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Manipulating placebo analgesia and nocebo hyperalgesia by changing brain excitability [Neuroscience]
Proceedings of the National Academy of Sciences of the United States of America ( IF 9.412 ) Pub Date : 2021-05-11 , DOI: 10.1073/pnas.2101273118
Yiheng Tu, Georgia Wilson, Joan Camprodon, Darin D. Dougherty, Mark Vangel, Fabrizio Benedetti, Ted J. Kaptchuk, Randy L. Gollub, Jian Kong

Harnessing placebo and nocebo effects has significant implications for research and medical practice. Placebo analgesia and nocebo hyperalgesia, the most well-studied placebo and nocebo effects, are thought to initiate from the dorsal lateral prefrontal cortex (DLPFC) and then trigger the brain’s descending pain modulatory system and other pain regulation pathways. Combining repeated transcranial direct current stimulation (tDCS), an expectancy manipulation model, and functional MRI, we investigated the modulatory effects of anodal and cathodal tDCS at the right DLPFC on placebo analgesia and nocebo hyperalgesia using a randomized, double-blind and sham-controlled design. We found that compared with sham tDCS, active tDCS could 1) boost placebo and blunt nocebo effects and 2) modulate brain activity and connectivity associated with placebo analgesia and nocebo hyperalgesia. These results provide a basis for mechanistic manipulation of placebo and nocebo effects and may lead to improved clinical outcomes in medical practice.



中文翻译:

通过改变大脑的兴奋性来控制安慰剂的镇痛和诺斯波的痛觉过敏[神经科学]

利用安慰剂和Nocebo的作用对研究和医学实践具有重要意义。安慰剂镇痛和Nocebo痛觉过敏是研究最深入的安慰剂和Nocebo效应,被认为是从背外侧前额叶皮层(DLPFC)引发的,然后触发大脑的下行疼痛调节系统和其他疼痛调节途径。结合重复经颅直流电刺激(tDCS),预期操纵模型和功能性MRI,我们使用随机,双盲和假对照研究了正确的DLPFC上的阳极和阴极tDCS对安慰剂镇痛和Nocebo痛觉过敏的调节作用。设计。我们发现,与假tDCS相比,活跃的tDCS可能会1)增强安慰剂和钝性Nocebo的作用,以及2)调节与安慰剂镇痛和Nocebo痛觉过敏相关的大脑活动和连通性。这些结果为机械控制安慰剂和Nocebo的作用提供了基础,并可能导致医疗实践中临床效果的改善。

更新日期:2021-05-03
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