ABSTRACT
Cognitive behavioral therapy (CBT) is believed to be an effective treatment for chronic pain due to its association with cognitive and emotional factors. Nevertheless, there is a paucity of magnetoencephalography (MEG) investigations elucidating its underlying mechanisms. This study investigated the neurophysiological effects of CBT employing MEG and analytical techniques. We administered resting-state MEG scans to 30 patients with chronic pain and 31 age-matched healthy controls. Patients engaged in a 12-session group CBT program. We conducted pretreatment (T1) and post-treatment (T2) MEG and clinical assessments. MEG data were examined within predefined regions of interest, guided by the authors' and others' prior magnetic resonance imaging studies. Initially, we selected regions displaying significant changes in power spectral density and multiscale entropy between patients at T1 and healthy controls. Then, we examined the changes within these regions after conducting CBT. Furthermore, we applied support vector machine analysis to MEG data to assess the potential for classifying treatment effects. We observed normalization of power in the gamma2 band (61-90 Hz) within the right inferior frontal gyrus (IFG) and multiscale entropy within the right dorsolateral prefrontal cortex (DLPFC) of patients with chronic pain after CBT. Notably, changes in pain intensity before and after CBT positively correlated with the alterations of multiscale entropy. Importantly, responders predicted by the support vector machine classifier had significantly higher treatment improvement rates than nonresponders. These findings underscore the pivotal role of the right IFG and DLPFC in ameliorating pain intensity through CBT. Further accumulation of evidence is essential for future applications. PERSPECTIVE: We conducted MEG scans on 30 patients with chronic pain before and after a CBT program, comparing results with 31 healthy individuals. There were CBT-related changes in the right IFG and DLPFC. These results highlight the importance of specific brain regions in pain reduction through CBT.
Subject(s)
Pemphigus , Pregnancy , Female , Humans , Pemphigus/diagnosis , Pemphigus/drug therapy , Blister/etiologySubject(s)
Churg-Strauss Syndrome , Granulomatosis with Polyangiitis , Humans , Churg-Strauss Syndrome/complications , Churg-Strauss Syndrome/diagnosis , Churg-Strauss Syndrome/drug therapy , Granulomatosis with Polyangiitis/diagnosis , Granulomatosis with Polyangiitis/diagnostic imaging , Immunosuppressive Agents , Granuloma/diagnostic imagingSubject(s)
Diabetes Mellitus, Type 2 , Dipeptidyl-Peptidase IV Inhibitors , Pemphigoid, Bullous , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Dipeptidyl-Peptidase IV Inhibitors/adverse effects , Dipeptidyl-Peptidases and Tripeptidyl-Peptidases , Humans , Hypoglycemic Agents , Pemphigoid, Bullous/chemically induced , Pemphigoid, Bullous/complicationsABSTRACT
The cutaneous manifestations of subacute cutaneous lupus erythematosus (SCLE), a subset of cutaneous lupus erythematosus, arise most often in sun-exposed areas. We report a case of SCLE with atypical distribution, following treatment with amlodipine. This highlighted a possible clue that can be used to clinically distinguish a drug-induced case from an idiopathic disorder. A 92-year-old Japanese woman presented with a 2-month history of progressive erythematous, papulosquamous rash, and annular plaques in non-sun-exposed sites with no systemic symptoms. Irbesartan/amlodipine besilate combination tablets were prescribed 8 months earlier for hypertension. The appearance of the skin eruptions, results of immunopathological findings, and temporal relationship between the rash and drugs were suggestive of a diagnosis of drug-induced SCLE, which was confirmed by the spontaneous resolution of these cutaneous eruptions within 4 weeks after cessation of amlodipine treatment. The evaluation of possible associations with medications should be performed in patients presenting with clinical features characterizing SCLE in atypical sites (non-sun-exposed areas).
Subject(s)
Air Pollutants/adverse effects , Catechols/adverse effects , Dermatitis, Allergic Contact/etiology , Lacquer/adverse effects , Adrenal Cortex Hormones/therapeutic use , Dermatitis, Allergic Contact/drug therapy , Dermatitis, Allergic Contact/pathology , Histamine Antagonists/therapeutic use , Humans , Male , Middle AgedSubject(s)
Angioedema , Eosinophilia , Aged , Angioedema/complications , Angioedema/diagnosis , Eosinophilia/complications , Eosinophilia/diagnosis , HumansABSTRACT
We report a case of ulcerative lupus vulgaris (LV) in a unique site, which facilitated the detection of internal organ tuberculosis (TB). A 68-year-old Japanese man presented with a reddish ulcerated painless lesion on his right wrist that had initially appeared 4 weeks earlier as a nontender nodule. There was no recent history of fever, weight loss, or cough. The results of tissue culture, PCR, and contrast-enhanced chest computed tomography were consistent with the diagnosis of ulcerative LV with underlying pulmonary TB and tuberculous lymphadenitis. The patient was started on anti-TB therapy. After 1 month of therapy, epithelialization of the ulcer was noted.
