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Clinical Characteristics of Predominantly Unilateral Oral Cenesthopathy With and Without Neurovascular Contact

Oral cenesthopathy (OC) is characterized by unusual oral discomfort without corresponding evidence, and it has often been categorized as “delusional disorder, somatic type”. Regarding possible causative factors of OC, involvement of neurovascular contact (NVC) of the trigeminal nerve, which transmit...

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Autores principales: Watanabe, Kazuya, Watanabe, Motoko, Takao, Chihiro, Hong, Chaoli, Liu, Zhenyan, Suga, Takayuki, Tu, Trang Thi Huyen, Sakamoto, Junichiro, Umezaki, Yojiro, Yoshikawa, Tatsuya, Takenoshita, Miho, Uezato, Akihito, Motomura, Haruhiko, Kurabayashi, Tohru, Abiko, Yoshihiro, Toyofuku, Akira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488299/
https://www.ncbi.nlm.nih.gov/pubmed/34616358
http://dx.doi.org/10.3389/fneur.2021.744561
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author Watanabe, Kazuya
Watanabe, Motoko
Takao, Chihiro
Hong, Chaoli
Liu, Zhenyan
Suga, Takayuki
Tu, Trang Thi Huyen
Sakamoto, Junichiro
Umezaki, Yojiro
Yoshikawa, Tatsuya
Takenoshita, Miho
Uezato, Akihito
Motomura, Haruhiko
Kurabayashi, Tohru
Abiko, Yoshihiro
Toyofuku, Akira
author_facet Watanabe, Kazuya
Watanabe, Motoko
Takao, Chihiro
Hong, Chaoli
Liu, Zhenyan
Suga, Takayuki
Tu, Trang Thi Huyen
Sakamoto, Junichiro
Umezaki, Yojiro
Yoshikawa, Tatsuya
Takenoshita, Miho
Uezato, Akihito
Motomura, Haruhiko
Kurabayashi, Tohru
Abiko, Yoshihiro
Toyofuku, Akira
author_sort Watanabe, Kazuya
collection PubMed
description Oral cenesthopathy (OC) is characterized by unusual oral discomfort without corresponding evidence, and it has often been categorized as “delusional disorder, somatic type”. Regarding possible causative factors of OC, involvement of neurovascular contact (NVC) of the trigeminal nerve, which transmits not only pain but also thermal, tactile, and pressure sensations, has never been observed yet. This study aimed to investigate the relationship between clinical characteristics of unilateral OC and the presence of trigeminal nerve NVC. This is a retrospective comparative study that involved 48 patients having predominantly unilateral OC who visited the Psychosomatic Dentistry Clinic of Tokyo Medical and Dental University between April 2016 and February 2019. Magnetic resonance imaging was performed to assess NVC presence. The Oral Dysesthesia Rating Scale (Oral DRS) was used to assess the various oral sensations and functional impairments besides psychometric questionnaires. Clinical characteristics were retrospectively obtained from the patients' medical charts. NVC was present in 45.8% (22/48) of the patients. There was no significant difference in sex, age, psychiatric history, oral psychosomatic comorbidity, and psychometric questionnaire scores between patients with and without NVC. However, compared to the patients with NVC, the patients without NVC had significantly higher scores for overall subjective severity of OC symptoms (p = 0.008). Moreover, patients having predominantly unilateral OC without NVC showed significantly higher scores in symptom severity and functional impairment of the following parameters: movement (p = 0.030), work (p = 0.004), and social activities (p = 0.010). In addition, compared with the patients with NVC, the patients without NVC showed significantly higher averages of the total symptom severity scale (SSS) and functional impairment scale (FIS) scores in the Oral DRS (p = 0.015 and p = 0.031, respectively). Furthermore, compared with the patients with NVC, the patients without NVC had significantly higher numbers of corresponding symptoms in both the SSS and FIS (p = 0.041 and p = 0.007, respectively). While NVC may be involved in the indescribable subtle OC symptoms, more complex mechanisms may also exist in OC patients without NVC, which yield varying and more unbearable oral symptoms.
