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J Neuropsychiatry Clin Neurosci. 2015 Winter;27(1):e40-50. doi: 10.1176/appi.neuropsych.13070170. Epub 2014 Nov 10.

A neural circuit framework for somatosensory amplification in somatoform disorders.

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From the Dept. of Psychiatry, Brigham and Women's Hospital, Boston, MA (DLP, AJB, DRV, GB, DAS);. Dept. of Neurology, Brigham and Women's Hospital, Boston, MA (DLP); Functional Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA (DLP, DRV DAS); Dept. of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA (DLP); and Harvard Medical School, Boston, MA (DLP, AJB, DRV, GB, DAS).


Although somatosensory amplification is theorized to serve a critical role in somatization, it remains poorly understood neurobiologically. In this perspective article, convergent visceral-somatic processing is highlighted, and neuroimaging studies in somatoform disorders are reviewed. Neural correlates of cognitive-affective amplifiers are integrated into a neurocircuit framework for somatosensory amplification. The anterior cingulate cortex, insula, amygdala, hippocampal formation, and striatum are some of the identified regions. Clinical symptomatology in a given patient or group may represent dysfunction in one or more of these neurobehavioral nodes. Somatosensory amplification may, in part, develop through stress-mediated aberrant neuroplastic changes and the neuromodulatory effects of inflammation.

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