Brain perfusion asymmetry in patients with oral somatic delusions.
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 (99m)Tc-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.
Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan. yume.ompm@tmd.ac.jp
Yojiro
Y
Umezaki
Ayano
A
Katagiri
Motoko
M
Watanabe
Miho
M
Takenoshita
Tomomi
T
Sakuma
Emi
E
Sako
Yusuke
Y
Sato
Akira
A
Toriihara
Akihito
A
Uezato
Hitoshi
H
Shibuya
Toru
T
Nishikawa
Haruhiko
H
Motomura
Akira
A
Toyofuku
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003702:Delusions / Q000000981:diagnostic imaging* / Q000523:psychology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006212:Hallucinations / Q000000981:diagnostic imaging* / Q000523:psychology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009055:Mouth; D015899:Tomography, Emission-Computed, Single-Photon