Brain dysfunction behind functional symptoms: neuroimaging and somatoform, conversive, and dissociative disorders

Curr Opin Psychiatry. 2009 Mar;22(2):224-31. doi: 10.1097/YCO.0b013e3283252d43.

Abstract

Purpose of review: Neuroimaging research in psychiatry has been increasing exponentially in recent years, yet many psychiatrists are relatively unfamiliar with this field. This article summarizes the findings of the most relevant research articles on the neuroimaging of somatoform, conversive, and dissociative disorders published from January 2007 through June 2008.

Recent findings: Neuroimaging findings summarized here include alterations of stress regulation and coping in somatoform pain disorders, the importance of catastrophizing in somatization disorder, and the relevance of a history of physical/sexual abuse in irritable bowel syndrome. Regarding fibromyalgia, three of the most significant advances have been the impossibility of differentiating primary and concomitant fibromyalgia in the presence of quiescent underlying disease, the role of hippocampal dysfunction, and the possibility that fibromyalgia may be characterized as an aging process. In dissociative disorders, the high levels of elaborative memory encoding and the reduced size of the parietal lobe are highlighted.

Summary: The most promising clinical consequence of these studies, in addition to improving knowledge about the etiology of these illnesses, is the possibility of using neuroimaging findings to identify subgroups of patients, which could allow treatments to be tailored.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adaptation, Psychological / physiology
  • Arousal / physiology
  • Borderline Personality Disorder / diagnosis
  • Borderline Personality Disorder / physiopathology
  • Borderline Personality Disorder / psychology
  • Brain / physiopathology*
  • Brain Mapping
  • Conversion Disorder / diagnosis
  • Conversion Disorder / physiopathology*
  • Conversion Disorder / psychology
  • Dissociative Disorders / diagnosis
  • Dissociative Disorders / physiopathology*
  • Dissociative Disorders / psychology
  • Fatigue Syndrome, Chronic / diagnosis
  • Fatigue Syndrome, Chronic / physiopathology
  • Fatigue Syndrome, Chronic / psychology
  • Fibromyalgia / diagnosis
  • Fibromyalgia / physiopathology
  • Fibromyalgia / psychology
  • Humans
  • Hypochondriasis / diagnosis
  • Hypochondriasis / physiopathology
  • Hypochondriasis / psychology
  • Image Processing, Computer-Assisted*
  • Irritable Bowel Syndrome / diagnosis
  • Irritable Bowel Syndrome / physiopathology
  • Irritable Bowel Syndrome / psychology
  • Magnetic Resonance Imaging*
  • Magnetic Resonance Spectroscopy*
  • Mental Recall / physiology
  • Nerve Net / physiopathology
  • Oxygen / blood
  • Pain / physiopathology
  • Pain / psychology
  • Somatoform Disorders / diagnosis
  • Somatoform Disorders / physiopathology*
  • Somatoform Disorders / psychology
  • Tomography, Emission-Computed, Single-Photon*

Substances

  • Oxygen