{"id":152292,"date":"2024-03-05T14:35:29","date_gmt":"2024-03-05T19:35:29","guid":{"rendered":"https:\/\/effectsofanxiety.net\/archives\/152292"},"modified":"2024-03-05T14:35:29","modified_gmt":"2024-03-05T19:35:29","slug":"sjogrens-syndrome-affects-the-brain-and-spine","status":"publish","type":"post","link":"https:\/\/effectsofanxiety.net\/archives\/152292","title":{"rendered":"Sjogren’s Syndrome Affects the Brain and Spine"},"content":{"rendered":"
https:\/\/www.youtube.com\/watch?v=ia3jGVzg3CY<\/div>Did you hear about Sjogren’s syndrome\u00a0 affecting your brain and your spine\u00a0\u00a0 today we’re gonna talk about how this syndrome\u00a0 sjogren will affect your central nervous system\u00a0\u00a0 so if you’re newly diagnosed with sjogran or if\u00a0 you have symptoms related to your brain or to\u00a0\u00a000:00:17<\/a>your spine that you could not understand this\u00a0 might be the cause rheumatologist oncall.com\u00a0\u00a0 when we think about Sjogren’s syndrome we think\u00a0 about sjogren that is primary not necessarily\u00a0\u00a0 caused by a disease or sjogren that is secondary\u00a0 associated with another autoimmune disease such\u00a0\u00a000:00:38<\/a>as lupus rheumatoid arthritis or Scleroderma is\u00a0 this syndrome frequent it is reported that about\u00a0\u00a0 0.1 up to 3 percent of the general population can\u00a0 develop primary Sjogren’s syndrome and females are\u00a0\u00a0 much more affected than males and the ratio that\u00a0 was reported is nine to one that means that nine\u00a0\u00a000:01:02<\/a>female will develop shogron versus only one male\u00a0 and the age of onset or the age when we diagnose\u00a0\u00a0 this disease is between 40 and 60 years now what\u00a0 are the most common signs and symptoms of sugar\u00a0\u00a0 if you want to learn more about sjogren and about\u00a0 the multitude of symptoms that this disease can\u00a0\u00a000:01:24<\/a>cause you can watch this video in my channel\u00a0 now you have to understand that children is\u00a0\u00a0 a systemic disease it’s not going to affect only\u00a0 your eyes or your mouth it can affect your skin it\u00a0\u00a0 can affect your teeth it can affect your stomach\u00a0 it can affect your vessels and it can also affect\u00a0\u00a000:01:48<\/a>your lungs or your kidneys if you look at this\u00a0 whole list of children manifestation you’re gonna\u00a0\u00a0 see that patients with sjogren can develop fatigue\u00a0 fever weight loss can develop joint pain or muscle\u00a0\u00a0 pain they can develop cough because of dryness\u00a0 in their trachea they can develop difficulties\u00a0\u00a000:02:08<\/a>to swallow food again because they lack saliva or\u00a0 they can have urinary tract infections vessels or\u00a0\u00a0 skin involvement but also neurological involvement\u00a0 and that’s we are going to talk about today\u00a0\u00a0 what are the laboratory tests that\u00a0 we order for patients with sugar\u00a0\u00a000:02:29<\/a>we do order a a SSA SSB antibodies chromative\u00a0 Factor anti-centromere antibodies but not all\u00a0\u00a0 patients will have those antibodies present if you\u00a0 look at these numbers only 80 percent of patients\u00a0\u00a0 will have positive DNA only 60 to 80 percent\u00a0 of patients will have a positive SSA or SSB\u00a0\u00a000:02:51<\/a>antibodies and 74 percent of patients will have a\u00a0 rheumatoid Factor present not only patients with\u00a0\u00a0 rheumatoid arthritis but also patients with\u00a0 sjogren have rheumatoid Factor positive there\u00a0\u00a0 are other tests that we do to evaluate dryness\u00a0 dryness of the eyes like Shimmer tests or dryness\u00a0\u00a000:03:12<\/a>of the mouth where we do measure the salivary\u00a0 flow or we do a salivary gland biopsy how do we\u00a0\u00a0 diagnose Sjogren’s syndrome we use different type\u00a0 of criteria like subjective criteria your dryness\u00a0\u00a0 in the eyes or your dryness in the mouth but we\u00a0 