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


RESULTS
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.


CONCLUSIONS
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.
García-Campayo
Javier
J
Somatoform Disorders and Fibromyalgia Unit, Miguel Servet University Hospital, University of Zaragoza, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain. jgarcamp@arrakis.es
Fayed
Nicolas
N
Serrano-Blanco
Antoni
A
Roca
Miquel
M
D000223:Adaptation, Psychological / Q000502:physiology; D001143:Arousal / Q000502:physiology; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D003291:Conversion Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D004213:Dissociative Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D005356:Fibromyalgia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D006998:Hypochondriasis / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D007091:Image Processing, Computer-Assisted; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D011939:Mental Recall / Q000502:physiology; D009415:Nerve Net / Q000503:physiopathology; D010100:Oxygen / Q000097:blood; D010146:Pain / Q000503:physiopathology / Q000523:psychology; D013001:Somatoform Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D015899:Tomography, Emission-Computed, Single-Photon
D010100:Oxygen