Neuroimaging in chronic pain, fibromyalgia, and somatization
Neuroimaging research in psychiatry has been increasing exponentially in recent years, yet many psychiatrists are relatively unfamiliar with this field. The neuroimaging findings summarized here include alterations related to fibromyalgia, chronic pain, and coping in somatoform pain disorders. Magnetic resonance imaging is the imaging method of choice for standard clinical sequences. Improvements in imaging technology now allow advanced sequences, once used exclusively for research, to be used clinically. Magnetic resonance spectroscopy (showing metabolism) offers invaluable information on living tissues, with a special contribution to the diagnosis and prognosis of diseases of the central nervous system. Voxel-based morphometry (structural information) is a recent technique that can simultaneously visualize group differences or statistical effects on gray and white matter throughout the brain. Perfusion (marker of vascularity) offers higher spatial resolution than radionuclide techniques such as positron emission tomography and single-photon emission computed tomography. Diffusion-weighted imaging (a marker of cellularity) detects subtle degradation of white matter microstructure in fibromyalgia. Diffusion tensor imaging shows integrity of surrounding white matter tracts. Functional magnetic resonance imaging is used to identify eloquent cortex.These techniques, all of which have advanced our understanding of chronic pain and can be used to improve knowledge on the etiology of these illnesses, will be discussed.
Fayed, N. , Garcia-Campayo, J. , Viguera, L. (2017)., Neuroimaging in chronic pain, fibromyalgia, and somatization, in , Psychiatry and neuroscience update II, Dordrecht, Springer, pp. 421-442.
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