Neuroimaging in functional somatic syndromes

A number of conditions are common in the clinical environment for which no readily demonstrable pathologies exist to explain the symptoms that plague afflicted individuals. A list of these "functional somatic syndromes" includes such entities as chronic fatigue syndrome, fibromyalgia syndrome, and irritable bowel syndrome. Given the enduring lack of peripheral pathology, research into the underlying abnormalities that might characterize these disorders has increasingly 1 9 focused on the central nervous system as the potential source of the problem. Accordingly, a variety of central imaging techniques have been used in the search for abnormalities that might explain these conditions, including both functional and structural magnetic resonance imaging, magnetic resonance spectroscopy, and positron emission tomography. This chapter is a review of these findings, which include changes in the function and structure of key brain areas. A discussion of potential mechanisms that may explain these phenomena is also presented, along with suggestions for future investigations.