also use objective criteria like measuring the\u00a0\u00a000:03:36<\/a>amount of lacrimal secretion that you have or\u00a0 the salivary flow or we can do a salivary gland\u00a0\u00a0 biopsy that will tell us if you have infiltration\u00a0 with certain immune cells in your salivary glands\u00a0\u00a0 we also test you for the antibodies like Ana SSA\u00a0 SSB and we use both of these types of criteria\u00a0\u00a000:04:03<\/a>to make the diagnosis of children now we have\u00a0 to consider certain situations that can also\u00a0\u00a0 cause dryness if you had for example lymphoma\u00a0 or if you had head or neck radiation if you\u00a0\u00a0 had hepatitis C HIV sarcoidosis if you had a\u00a0 transplant in your history or if you had IGG\u00a0\u00a000:04:29<\/a>4 disease or if you have any treatments\u00a0 with anticholinergic drugs all of this\u00a0\u00a0 can cause dryness in your mouth and needs to be\u00a0 excluded before we make the diagnosis of sjogren\u00a0\u00a0 how can shogren affect your nervous system when we\u00a0 think about the nervous system we try to be more\u00a0\u00a000:04:54<\/a>specific and we stratify that into the peripheral\u00a0 and the central nervous system the central nervous\u00a0\u00a0 system refers to your brain and your spine while\u00a0 your peripheral nervous system refers to all the\u00a0\u00a0 nerves that come out of your spine and they can\u00a0 control involuntary body function and regulate\u00a0\u00a000:05:18<\/a>your gland or muscles that controls your movement\u00a0 how often was neurosogen reported the symptoms of\u00a0\u00a0 neurological involvement in sjogren were\u00a0 reported in primary children since 1935.\u00a0\u00a0 if you look at different studies between 10 to\u00a0 60 percent of patients with primary sjogren will\u00a0\u00a000:05:42<\/a>have some neurological complaints now peripheral\u00a0 nervous system involvement is much well recognized\u00a0\u00a0 and documented compared to central nervous\u00a0 system involvement which we will discuss today\u00a0\u00a0 as I said before central nervous system refers to\u00a0 your brain and refers to your spine the central\u00a0\u00a000:06:06<\/a>nervous system was shown to be affected mostly\u00a0 in females between 40 and 50 years of age and\u00a0\u00a0 sometimes the disease was there for about 10\u00a0 to 11 years before those symptoms would appear\u00a0\u00a0 but not always and the prevalence or how often\u00a0 it was reported was shown to be between three\u00a0\u00a000:06:29<\/a>percent up to 80 percent of patients as I already\u00a0 mentioned the peripheral nervous system is well\u00a0\u00a0 documented to be affected in Shogun syndrome and\u00a0 patients will complain of neuropathy which could\u00a0\u00a0 be sensory or sensory and motor neuropathy which\u00a0 could involve one nerve or multiple nerves and can\u00a0\u00a000:06:52<\/a>cause also autonomic neuropathy some patients\u00a0 can also develop myasthenia gravis the central\u00a0\u00a0 nervous system is affected in a diffuse way or\u00a0 just focal way and you can have involvement of\u00a0\u00a0 the brain or involvement of the spine or both\u00a0 there are many studies published that they show\u00a0\u00a000:07:16<\/a>that the central nervous system to your brain and\u00a0 your spine can be involved in shogren and I just\u00a0\u00a0 listed a few here when the brain is affected\u00a0 just in certain areas you can have sensory\u00a0\u00a0 loss you can have motor issues but you can also\u00a0 have difficulties to talk difficulties to think\u00a0\u00a000:07:37<\/a>you may develop seizures movement disorder you\u00a0 can develop Subacute transverse myelitis and\u00a0\u00a0 sometimes you can have involvement of the optical\u00a0 nerve and sometimes sjogren can look like a tumor\u00a0\u00a0 but is not really a tumor there when the brain is\u00a0 involved diffusely you you can have symptoms like\u00a0\u00a000:08:01<\/a>encephalopathy