Figure 3
Box plots showing the distribution of the values for the psoas–lumbar vertebral index (PLVI) in the non-PHN and PHN groups in men (A) and women (B). Top-to-bottom data next to each box plot indicate the maximum, upper quartile, median, lower quartile, and minimum values of PLVI. PHN, postherpetic neuralgia. * p values were calculated using t-test.
Figure 4
Figure 4
Receiver-operating characteristic curves for predicting PHN using (A) PLVI and (B) mFI score. AUC; area under the curve; PHN, postherpetic neuralgia; PLVI, psoas: lumbar vertebral index; mFI, modified frailty index.
See this image and copyright information in PMC

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