Lane Richard D, Waldstein Shari R, Chesney Margaret A, Jennings J Richard, Lovallo William R, Kozel Peter J, Rose Robert M, Drossman Douglas A, Schneiderman Neil, Thayer Julian F, Cameron Oliver G
Department of Psychiatry, University of Arizona, Tucson, AZ 85724-5002, USA.
Psychosom Med. 2009 Feb;71(2):117-34. doi: 10.1097/PSY.0b013e31819783be. Epub 2009 Feb 5.
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.
神经科学在20世纪初身心医学创立之初就是其不可或缺的一部分。然而，自20世纪中叶以来，身心医学研究在很大程度上忽视了大脑。近年来神经科学领域迅速发展，主要是因为出现了各种强大的新方法。其中许多方法能够对活体人类大脑进行非侵入性研究，因此目前有可能被整合到身心医学研究中。在第一篇论文中，我们研究了可用于人类神经科学研究的各种方法，并讨论了它们的相对优缺点。接下来，我们回顾一些基本的功能神经解剖学，涉及越来越多地被认为与身心过程相关的结构。然后，我们讨论大脑如何通过“信息传递系统”（包括自主神经系统、神经内分泌系统和免疫系统）影响终末器官，并给出相关例子。目前可得的证据表明，神经科学对于推进理解社会心理变量影响身体疾病结果的机制这一目标有着巨大的前景。身心医学需要更多地关注此类机制性研究，以进一步被医学领域所接受。
