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. 2024 Sep 14;14(1):21476.
doi: 10.1038/s41598-024-69973-5.

The neuroscience of itch in relation to transdiagnostic psychological approaches

Affiliations

The neuroscience of itch in relation to transdiagnostic psychological approaches

Jeffrey J Kim et al. Sci Rep. .

Abstract

The experience of itch and its associated chronic conditions (i.e., atopic dermatitis) form a significant burden of disease. Knowledge of how the brain processes itch, that might occur uniquely for chronic itch populations, could be used to guide more effective psychotherapeutic interventions for these groups. To build the evidence base for such approaches, we conducted a series of coordinates-based fMRI analyses, to identify the shared neural mechanisms for itch across the published literature. Upon so doing, we identified a core "itch network" that spans the Basal Ganglia/Thalamus, Claustrum and Insula. Additionally, we found evidence that the Paracentral Lobule and Medial Frontal Gyrus, regions associated with cognitive control and response inhibition, deactivate during itch. Interestingly, a separate analysis for chronic itch populations identified significant recruitment of the Left Paracentral Lobule, potentially suggesting the recruitment of cognitive control mechanisms to resist the urge to scratch. We position these results in light of further integrative studies that could use neuroimaging alongside clinical studies, to explore how transdiagnostic psychological approaches-such as mindfulness and compassion training-might help to improve quality of life for individuals who experience chronic itch.

Keywords: CBT; Compassion; Itch; Mindfulness; fMRI.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Shared Brain Regions for Itch across Published fMRI Studies. This figure demonstrates significant shared activation and deactivation associated with itch. Figure legend indicates ALE activation map (orange) and ALE deactivation map (green). Colour bar indicates the Activation-Likelihood Estimate (ALE) test-statistic, which is the degree of convergence of activation across multiple studies within a given voxel. (a) These clusters show significant activation across Bilateral Thalamus and Basal Ganglia circuits, including Putamen. (b) These clusters show significant deactivations in Medial Frontal Gyrus and Paracentral Lobule. (c) This cluster shows significant activation across Basal Ganglia/Thalamus extending through the midbrain. (d) These clusters show activation across Bilateral Insula and Inferior Frontal Gyri, as well as Left Thalamus. These ALE maps were corrected at a cluster-level threshold of FWE, p < .05, with a voxel-level forming threshold at p < .001, uncorrected.
Figure 2
Figure 2
Brain Regions for Itch as a Function of Participant Groups. This figure demonstrates significant brain activation associated with itch across healthy participants and clinical groups. Figure legend indicates ALE map for healthy participants (blue) and ALE map for clinical groups (gold). Colour bar indicates the Activation-Likelihood Estimate (ALE) test-statistic, which is the degree of convergence of activation across multiple studies within a given voxel. Across both axial (a) and coronal (b) images, significant activation across Thalamus and Basal Ganglia circuits were observed for healthy participants, as opposed to activation of the Paracentral Lobule for clinical groups (a, b). These ALE maps were corrected at a cluster-level threshold of FWE, p < .05, with a voxel-level forming threshold at p < .001, uncorrected.

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