or dementia you can develop\u00a0 psychiatric problems or you can have what it\u00a0\u00a0 looks like a meningo Encephalitis but it’s\u00a0 without any infectious cause there you can\u00a0\u00a0 also develop an intellectual decline you can have\u00a0 difficulties with your memories or difficulties\u00a0\u00a000:08:23<\/a>to formulate ideas and you can have also mood\u00a0 changes let me introduce you to some of the\u00a0\u00a0 symptoms that you can encounter if you have\u00a0 your brain affected by chogren headaches that\u00a0\u00a0 looks like migraine or tension type headaches\u00a0 are very frequent in patients with sjogren\u00a0\u00a000:08:45<\/a>spinal cord involvement are also frequent seizures\u00a0 motor and sensory deficits or neuromyelitis Optica\u00a0\u00a0 as I mentioned headaches looks to be a very\u00a0 frequent complaint of patients with neurosogram\u00a0\u00a0 this is a table with many studies that prove that\u00a0 headaches neuromyelitis Optical seizures are very\u00a0\u00a000:09:10<\/a>frequent in patients with involvement of their\u00a0 brain now this is another study that shows that\u00a0\u00a0 headaches can be seen in 47 percent of patients\u00a0 cognitive dysfunction can be seen in 44 percent of\u00a0\u00a0 patients and mood disorders are also very frequent\u00a0 depression as I said is one of the mood disorders\u00a0\u00a000:09:34<\/a>that can be seen very frequently in patients with\u00a0 sjogren shogren can involve your central nervous\u00a0\u00a0 system and also the peripheral nervous system\u00a0 at the same time but in about 40 percent of\u00a0\u00a0 cases we do see only involvement of the central\u00a0 nervous system meaning the brain and the spine\u00a0\u00a000:09:57<\/a>now what are the other symptoms that can accompany\u00a0 the Brain and Spine involvement here is a study\u00a0\u00a0 that shows that neurological involvement is often\u00a0 associated with dryness with pain in the joints\u00a0\u00a0 with pain in the muscles Raynaud’s phenomenon\u00a0 severe fatigue autoimmune thyroiditis and less\u00a0\u00a000:10:20<\/a>frequently with pulmonary involvement or lung\u00a0 involvement this is another study that shows that\u00a0\u00a0 patients will complain about dryness will complain\u00a0 about fatigue weight loss joint pain and Raynaud’s\u00a0\u00a0 phenomenon in conclusion neurological involvement\u00a0 is also associated with dryness in the eyes in the\u00a0\u00a000:10:45<\/a>mouth reynard’s phenomenon which is a change in\u00a0 your hands or feet color when you expose to them\u00a0\u00a0 to cold weather most of the time it can associate\u00a0 with thyroiditis or autoimmune thyroiditis fatigue\u00a0\u00a0 lung issues and arthritis now what is coming first\u00a0 the dryness or the neurological symptoms in 46\u00a0\u00a000:11:12<\/a>of patients with neurological involvement this is\u00a0 actually the first symptom of the disease and that\u00a0\u00a0 is more frequent in patients that have brain and\u00a0 spine involvement compared to peripheral nervous\u00a0\u00a0 system involvement how do we diagnose neurosogram\u00a0 or sjogren involving the central nervous system\u00a0\u00a000:11:37<\/a>cerebrospinal fluid or the spinal fluid analysis\u00a0 is very important for the diagnosis of neurosogram\u00a0\u00a0 we can see certain changes like your lymphocytes\u00a0 being elevated there your IGG index being elevated\u00a0\u00a0 but less oligochloral bands and we’ll talk about\u00a0 that in a little bit and we also do blood work the\u00a0\u00a000:12:00<\/a>blood work that I mentioned before we test for\u00a0 your Ana SSA and SSB antibody we look at your\u00a0\u00a0 number of white blood cells we look to see if\u00a0 you have more gamma globulins we look to see if\u00a0\u00a0 you have Rheumatic Factor complement levels all\u00a0 of these are important to be tested and what it\u00a0\u00a000:12:23<\/a>was seen in patients that