title: Comparison of cerebral blood flow in oral somatic delusion in patients with and without a history of depression: a comparative case series.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. totoompm@tmd.ac.jp.
authors.forename: Motoko
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of 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.
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Umezaki
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. annaompm@tmd.ac.jp.
authors.forename: Anna
authors.initials: A
authors.lastname: Miura
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. yshinohara.ompm@tmd.ac.jp.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Shinohara
authors.affiliation: Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. tyoshi.ompm@tmd.ac.jp.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. tomoz08.ompm@tmd.ac.jp.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Sakuma
authors.affiliation: Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. shitano.orts@tmd.ac.jp.
authors.forename: Chisa
authors.initials: C
authors.lastname: Shitano
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. a.katagiri.ompm@tmd.ac.jp.
authors.forename: Ayano
authors.initials: A
authors.lastname: Katagiri
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. takenoshita.ompm@tmd.ac.jp.
authors.forename: Miho
authors.initials: M
authors.lastname: Takenoshita
authors.affiliation: Department of Diagnostic Radiology and Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. trihmrad@tmd.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Toriihara
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. uezapsyc@tmd.ac.jp.
authors.forename: Akihito
authors.initials: A
authors.lastname: Uezato
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. tnis.psyc@tmd.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Nishikawa
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. haruompm@tmd.ac.jp.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Motomura
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan. toyoompm@tmd.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Toyofuku
mesh_terms: D000328:Adult; D000368:Aged; D002531:Cerebellum / Q000098:blood supply; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003702:Delusions / Q000503:physiopathology*; D003866:Depressive Disorder / Q000503:physiopathology*; D005260:Female; D006624:Hippocampus / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D012678:Sensation Disorders / Q000503:physiopathology*; D013001:Somatoform Disorders / Q000503:physiopathology*; D009057:Stomatognathic Diseases / Q000503:physiopathology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods