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J R Soc Med. 2005 March; 98(3): 135.
PMCID: PMC1079425

Brain imaging in fatigue syndromes

In their article on the incidence of fatigue symptoms and diagnoses (December 2004, JRSM1) Gallagher and co-workers cite Wessely's view that 'chronic fatigue is one of a diverse group of physical symptoms that have long defied satisfactory explanation by doctors'.2 Recent developments in functional MRI have pointed to a more scientific approach in diagnosing these conditions. Gracely et al.3 demonstrated augmented pain processing in fibromyalgia with increased signals in the anterior cingulate cortex during fMRI. Furthermore, in order to ascertain the veracity of subjective claims, fMRI indicates that attempted deception will cause increased activity in the ventrolateral, prefrontal, anterior cingulate and premotor cortex.46


1. Gallagher AM, Thomas JM, Hamilton WT, White PD. Incidence of fatigue symptoms and diagnoses presenting in UK primary care from 1990 to 2001. J R Soc Med 2004; 97: 571-5 [PMC free article] [PubMed]
2. Wessely S, Nimnuan C, Sharpe M. Functional somatic syndromes: one or many? Lancet 1999; 354: 936-9 [PubMed]
3. Gracely RH, Petzke F, Wolf JM, Clauw DJ. Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum 2002; 46: 1333-43 [PubMed]
4. Langleben DD, Schroeder L, Maldjian JA, et al. Brain activity during simulated deception: an event related functional magnetic resonance study. Neuroimage 2002; 15: 727-32 [Rapid Communication 1-6] [PubMed]
5. Lee TM, Liu HL, Tan LH, et al. Lie detection by functional magnetic resonance imaging. Human Brain Mapping 2002; 15: 157-64 [PubMed]
6. Spence SA, Farrow TFD, Herford AE, Wilkinson ID, Zheng Y, Woodruff PWR. Behavioural and functional anatomical correlates of deception in humans. Neurorep 2001; 12: 2849-53 [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press