have CNS involvement\u00a0 or central nervous system involvement is that\u00a0\u00a0 not all of them they have a positive DNA and\u00a0 only 38 percent will will have a positive early\u00a0\u00a0 about 48 percent have a positive SSA and only\u00a0 six percent will have a positive SSB antibody\u00a0\u00a000:12:48<\/a>as I just mentioned in shogron that affect your\u00a0 brain and your spine only 40 to 50 percent of\u00a0\u00a0 them will have a positive SSA antibody and only\u00a0 six percent will have a positive SSB antibody\u00a0\u00a0 and this is important because that makes\u00a0 the diagnosis very challenging this type\u00a0\u00a000:13:10<\/a>of antibodies SSA antibodies they actually have\u00a0 been associated with a more aggressive disease of\u00a0\u00a0 the brain what does it mean it means that if you\u00a0 have SSA antibodies with neurological involvement\u00a0\u00a0 that could mean that you have a more aggressive\u00a0 disease towards your brain or your spine we do\u00a0\u00a000:13:33<\/a>use other tests like visual evoked potential which\u00a0 are abnormal in 61 percent of patients we use EEG\u00a0\u00a0 or Electro as a pallogram which sometimes has\u00a0 a limited value but it can be useful to detect\u00a0\u00a0 subclinical signs of neurological involvement we\u00a0 also use MRI and I’m going to take the time to\u00a0\u00a000:13:58<\/a>explain to you the value of MRI in neurological\u00a0 involvement of shogron MRIs are more sensitive\u00a0\u00a0 that CAT scans to detect anatomical abnormalities\u00a0 in primary CNS or primary neurological shogran\u00a0\u00a0 there are multiple areas of increased signal that\u00a0 will show inflammation specifically located in the\u00a0\u00a000:14:24<\/a>subcortical and periventricular white matter\u00a0 and those lesions are found more frequently\u00a0\u00a0 in patients that have involvement of their brain\u00a0 let me talk to you more about brain MRI findings\u00a0\u00a0 in sjogren I mentioned to you about white matter\u00a0 lesions and I made the comment that they have to\u00a0\u00a000:14:45<\/a>be located in certain areas like periventricular\u00a0 areas and this makes the diagnosis challenging\u00a0\u00a0 because some patients with multiple sclerosis they\u00a0 can have the lesions in the same areas we’ll talk\u00a0\u00a0 more about that in a little bit in some patients\u00a0 we do see signs of cerebral Venous Thrombosis and\u00a0\u00a000:15:07<\/a>in other patients we do see two more like lesions\u00a0 that are actually not tumor but there is a sign of\u00a0\u00a0 program syndrome let’s talk about spinal MRIS\u00a0 spinal MRIs are ordered to evaluate the spinal\u00a0\u00a0 cord involvement and they can show in patients\u00a0 with sjogren intensities or hyperintensities in\u00a0\u00a000:15:33<\/a>the cervical area most of the time 82 percent of\u00a0 patients will have that problem or they can have\u00a0\u00a0 extended lesions in cases of acute myelopathy\u00a0 this is an MRI of a patient with Hyper signal\u00a0\u00a0 in the cord that is suggestive of acute myelopathy\u00a0 this is also an MRI from a patient with extensive\u00a0\u00a000:16:01<\/a>transverse myelitis this is also another MRI of\u00a0 a patient with neuromyelitis Optica a patient\u00a0\u00a0 that also has shogron this is another case of\u00a0 neuromyelitis optica where you can see involvement\u00a0\u00a0 of the dorsal midbrain and and the point in\u00a0 lesion in a patient with sjogren that develop\u00a0\u00a000:16:24<\/a>neuromyelitis Optica we also use combinations of\u00a0 tests like MRI and a voxel-based morphometry and\u00a0\u00a0 this is a method commonly used to quantitate and\u00a0 objectively evaluate the differences in Regional\u00a0\u00a0 cerebral volumes this type of test was able to\u00a0 shown that patients with sjogren had certain\u00a0\u00a000:16:48<\/a>areas of white matter hyper intensities and those\u00a0 areas were also