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From the Department of Psychiatry (R.D.L.), University of Arizona, Tucson, Arizona; Department of Psychology (S.R.W.), University of Maryland, Baltimore County and Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, Maryland; Department of Medicine (M.A.C.), University of Maryland, Baltimore, Maryland; Department of Psychiatry (J.R.J.), University of Pittsburgh, Pittsburgh, Pennsylvania; Behavioral Sciences Laboratories (W.R.L.), VA Medical Center, Oklahoma City, Oklahoma; Division of Extramural Activities (P.J.K.), National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Maryland; Mind-Brain-Body and Health Initiative (R.M.R.), Galveston, Texas; Department of Medicine (D.A.D.), University of North Carolina, Chapel Hill, North Carolina; Department of Psychology (N.S.), University of Miami, Miami, Florida; Department of Psychology (J.F.T.), Ohio State University, Columbus, Ohio, and Mannheim Institute of Public Health, Heidelberg University, Heidelberg, Germany; and Department of Psychiatry (O.G.C.), University of Michigan, Ann Arbor, Michigan.
Address correspondence and reprint requests to Richard D. Lane, Department of Psychiatry, P.O. Box 245002, Tucson, AZ 85724-5002. E-mail: lane{at}email.arizona.edu
Neuroscience was an integral part of psychosomatic medicine at its inception in the early 20th century. Since the mid-20th century, however, psychosomatic research has largely ignored the brain. The field of neuroscience has burgeoned in recent years largely because a variety of powerful new methods have become available. Many of these methods allow for the noninvasive study of the living human brain and thus are potentially available for integration into psychosomatic medicine research at this time. In this first paper we examine various methods available for human neuroscientific investigation and discuss their relative strengths and weaknesses. We next review some basic functional neuroanatomy involving structures that are increasingly being identified as relevant for psychosomatic processes. We then discuss, and provide examples of, how the brain influences end organs through "information transfer systems," including the autonomic, neuroendocrine, and immune systems. The evidence currently available suggests that neuroscience holds great promise for advancing the goal of understanding the mechanisms by which psychosocial variables influence physical disease outcomes. An increased focus on such mechanistic research in psychosomatic medicine is needed to further its acceptance into the field of medicine.
Key Words: neuroscience • brain imaging • information transfer systems • autonomic nervous system • neuroendocrinology • psychoneuroimmunology
Abbreviations: ACC = anterior cingulate cortex; ALS = anterolateral system; ANS = autonomic nervous system; BOLD = blood oxygen level dependent; CANTAB = Cambridge Neuropsychological Test Automated Battery; CBF = cerebral blood flow; CNS = central nervous system; CRH = corticotropin-releasing hormone; CT = computed tomography; ECG = electrocardiography; EEG = electroencephalography; ERPs = event-related potentials; fMRI = functional magnetic resonance imaging; HIV = human immunodeficiency virus; HPA = hypothalamic pituitary axis; MEG = magnetoencephalography; MRI = magnetic resonance imaging; NKC = natural killer cells; SPECT = single photon emission computed tomography.
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  R. D. Lane, S. R. Waldstein, H. D. Critchley, S. W. G. Derbyshire, D. A. Drossman, T. D. Wager, N. Schneiderman, M. A. Chesney, J. R. Jennings, W. R. Lovallo, et al. The Rebirth of Neuroscience in Psychosomatic Medicine, Part II: Clinical Applications and Implications for Research Psychosom Med, February 1, 2009; 71(2): 135 - 151. [Abstract] [Full Text] [PDF]
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