Psychosomatic medicine
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Psychosomatic medicine · Jan 2012
Disrupted functional connectivity of the pain network in fibromyalgia.
To investigate the impact of chronic pain on brain dynamics at rest. ⋯ These findings demonstrate that patients with FM display a substantial imbalance of the connectivity within the pain network during rest, suggesting that chronic pain may also lead to changes in brain activity during internally generated thought processes such as occur at rest.
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Psychosomatic medicine · Jan 2012
Preoperative cerebral hypoperfusion in the left, not in the right, hemisphere is associated with cognitive decline after cardiac surgery.
Postoperative cognitive decline (POCD) is a frequent complication after cardiac surgery. Although intraoperative events are risk factors for POCD, the role played by preoperative hypoperfusion in cognitive decline has not yet been investigated. It is also unknown whether the impact of preoperative hypoperfusion in the left or right middle cerebral arteries (MCAs) can differentially account for POCD. The main aims of this study were to investigate whether preoperative cerebral hypoperfusion was associated with early POCD and whether lateralized hypoperfusion would differentially affect POCD in patients after cardiac surgery. ⋯ Patients who underwent cardiac surgery with reduced CBF velocity in the left MCA preoperatively are at greater risk for POCD. Left cerebral hypoperfusion may also represent an independent predictor of POCD in these patients. TCD evaluation may have substantial clinical benefits for the detection of patients at high risk of POCD after cardiac surgery.
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Psychosomatic medicine · Jan 2012
Are somatic symptoms of depression better predictors of cardiac events than cognitive symptoms in coronary heart disease?
Several recent studies have found that somatic symptoms of depression predict cardiac events in patients with established coronary heart disease but cognitive symptoms of depression do not. However, other studies have not supported this finding, and the research in this area is complicated by methodological differences and inconsistencies in the classification of "cognitive" and "somatic" symptoms. ⋯ Some reasons why somatic symptoms may be more common than cognitive symptoms in cardiac patients are considered, as well as whether somatic symptoms are likely to be symptoms of depression or of medical illness. Finally, some directions for future research are proposed.
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Psychosomatic medicine · Jan 2012
Serotonergic and BDNF genes associated with depression 1 week and 1 year after mastectomy for breast cancer.
Polymorphisms of serotonin transporter (5-HTT) and brain-derived neurotrophic factor (BDNF) genes have been investigated as candidate genes for depression occurring in medical disorders. The serotonin 2a receptor (5-HTR2a) genes have been investigated as risk factors for depression but rarely in combination with medical conditions. This study aimed to investigate whether polymorphisms of interest in 5-HTT, 5-HTR2a, and BDNF genes are associated with depression after mastectomy for breast cancer. ⋯ Our findings support a role of BDNF, not serotonin, in the etiology of depression occurring in women with breast cancer who received a mastectomy.
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Psychosomatic medicine · Nov 2011
Cerebral activation and catastrophizing during pain anticipation in patients with fibromyalgia.
Anticipation of pain influences its cerebral processing and dysfunctional cognitive style like catastrophizing correlates with the severity of pain. Patients with fibromyalgia syndrome (FMS) exhibit higher levels of catastrophizing, increased attention to pain, and augmented cerebral pain processing. Therefore, alteration in cerebral processing during anticipation of experimental pain and its relation to catastrophizing are the main focus of the study. ⋯ The lack of difference in catastrophizing during the experimental pain suggests independent coping mechanisms during experimental and clinical pain. Regarding the importance of the frontal cortex and the PAG in the descending pain modulation system, it seems reasonable to assume that these functional changes related to the context of stimulus presentation may contribute to central sensitization in FMS.