associated with more atrophy these\u00a0\u00a0 studies show that patients with primary children\u00a0 that have this white matter intensities and gray\u00a0\u00a0 and white matter atrophy those are probably\u00a0 related to a sort of cerebral vasculitis or\u00a0\u00a000:17:13<\/a>inflammation in the vessels of the brain there\u00a0 are other tests like single Photon emission CT or\u00a0\u00a0 pet scans that can evaluate the blood flow in the\u00a0 brain and it was shown that patients with children\u00a0\u00a0 they have reduced cerebral blood flow they have\u00a0 brain atrophy and decreased glucose metabolism in\u00a0\u00a000:17:35<\/a>the brain in certain patients neuropsychological\u00a0 testing it’s also very important to evaluate\u00a0\u00a0 symptoms that are very subtle in affecting the\u00a0 brain cerebral angiography is used more rarely in\u00a0\u00a0 patients with primary sjogren but when it was used\u00a0 in 45 percent of Highly selected patients with\u00a0\u00a000:17:58<\/a>children and active CNS involvement they actually\u00a0 shown to have small vessel vasculitis in the brain\u00a0\u00a0 it is important to differentiate children from\u00a0 other diseases and let’s talk about shogron\u00a0\u00a0 versus multiple sclerosis the brain involvement\u00a0 in sjogran can mimic multiple sclerosis and it\u00a0\u00a000:18:22<\/a>is very hard to differentiate even for the most\u00a0 experienced clinicians Sienna shogron or brain\u00a0\u00a0 involvement in the sjogran can mimic a type\u00a0 of multiple sclerosis that we call relapsing\u00a0\u00a0 remitting Multiple Sclerosis but these two\u00a0 diseases they have features in common like they\u00a0\u00a000:18:44<\/a>both tend to involve the brain they both tend to\u00a0 involve the spinal cord and the optical tract let\u00a0\u00a0 me show you some differences between neurological\u00a0 sjogran and multiple sclerosis shogran with brain\u00a0\u00a0 involvement tends to affect people over the age of\u00a0 40. many of them are females and not many of them\u00a0\u00a000:19:10<\/a>will have clinical criteria for multiple sclerosis\u00a0 when we do the spinal fluid analysis only 30\u00a0\u00a0 percent of them will have molecular coronal bands\u00a0 when we do the MRI of the brain only 40 percent\u00a0\u00a0 of these people will meet criteria for multiple\u00a0 sclerosis SSA SSB antibodies are more frequently\u00a0\u00a000:19:33<\/a>seen in patients with brain involvement in sjogran\u00a0 compared to Multiple Sclerosis about 50 percent of\u00a0\u00a0 patients with sjogran and brain involvement will\u00a0 have these antibodies positive while only five\u00a0\u00a0 percent of people with multiple sclerosis will\u00a0 have an SSA or SSB antibody positive multiple\u00a0\u00a000:19:56<\/a>sclerosis tends to appear at younger age between\u00a0 20 and 40 years old and only 65 percent of these\u00a0\u00a0 people will be female now when we look at the\u00a0 spinal analysis 90 of them will have oligo coronal\u00a0\u00a0 bands in multiple sclerosis eighty percent\u00a0 of them will meet MRI criteria for multiple\u00a0\u00a000:20:19<\/a>sclerosis and only five percent as I said will\u00a0 have an SSA or SSB antibody positive there are\u00a0\u00a0 some signs and symptoms that goes against multiple\u00a0 sclerosis and goes towards more primary children\u00a0\u00a0 for example when both peripheral and cranial nerve\u00a0 involvement are affected then that goes against\u00a0\u00a000:20:48<\/a>multiple sclerosis when we see less oligroclonal\u00a0 bands in the spinal fluid that again goes towards\u00a0\u00a0 shogren unless the words multiple sclerosis when\u00a0 we see more Ana positive SSA and SSB and positive\u00a0\u00a0 motive factor that goes against multiple sclerosis\u00a0 and when we see zika symptoms like dryness in\u00a0\u00a000:21:13<\/a>the mouth and dryness in the eyes that goes\u00a0 against multiple sclerosis and more