Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
Neurosci Biobehav Rev. 2021 Mar;122:66-78. doi: 10.1016/j.neubiorev.2020.12.017. Epub 2020 Dec 20.
Although there has been an increment in neuroimaging research in somatoform disorders (SD), to date little is known about the neural correlates of these diseases. Therefore, in this systematic, review we aimed at summarizing the existing evidence of structural brain alterations in SD as per DSM-IV and DSM-5 criteria. Three electronic databases (Scopus, PubMed and Web of Science) were searched. Only case-control studies using structural neuroimaging were included. Forty-five out of 369 articles fulfilled inclusion criteria and were reviewed. Compared to controls, subjects with SD showed morphological alterations encompassing motor, limbic and somatosensory circuits. Although far from being conclusive, the results suggested that SD are characterized by selective alterations of large-scale brain networks implicated in cognitive control, emotion regulation and processing, stress and somatic-visceral perception. This review highlights the need for further multimodal neuroimaging studies with longitudinal designs, in larger and better-characterized samples, to elucidate the temporal and causal relationship between neuroanatomical changes and SD, which is paramount for informing tailored treatments.
尽管躯体形式障碍（SD）的神经影像学研究有所增加，但迄今为止，人们对这些疾病的神经相关性知之甚少。因此，在这项系统综述中，我们旨在根据 DSM-IV 和 DSM-5 标准总结 SD 结构脑改变的现有证据。我们检索了三个电子数据库（Scopus、PubMed 和 Web of Science）。仅纳入使用结构神经影像学的病例对照研究。45 篇文章符合纳入标准并进行了综述。与对照组相比，SD 患者表现出涉及运动、边缘和躯体感觉回路的形态改变。尽管远非结论性的，但结果表明，SD 的特征是与认知控制、情绪调节和处理、应激和躯体-内脏感知相关的大规模脑网络的选择性改变。本综述强调需要进一步进行具有纵向设计、更大和更好特征化样本的多模态神经影像学研究，以阐明神经解剖学变化与 SD 之间的时间和因果关系，这对于提供针对性治疗至关重要。
