Comparison of cerebral blood flow in oral somatic delusion in patients with and without a history of depression: a comparative case series

BMC Psychiatry

Akira Toyofuku²  Haruhiko Motomura²  Toru Nishikawa¹  Akihito Uezato¹  Akira Toriihara³  Miho Takenoshita²  Ayano Katagiri²  Chisa Shitano⁴  Tomomi Sakuma⁴  Tatsuya Yoshikawa⁴  Yukiko Shinohara²  Anna Miura²  Yojiro Umezaki²  Motoko Watanabe² 

[1] Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku 113-8519, Tokyo, Japan;Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku 113-8549, Tokyo, Japan;Department of Diagnostic Radiology and Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku 113-8519, Tokyo, Japan;Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, 1-5-45 Yushima, Bunkyo-ku 113-8549, Tokyo, Japan

关键词: Temporal region;    SPECT;    Remitted depression;    Oral somatic delusion;    Delusional disorder somatic type;    Brain perfusion;   

Others  :  1137833
DOI  :  10.1186/s12888-015-0422-0

 received in 2014-11-20, accepted in 2015-02-19,  发布年份 2015

【 摘 要 】

Background

A significant number of patients visit dental clinics because of unusual oral sensations for which no physical cause can be found. Such patients are recognized as having oral somatic delusion (OSD). OSD may be either primary (monosymptomatic) or secondary to another disease, such as depression or cerebral infarction. Although the presenting complaints of patients with primary and secondary OSD are nearly indistinguishable, symptoms in patients with secondary OSD seem to be resistant to treatment compared with those in patients with primary OSD. Moreover, right dominant cerebral blood flow (CBF) has been reported in patients with primary OSD, but the difference in CBF between patients with primary and secondary OSD remains unclear. The aim of this study was to assess the differences in clinical characteristics and CBF distribution between patients with monosymptomatic OSD (non-depression group) and OSD in conjunction with remitted depression (depression group).

Methods

Participants were 27 patients of a psychosomatic dentistry clinic, all diagnosed with OSD. They were categorized into either the non-depression group (17 patients) or the depression group (10 patients) on the basis of assessments by their personal medical providers. CBF was examined using single-photon emission computed tomography.

Results

There was no difference in clinical presentation between the two groups. A significant right dominant asymmetry in the temporal and posterior cerebral regions was observed in both groups. In the central region, a right dominance was seen in the non-depression group, while a left dominance was seen in the depression group. Moreover, the mean regional CBF values for patients in the depression group were significantly lower in several regions (including bilateral callosomarginal, precentral, angular, temporal, posterior cerebral, pericallosal, lenticular nucleus, thalamus, and hippocampus; and right central and cerebellum) than for patients in the non-depression group.

Conclusion

These results suggest that the temporal and posterior cerebral regions are involved in in the pathophysiology of OSD, regardless of depression history, and that widespread CBF reduction is a characteristic of remitted depression.

【 授权许可】

   
2015 Watanabe et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 1.

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