Title
Cerebral activation in patients with somatoform pain disorder exposed to pain and stress: an fMRI study.
Abstract
Patients with somatoform pain disorders are supposed to suffer from an early acquired defect in stress regulation. In order to look for common alterations of the pain- and stress-responsive cortical areas, we prospectively recorded cerebral activations induced by pin-prick pain, by cognitive stress and emotional stress using functional magnetic resonance imaging (fMRI) in a group of 17 patients and an age-matched control group. In addition, the hippocampal volumes of both groups were measured. Patients showed increased activations of the known pain-processing areas (thalamus, basal ganglia, operculo-insular cortex), but also of some prefrontal, temporal and parietal regions during first pain exposure and of temporal and parietal areas during cognitive stress, but reduced activations during emotional stress. In contrast to these functional differences, hippocampal volume was not significantly reduced in patients. Although the superior temporal gyrus was the only common area of an “overactivation” in patients in the pain and stress condition, findings of our study support the current concept of mechanisms involved in somatoform pain disorders: central processing of pain and of cognitive stress is increased in patients possibly due to exaggerated memory and/or anticipation of pain exposure and to a disturbance of stress-regulating systems which has to be worked out on a cortical level in more detail. Our finding of a reduced responsiveness to emotional stress is surprising, but not contradictive to these results because some sort of neglect or coping mechanisms may have developed over time as a response to early adversities.
Year
DOI
Venue
2007
10.1016/j.neuroimage.2007.01.052
NeuroImage
Keywords
Field
DocType
control group,stress response
Thalamus,Developmental psychology,Neuroscience,Functional magnetic resonance imaging,Anticipation,Coping (psychology),Psychology,Cognition,Hippocampal formation,Superior temporal gyrus,Basal ganglia
Journal
Volume
Issue
ISSN
36
2
1053-8119
Citations 
PageRank 
References 
0
0.34
8
Authors
8
Name
Order
Citations
PageRank
Peter Stoeter17410.09
Th Bauermann200.34
R Nickel300.34
L Corluka400.34
J Gawehn500.34
G Vucurevic6142.85
G Vossel700.34
U T Egle800.34