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spelling pubmed-84882992021-10-05 Clinical Characteristics of Predominantly Unilateral Oral Cenesthopathy With and Without Neurovascular Contact Watanabe, Kazuya Watanabe, Motoko Takao, Chihiro Hong, Chaoli Liu, Zhenyan Suga, Takayuki Tu, Trang Thi Huyen Sakamoto, Junichiro Umezaki, Yojiro Yoshikawa, Tatsuya Takenoshita, Miho Uezato, Akihito Motomura, Haruhiko Kurabayashi, Tohru Abiko, Yoshihiro Toyofuku, Akira Front Neurol Neurology Oral cenesthopathy (OC) is characterized by unusual oral discomfort without corresponding evidence, and it has often been categorized as “delusional disorder, somatic type”. Regarding possible causative factors of OC, involvement of neurovascular contact (NVC) of the trigeminal nerve, which transmits not only pain but also thermal, tactile, and pressure sensations, has never been observed yet. This study aimed to investigate the relationship between clinical characteristics of unilateral OC and the presence of trigeminal nerve NVC. This is a retrospective comparative study that involved 48 patients having predominantly unilateral OC who visited the Psychosomatic Dentistry Clinic of Tokyo Medical and Dental University between April 2016 and February 2019. Magnetic resonance imaging was performed to assess NVC presence. The Oral Dysesthesia Rating Scale (Oral DRS) was used to assess the various oral sensations and functional impairments besides psychometric questionnaires. Clinical characteristics were retrospectively obtained from the patients' medical charts. NVC was present in 45.8% (22/48) of the patients. There was no significant difference in sex, age, psychiatric history, oral psychosomatic comorbidity, and psychometric questionnaire scores between patients with and without NVC. However, compared to the patients with NVC, the patients without NVC had significantly higher scores for overall subjective severity of OC symptoms (p = 0.008). Moreover, patients having predominantly unilateral OC without NVC showed significantly higher scores in symptom severity and functional impairment of the following parameters: movement (p = 0.030), work (p = 0.004), and social activities (p = 0.010). In addition, compared with the patients with NVC, the patients without NVC showed significantly higher averages of the total symptom severity scale (SSS) and functional impairment scale (FIS) scores in the Oral DRS (p = 0.015 and p = 0.031, respectively). Furthermore, compared with the patients with NVC, the patients without NVC had significantly higher numbers of corresponding symptoms in both the SSS and FIS (p = 0.041 and p = 0.007, respectively). While NVC may be involved in the indescribable subtle OC symptoms, more complex mechanisms may also exist in OC patients without NVC, which yield varying and more unbearable oral symptoms. Frontiers Media S.A. 2021-09-20 /pmc/articles/PMC8488299/ /pubmed/34616358 http://dx.doi.org/10.3389/fneur.2021.744561 Text en Copyright © 2021 Watanabe, Watanabe, Takao, Hong, Liu, Suga, Tu, Sakamoto, Umezaki, Yoshikawa, Takenoshita, Uezato, Motomura, Kurabayashi, Abiko and Toyofuku. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Watanabe, Kazuya
Watanabe, Motoko
Takao, Chihiro
Hong, Chaoli
Liu, Zhenyan
Suga, Takayuki
Tu, Trang Thi Huyen
Sakamoto, Junichiro
Umezaki, Yojiro
Yoshikawa, Tatsuya
Takenoshita, Miho
Uezato, Akihito
Motomura, Haruhiko
Kurabayashi, Tohru
Abiko, Yoshihiro
Toyofuku, Akira
Clinical Characteristics of Predominantly Unilateral Oral Cenesthopathy With and Without Neurovascular Contact
title Clinical Characteristics of Predominantly Unilateral Oral Cenesthopathy With and Without Neurovascular Contact
title_full Clinical Characteristics of Predominantly Unilateral Oral Cenesthopathy With and Without Neurovascular Contact
title_fullStr Clinical Characteristics of Predominantly Unilateral Oral Cenesthopathy With and Without Neurovascular Contact
title_full_unstemmed Clinical Characteristics of Predominantly Unilateral Oral Cenesthopathy With and Without Neurovascular Contact
title_short Clinical Characteristics of Predominantly Unilateral Oral Cenesthopathy With and Without Neurovascular Contact
title_sort clinical characteristics of predominantly unilateral oral cenesthopathy with and without neurovascular contact
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488299/
https://www.ncbi.nlm.nih.gov/pubmed/34616358
http://dx.doi.org/10.3389/fneur.2021.744561
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