Dysfunction in Serotonergic and Noradrenergic Systems and Somatic Symptoms in Psychiatric Disorders

Abstract

Somatic symptoms include a range of physical experiences, such as pain, muscle tension, body shaking, difficulty in breathing, heart palpitation, blushing, fatigue, and sweating. Somatic symptoms are common in major depressive disorder (MDD), anxiety disorders, and some other psychiatric disorders. However, the etiology of somatic symptoms remains unclear. Somatic symptoms could be a response to emotional distress in patients with those psychiatric conditions. Increasing evidence supports the role of aberrant serotoninergic and noradrenergic neurotransmission in somatic symptoms. The physiological alterations underlying diminished serotonin (5-HT) and norepinephrine (NE) signaling may contribute to impaired signal transduction, reduced 5-HT, or NE release from terminals of presynaptic neurons, and result in alternations in function and/or number of receptors and changes in intracellular signal processing. Multiple resources of data support each of these mechanisms. Animal models have shown physiological responses, similar to somatic symptoms seen in psychiatric patients, after manipulations of 5-HT and NE neurotransmission. Human genetic studies have identified many single-nucleotide polymorphisms risk loci associated with somatic symptoms. Several neuroimaging findings support that somatic symptoms are possibly associated with a state of reduced receptor binding. This narrative literature review aimed to discuss the involvement of serotonergic and noradrenergic systems in the pathophysiology of somatic symptoms. Future research combining neuroimaging techniques and genetic analysis to further elucidate the biological mechanisms of somatic symptoms and to develop novel treatment strategies is needed.

A Systematic Review of Efficacy, Safety, and Tolerability of Duloxetine

“…The monoaminergic hypothesis is based on a partial or total deficit of 5-HT or NE in the central nervous system (CNS) (128,129). Somatic symptoms such as muscle tension, neuropathic and musculoskeletal pain, fatigue, or dizziness are common in MDD and GAD among other psychiatric disorders as result of aberrant 5-HT and NE neurotransmission (130). Regarding pain, antinociception and pronociceptive modulation occurs through 5-HT receptors, in both the central and peripheral nervous systems (131).…”

Regulation of GABAA and 5-HT Receptors Involved in Anxiolytic Mechanisms of Jujube Seed: A System Biology Study Assisted by UPLC-Q-TOF/MS and RT-qPCR Method

“…It was well established that the alteration of various behaviors in anxiety disorders including appetite, mood, sleep, and cognitive function have been linked to the serotonergic system (Liu Y. et al, 2018;Liu et al, 2019). Serotonin receptors are FIGURE 4 | The interaction networks of enriched biological processes.…”

“…It was well established that the alteration of various behaviors in anxiety disorders including appetite, mood, sleep, and cognitive function have been linked to the serotonergic system ( Liu Y. et al, 2018 ; Liu et al, 2019 ). Serotonin receptors are prevalent throughout the nervous system and the periphery, and they potentially control the serotonergic neurotransmission throughout the brain and neuronal activity to alleviate neuropsychiatric disorders ( Okazawa et al, 1999 ).…”

A Systematic Literature Review of the Association Between Somatic Symptom Disorder and Antisocial Personality Disorder

“…5-HT is involved in vascular function, proper cardiac function, gastrointestinal function, reproduction, and pregnancy [16]. It is released from the presynaptic nerve terminal and 5-HT transporter receives the signal [17,18]. The decreased levels of the neurotransmitter are proposed to be associated with somatic symptoms [17,18].…”

“…It is released from the presynaptic nerve terminal and 5-HT transporter receives the signal [17,18]. The decreased levels of the neurotransmitter are proposed to be associated with somatic symptoms [17,18]. It has previously been found that the amount of right orbitofrontal serotonin transporter expressed in the prefrontal cortex region is positively correlated with somatization and the development of SSD [18].…”