Improvement of Asymmetrical Temporal Blood Flow in Refractory Oral Somatic Delusion After Successful Electroconvulsive Therapy

Uezato, Akihito; Yamamoto, Naoki; Kurumaji, Akeo; Toriihara, Akira; Umezaki, Yojiro; Toyofuku, Akira; Nishikawa, Toru

doi:10.1097/yct.0b013e31822e581e

Cited by 16 publications

(24 citation statements)

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“…The patient group was composed mainly of elderly women. The sex and age distributions, shown in this table, were consistent with those in our previous paper [33]. The patients’ chief complaints (for example, sticky saliva or bubbles flowing behind their dentures or wires for the mandibular incisors when removing dentures) were strange, bizarre, and hard to empathize with.…”

Section: Resultssupporting

confidence: 88%

“…Recently, we also reported a patient with oral cenesthopathy in whom hyperperfusion in the right relative to the left temporal lobe improved after mECT, in parallel with alleviation of the clinical symptoms [33]. Irrespective of whether right-side hyperperfusion or left-side hypoperfusion exists, a predominant asymmetry in the right side compared with the other side of the rCBF that is attenuated by subsequent successful treatment may be a common characteristic of these previous reports.…”

Section: Discussionmentioning

confidence: 70%

“…We also previously reported a case of oral cenesthopathy in which a rightward asymmetry of blood flow in the temporal area of the brain disappeared after mECT [33]. …”

Section: Introductionmentioning

confidence: 99%

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Brain perfusion asymmetry in patients with oral somatic delusions

Umezaki

Katagiri

Watanabe

et al. 2013

Eur Arch Psychiatry Clin Neurosci

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Oral cenesthopathy is a somatic delusion or hallucination involving the oral area and is categorized as a delusional disorder, somatic type. The pathophysiology of this intractable condition remains obscure. In this study, we clarified the pathophysiology of oral cenesthopathy by evaluating regional brain perfusion. We performed single photon emission computed tomography (SPECT) using 99mTc-ethylcysteinate dimer in 16 subjects (cenesthopathy:control = 8:8). The SPECT images were visually assessed qualitatively, and quantitative analyses were also performed using a three-dimensional stereotactic region-of-interest template. The visual assessment revealed a right > left perfusion asymmetry in broad areas of the brain among the patients. The quantitative analysis confirmed that the regional cerebral blood flow values on the right side were significantly larger than those on the left side for most areas of the brain in the patients. A comparison of the R/(R + L) ratios in both groups confirmed the significant brain perfusion asymmetry between the two sides in the callosomarginal, precentral, and temporal regions in the patients. Qualitative evaluation of the SPECT images revealed right > left brain perfusion asymmetry in broad regions of the brain. Moreover, the quantitative analyses confirmed the perfusion asymmetry between the two sides in the frontal and temporal areas. Those may provide the key for elucidation of the pathophysiology of oral cenesthopathy.

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Section: Resultssupporting

confidence: 88%

Section: Discussionmentioning

confidence: 70%

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Brain perfusion asymmetry in patients with oral somatic delusions

Umezaki

Katagiri

Watanabe

et al. 2013

Eur Arch Psychiatry Clin Neurosci

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“…10 In the present cases, we found similar rCBF change to former case reports regardless of treatment method. It suggests that the rCBF change might be an objective therapeutic indicator for oral cenesthopathy.…”

Section: Discussionsupporting

confidence: 91%

Two Cases of Oral Somatic Delusions Ameliorated With Brain Perfusion Asymmetry: A Case Report

Umezaki¹,

Uezato²,

Toriihara³

et al. 2017

Clin Neuropharm

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BackgroundOral cenesthopathy is the complaint of abnormal oral sensation where no underlying organic cause can be identified. It is also called oral dysesthesia or oral somatic delusion and classified as delusional disorder, somatic type. The patients with oral cenesthopathy show right > left asymmetric regional cerebral blood flow (rCBF) in the broad brain region. However, the studies scrutinizing the rCBF change before and after the successful treatment are still a few so far.CaseWe present 2 cases of oral cenesthopathy, who responded well to aripiprazole. The asymmetric rCBF patterns were attenuated after successful treatment in both cases.ConclusionsWe found a marked improvement of oral cenesthopathy with aripiprazole. It is suggested that right > left rCBF asymmetry in the frontal and temporal lobes and thalamus, and the dopaminergic and serotonergic dysfunctions are involved in the pathology of oral cenesthopathy.

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“…The concept of oral dysesthesia overlaps with that of medically unexplained oral symptoms/syndromes and complex oral sensitivity disorder , and includes so‐called oral cenesthopathy , burning mouth syndrome, atypical odontalgia, phantom bite syndrome, occlusal discomfort syndrome , formication, somatic symptom disorders, and somatic‐type delusional disorder affecting oral regions . Although several reports point to the etiology of oral dysesthesia and possible treatments , these are far from established. Therefore, oral dysesthesia often causes extreme frustration for both patients and health‐care providers, sometimes resulting in unfortunate struggles and discord between them .…”

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confidence: 99%

Oral dysesthesia associated with autistic traits: a retrospective chart review

Uezato

Toyofuku

Umezaki

et al. 2019

European J Oral Sciences

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Oral dysesthesia denotes a condition characterized by abnormal sensations in oral regions without a somatic basis, and is often seen in people with autistic traits, including those with autism spectrum disorder. This study aimed to examine the association between the symptoms of oral dysesthesia and the degree of autistic traits. A retrospective chart review was performed on 44 patients with oral dysesthesia, and associations among the subscales of the Oral Dysesthesia Rating Scale (Oral DRS), Autism Spectrum Quotient (AQ), and Glasgow Sensory Questionnaire (GSQ) were investigated. A Pearson correlation analysis revealed a significant, positive correlation between AQ scores and the A3 (squeezing or pulling) subscale of the Oral DRS (r = 0.37), but there were no significant correlations between the AQ and other subscale scores. There was a significant correlation between the AQ and GSQ score, but no correlation was detected between the GSQ and A3 scores or any other Oral DRS subscale scores. In conclusion, an abnormal squeezing or pulling sensation in oral regions without a somatic basis was associated with autistic traits and could be highlighted as a specific abnormality in sensory processing in autism spectrum disorder.

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Improvement of Asymmetrical Temporal Blood Flow in Refractory Oral Somatic Delusion After Successful Electroconvulsive Therapy

Cited by 16 publications

References 0 publications

Brain perfusion asymmetry in patients with oral somatic delusions

Brain perfusion asymmetry in patients with oral somatic delusions

Two Cases of Oral Somatic Delusions Ameliorated With Brain Perfusion Asymmetry: A Case Report

Oral dysesthesia associated with autistic traits: a retrospective chart review

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