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Psychosomatics. 2019 May - Jun;60(3):278-288. doi: 10.1016/j.psym.2018.07.005. Epub 2018 Jul 20.

The Neuroanatomy of Somatoform Disorders: A Magnetic Resonance Imaging Study.

Author information

1
University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
2
Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology - University of Verona, Italy.
3
Fondazione IRCCS Ca' Granda.Ospedale Maggiore Policlinico, Milan, Italy.
4
University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda.Ospedale Maggiore Policlinico, Milan, Italy; "Dino Ferrari" Center, Milan, Italy.
5
University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda.Ospedale Maggiore Policlinico, Milan, Italy.
6
University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Scientific Institute IRCCS "E. Medea", Bosisio Parini (Lc), Italy. Electronic address: paolo.brambilla1@unimi.it.

Abstract

BACKGROUND:

Somatoform disorders (SDs) are a heterogeneous group of psychiatric syndromes characterized by common symptoms, which may mimic a physical condition but they are not explained by a medical condition. Although the biologic nature of this disorder has been widely accepted, the neuroanatomical correlates characterizing SDs are still inconclusive.

OBJECTIVE:

This study aims to explore gray matter (GM) volume alterations in SD patients compared to healthy controls and their possible association with clinical and cognitive measures.

METHOD:

We used voxel-based morphometry to examine regional GM volumes in 20 inpatients with SDs and 24-matched healthy controls. Only for SD patients, we employed multiple instruments to assess psychopathology and cognitive functioning, which were then used to explore their association with GM volume deficits.

RESULTS:

Compared to healthy controls, SD patients showed GM volume reductions in the hypothalamus, left fusiform gyrus, right cuneus, left inferior frontal gyrus, left posterior cingulate, and right amygdala (p < 0.05, cluster Family Wise Error corrected). Additionally, in SD, Symptom Checklist-90-Phobia and Hamilton Depressive Rating Scale scores negatively correlated with specific fronto-temporoparietal regions whereas Symptom Checklist-90-Sleep scores positively correlated with anterior cingulate cortex. Lastly, the Boston Naming Test negatively correlated with fronto-temporoparietal and striatal volumes whereas Free and Cued Selective Reminding Test and Stroop scores positively correlated with superior temporal gyrus and cuneus, respectively (all p < 0.05, cluster Family Wise Error corrected).

CONCLUSION:

Our results suggest that SDs might be characterized by selective impairments in specific cortico-limbic regions associated to two overlapping circuits, the neuromatrix of pain and the emotion regulation system.

KEYWORDS:

MRI; clinical profile; cognition; gray matter; somatoform disorder

PMID:
30119840
DOI:
10.1016/j.psym.2018.07.005

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