towards\u00a0\u00a0 Sjogren’s syndrome how do we treat neurological\u00a0 involvement in shogran when it comes to treatment\u00a0\u00a0 of brain or spine involvement in sjogren\u00a0 there is no consensus between us we can\u00a0\u00a000:21:33<\/a>use corticosteroids usually we use them in high\u00a0 doses when we see neurological involvement that\u00a0\u00a0 can put the patient in danger but sometimes\u00a0 corticosteroids are not effective especially\u00a0\u00a0 in patients with spinal cord involvement in some\u00a0 patients we do consider to use immunosuppressive\u00a0\u00a000:21:54<\/a>therapy like cyclophosphamide or rituximal and\u00a0 there are also reports about using il-6 inhibitor\u00a0\u00a0 like tocilizumab however the results are variable\u00a0 and we have to adjust that to the patient needs\u00a0\u00a0 however that could result in partially recovery\u00a0 or just to stabilize the disease plasmapheresis in\u00a0\u00a000:22:21<\/a>combination with prednisone was also reported to\u00a0 be affected in some patients especially patients\u00a0\u00a0 with acute transverse myelopathy in severe\u00a0 cases IVIG was also used successfully in a\u00a0\u00a0 small group of patients however the role of IVIG\u00a0 is more recognized towards small fiber neuropathy\u00a0\u00a000:22:44<\/a>there are multiple reports that show that IVIG\u00a0 is helpful for patients with peripheral nervous\u00a0\u00a0 system involvement in conclusion neurological\u00a0 involvement of the spine and the brain is common\u00a0\u00a0 in patients with primary sjogren sometimes it can\u00a0 come before the dryness of the eyes or dryness\u00a0\u00a000:23:06<\/a>of the mouth now how often does it happen we\u00a0 still don’t have very clear idea because of the\u00a0\u00a0 heterogeneity of these studies that I presented\u00a0 it could be disabling and you have to know about\u00a0\u00a0 this type of disease for you to call your doctor\u00a0 and discuss the symptoms that you have if you have\u00a0\u00a000:23:29<\/a>any symptoms that I presented now we need more\u00a0 studies more prospective control studies with\u00a0\u00a0 larger number of patients to assess the treatment\u00a0 and the efficacy and safety of the treatment for\u00a0\u00a0 brain involvement in sjogren and with that I would\u00a0 like to thank you and wish you a very good day see\u00a0\u00a0
Source : Youtube<\/a><\/div><\/div>","protected":false},"excerpt":{"rendered":"

https:\/\/www.youtube.com\/watch?v=ia3jGVzg3CYDid you hear about Sjogren’s syndrome\u00a0 affecting your brain and your spine\u00a0\u00a0 today we’re gonna talk about how this syndrome\u00a0 sjogren will affect your central nervous system\u00a0\u00a0 so if you’re newly diagnosed with sjogran or if\u00a0 you have symptoms related to your brain or to\u00a0\u00a000:00:17your spine that you could not understand this\u00a0 might be the … Continue reading Sjogren’s Syndrome Affects the Brain and Spine<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":152293,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[1973],"tags":[],"class_list":["post-152292","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-legislative-branch"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/effectsofanxiety.net\/wp-content\/uploads\/2024\/03\/1709667330-maxresdefault.jpg","_links":{"self":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152292"}],"collection":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/comments?post=152292"}],"version-history":[{"count":0,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152292\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media\/152293"}],"wp:attachment":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media?parent=152292"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/categories?post=152292"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/tags?post=152292"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}