The Frontal Cortex Implicated with Somatic Symptom Disorder

We have more and more research indicating there being changes in the brain with chronic pain. In particular, an area of the brain called the orbitofrontal cortex has been implicated with somatic symptom disorder. Somatic symptom disorder (SSD) can be many different symptoms in the body without a structural cause. It’s primarily what I diagnose and treat daily.

What they found from that 2023 study was that:

“The orbitofrontal cortex (OFC) was markedly smaller in SSD patients than in healthy controls, suggesting that the OFC may be associated with SSD pathophysiology.”

What you can take from that study is that the OFC is atrophied, like a muscle that has been weakened. The good news is that it can be strengthened, which is a big part of the work I do with people in treating SSD.

An article in the New York Times titled ‘Scientists find brain signals of chronic pain’ talks more about this area of the brain and its role and importance in chronic pain. Dr. Ajay Wasan, a pain medicine specialist at the University of Pittsburgh School of Medicine says: “The study really advances a whole generation of research that has shown that the functioning of the brain is really important to processing and perceiving pain.”

The OFC part of the brain has been shown to be involved with emotion regulation, self-evaluation, and decision-making, all areas that I work on with people suffering from chronic pain and SSD. There’s lots more to discover in the brain, it’s the final frontier you could say with medicine. “We’re just getting started,” said Dr. Edward Chang, a neurosurgeon at the University of California, San Francisco. “This is just chapter one.” We have more to learn but what can start to do is apply what we know about the brain and work to change it to our benefit for healing.