The rebirth of neuroscience in psychosomatic medicine, Part II: clinical applications and implications for research.
During the second half of the last century, biopsychosocial research in psychosomatic medicine largely ignored the brain. Neuroscience has started to make a comeback in psychosomatic medicine research and promises to advance the field in important ways. In this paper we briefly review select brain imaging research findings in psychosomatic medicine in four key areas: cardiovascular regulation, visceral pain in the context of functional gastrointestinal disorders, acute and chronic somatic pain and placebo. In each area, there is a growing literature that is beginning to define a network of brain areas that participate in the functions in question. Evidence to date suggests that cortical and subcortical areas that are involved in emotion and emotion regulation play an important role in each domain. Neuroscientific research is therefore validating findings from previous psychosomatic research and has the potential to extend knowledge by delineating the biological mechanisms that link mind and body more completely and with greater specificity. We conclude with a discussion of the implications of this work for how research in psychosomatic medicine is conducted, the ways in which neuroscientific advances can lead to new clinical applications in psychosomatic contexts, the implications of this work for the field of medicine more generally, and the priorities for research in the next 5 to 10 years.
Lane
Richard D
RD
Department of Psychiatry, University of Arizona, Tucson, AZ 85724-5002, USA. lane@email.arizona.edu
Waldstein
Shari R
SR
Critchley
Hugo D
HD
Derbyshire
Stuart W G
SW
Drossman
Douglas A
DA
Wager
Tor D
TD
Schneiderman
Neil
N
Chesney
Margaret A
MA
Jennings
J Richard
JR
Lovallo
William R
WR
Rose
Robert M
RM
Thayer
Julian F
JF
Cameron
Oliver G
OG
D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D002319:Cardiovascular System / Q000503:physiopathology; D003952:Diagnostic Imaging / Q000379:methods; D004644:Emotions / Q000502:physiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D041981:Gastrointestinal Tract / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D008297:Male; D009420:Nervous System / Q000503:physiopathology; D009488:Neurosciences / Q000379:methods / Q000639:trends*; D010146:Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D015990:Placebo Effect; D011584:Psychology; D011603:Psychophysiology; D011611:Psychosomatic Medicine / Q000379:methods / Q000639:trends*; D012107:Research Design; D013001:Somatoform Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D013315:Stress, Psychological / Q000503:physiopathology