This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lane, R. D. Articles by Cameron, O. G. Search for Related Content PubMed PubMed Citation Articles by Lane, R. D. Articles by Cameron, O. G. Related Collections Radiology and Brain Imaging Reviews Neuroscience

The Rebirth of Neuroscience in Psychosomatic Medicine, Part II: Clinical Applications and Implications for Research

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; Brighton and Sussex Medical School (H.D.C.), Brighton, UK; School of Psychology (S.W.G.D.), University of Birmingham, Birmingham, UK; Department of Medicine (D.A.D.), University of North Carolina, Chapel Hill, North Carolina; Department of Psychology (T.D.W.), Columbia University, New York, New York; Department of Psychology (N.S.), University of Miami, Miami, Florida; 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; Mind-Brain-Body and Health Initiative (R.M.R.), Galveston, Texas; Department of Psychology (J.F.T.), The Ohio State University, Columbus, Ohio, and The Mannheim Institute of Public Health, Heidelberg University, Heidelberg, Germany; and the 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

During the second half of the last century, biopsychosocial research in psychosomatic medicine largely ignored the brain. Neuroscience has started to make a comeback in psychosomatic medicine research and promises to advance the field in important ways. In this paper we briefly review select brain imaging research findings in psychosomatic medicine in four key areas: cardiovascular regulation, visceral pain in the context of functional gastrointestinal disorders, acute and chronic somatic pain and placebo. In each area, there is a growing literature that is beginning to define a network of brain areas that participate in the functions in question. Evidence to date suggests that cortical and subcortical areas that are involved in emotion and emotion regulation play an important role in each domain. Neuroscientific research is therefore validating findings from previous psychosomatic research and has the potential to extend knowledge by delineating the biological mechanisms that link mind and body more completely and with greater specificity. We conclude with a discussion of the implications of this work for how research in psychosomatic medicine is conducted, the ways in which neuroscientific advances can lead to new clinical applications in psychosomatic contexts, the implications of this work for the field of medicine more generally, and the priorities for research in the next 5 to 10 years.

Key Words: neuroscience • anterior cingulate cortex • emotion • pain • cardiovascular regulation • placebo

Abbreviations: ACC = anterior cingulate cortex; aMCC = anterior midcingulate cortex; CAD = coronary artery disease; CVD = cardiovascular diseases; DBS = deep brain stimulation; DLPFC = dorsolateral prefrontal cortex; ECG = electrocardiographic; FGID = functional gastrointestinal disorder; fMRI = functional magnetic resonance imaging; IBS = irritable bowel syndrome; MCC = midcingulate cortex; MEG = magnetoencephalography; MPFC = medial prefrontal cortex; NAC = nucleus accumbens; OFC = orbitofrontal (or orbital prefrontal) cortex; pACC = pregenual anterior cingulate cortex; PAG = periacqueductal gray; PET = positron emission tomography; PCC = posterior cingulate cortex; PI-IBS = post infectious irritable bowel syndrome; S1 = primary somatosensory cortex; S2 = secondary somatosensory cortex; sACC = subgenual anterior cingulate cortex; sTMS = slow transcranial magnetic stimulation; TMS = transcranial magnetic stimulation; VNS = vagus nerve stimulation.

This article has been cited by other articles:

				R. D. Lane, S. R. Waldstein, M. A. Chesney, J. R. Jennings, W. R. Lovallo, P. J. Kozel, R. M. Rose, D. A. Drossman, N. Schneiderman, J. F. Thayer, et al. The Rebirth of Neuroscience in Psychosomatic Medicine, Part I: Historical Context, Methods, and Relevant Basic Science Psychosom Med, February 1, 2009; 71(2): 117 - 134. [Abstract] [Full Text] [PDF]