Chronic Itch-Scratch Behaviour is a Cognitive Phenomenon Mediated through Neuroendocrine Receptors
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 11, Issue 5
Abstract
Objectives: Chronic itch is a common and severe debilitating disease in our population with a significant health burden. Pharmacological treatments despite widely used has not been satisfactory especially in managing anxiety and stress. Identification of a specific itch pathway involving the brain and its cognitive domains and functional anatomy provide opportunities to develop effective, non-invasive man machine devices to rehabilitate chronic pruritic dermatosis. In the following article, evidences and details of the chronic itch scratch cognitive pathways will be presented. A method devised to distract pruritic patients during scratching behaviour through analysing the electromyographic (EMG) signals from muscle sensors to predict the itch gesture. With the assistance of Apps functions; non-invasive signals like melody, music or virtual reality will be broadcasted and feedback in a timely manner.Chronic pruritus is a distressing condition occurs both in childhood and adult with a prevalence between 8 to 38% of the population [1]. Scratching adversely affect a person’s quality of life; sleep pattern, work concentration and social functions [2,3]. Stress, anxiety and depression may induce itch and vice versa [4, 5]. Chronic atopic dermatitis (AD), prurigo nodularis (PN), dermatitis artefacta (DA), psoriasis and uraemia are chronic dermatosis resistant to conventional therapy and diseases relapses are frequently seen. It constitutes a significant disease burden to health care system and community. Side effects of systemic medications are not uncommon and newer anti-inflammatory biologics are costly. The emergence of methicillin resistant Staphylococcus aureus (MRSA) complicated the management and further limit the present treatment protocol. There is a pressing need to formulate a more holistic, efficacious, non-invasive integrated approach to the management of chronic scratching. Advances in neuroscience provides important data to the existence of a specific itchy anatomical pathway comprising not only in the periphery; the skin but also the central nervous system (CNS) with its cognitive domains and anatomy [6].The discoveries of itch specific neurones and the elucidation of such itch scratch cognitive behavioural pathway give insights and basis to develop newer psycho behaviour therapy involving man-machine interaction and artificial intelligence (AI). Achieving this may enable the person to rehabilitate to their normal physiological function of the sensation of itch and help restoring their normal body epidermal barrier function and immune status. The objectives of this article are to evaluate a possible central itch transmission anatomical functional pathway in human body relevant in chronic pruritic dermatosis based on Medline search and also to discuss possible non-pharmacological intervention strategies based on brain behaviour relationship.
Authors and Affiliations
Chan Kam Tim Michael, Tong Kwun Wah, Hiu Kim Yuen
Keywords
Related Articles
- EP ID EP592717
- DOI 10.26717/BJSTR.2018.11.002170
- Views 167
- Downloads 0
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