Abstract
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.4–6
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