Elsevier

NeuroImage: Clinical

Volume 11, 2016, Pages 606-613
NeuroImage: Clinical

Neural correlates of somatoform disorders from a meta-analytic perspective on neuroimaging studies

https://doi.org/10.1016/j.nicl.2016.04.001Get rights and content
Under a Creative Commons license
open access

Highlights

  • Five neurobiological areas correlate with the occurrence of somatoform disorders (SD).

  • Areas are crucial for emotional, evaluative and cognitive aspects of pain processing.

  • Prefrontal areas indicate involvement of pain memory in SD.

  • Functional disorders might have central sensitization as an underlying factor.

  • Results do not support the classification of SD as medically unexplained symptoms.

Abstract

Somatoform disorders (SD) are common medical disorders with prevalence rates between 3.5% and 18.4%, depending on country and medical setting. SD as outlined in the ICD-10 exhibits various biological, social, and psychological pathogenic factors. Little is known about the neural correlates of SD. The aims of this meta-analysis are to identify neuronal areas that are involved in SD and consistently differ between patients and healthy controls. We conducted a systematic literature research on neuroimaging studies of SD. Ten out of 686 studies fulfilled the inclusion criteria and were analyzed using activation likelihood estimation. Five neuronal areas differ between patients with SD and healthy controls namely the premotor and supplementary motor cortexes, the middle frontal gyrus, the anterior cingulate cortex, the insula, and the posterior cingulate cortex. These areas seem to have a particular importance for the occurrence of SD. Out of the ten studies two did not contribute to any of the clusters. Our results seem to largely overlap with the circuit network model of somatosensory amplification for SD. It is conceivable that functional disorders, independent of the clinical impression, show similar neurobiological processes. While overlaps do occur it is necessary to understand single functional somatic syndromes and their aetiology for future research, terminology, and treatment guidelines.

Keywords

Somatoform disorders
Somatoform pain disorders
Neuroimaging
MRI
ALE
Activation likelihood estimation
Meta-analysis
Premotor area
Supplementary motor cortex
Middle frontal gyrus
Anterior cingulate cortex
Insula
Posterior cingulate cortex

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