ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Neuroimaging
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1653444
Alleviation of Symptoms and Paradoxical Brain Perfusion Shift in Oral Cenesthopathy: A Retrospective Neuroimaging Study
Provisionally accepted
- 1Fukuoka Dental College, Sawara, Japan
- 2Fukuoka Daigaku, Fukuoka, Japan
- 3Tokyo Kagaku Daigaku - Yushima Campus, Bunkyo, Japan
- 4University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Oral cenesthopathy is characterized by abnormal, distressing oral sensations without identifiable physiological or pathological causes. Right side predominant regional cerebral blood flow (rCBF) asymmetry in the broad brain area is suggested as pathophysiology of oral cenesthopathy. Coping behaviors, which provide temporary symptom relief, are sometimes employed by patients, but their effect on brain function is unclear. This study aims to examine changes in rCBF associated with coping behaviors.[Methods]Seven patients with oral cenesthopathy were included in this study. Each patient underwent two single photon emission computed tomography (SPECT) scans: one during the state of discomfort (at steady state) and another after performing coping behaviors. SPECT data were analyzed using threedimensional stereotactic regions of interest template, and Fine stereotactic regions of interest template.[Results] At the steady state, right-side rCBF predominated in several brain regions, including the temporal lobe, without significant difference. During coping behaviors, this right-sided rCBF asymmetry was amplified, and showed significant differences, including the fusiform, lingual and parahippocampal gyri. These regions, associated with visual processing, suggest that oral cenesthopathy may involve more than just somatosensory dysfunction.Coping behaviors in oral cenesthopathy were associated with amplified right-sided rCBF asymmetry. This finding challenges the expectation that symptom alleviation would reduce rCBF asymmetry. It may suggest that the coping behavior of the patients with oral cenesthopathy is potentially amplifying asymmetry especially in the higher visual processing to adapt to their symptoms.
Keywords: Oral cenesthopathy, Oral dysesthesia, Oral somatic delusions, cerebral blood flow, Single Photon Emission Computed Tomography, coping behavior
Received: 25 Jun 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 Umezaki, Motomura, Nagamachi, Toyofuku, Tu and Naito. 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) or licensor 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.
* Correspondence: Yojiro Umezaki, Fukuoka Dental College, Sawara, Japan
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