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New insights into the placebo and nocebo responses.
Neuron. 2008 Jul 31; 59(2):195-206.N

Abstract

In modern medicine, the placebo response or placebo effect has often been regarded as a nuisance in basic research and particularly in clinical research. The latest scientific evidence has demonstrated, however, that the placebo effect and the nocebo effect, the negative effects of placebo, stem from highly active processes in the brain that are mediated by psychological mechanisms such as expectation and conditioning. These processes have been described in some detail for many diseases and treatments, and we now know that they can represent both strength and vulnerability in the course of a disease as well as in the response to a therapy. However, recent research and current knowledge raise several issues that we shall address in this review. We will discuss current neurobiological models like expectation-induced activation of the brain reward circuitry, Pavlovian conditioning, and anxiety mechanisms of the nocebo response. We will further explore the nature of the placebo responses in clinical trials and address major questions for future research such as the relationship between expectations and conditioning in placebo effects, the existence of a consistent brain network for all placebo effects, the role of gender in placebo effects, and the impact of getting drug-like effects without drugs.

Authors+Show Affiliations

Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital, 72076 Tübingen, Germany. paul.enck@uni-tuebingen.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18667148

Citation

Enck, Paul, et al. "New Insights Into the Placebo and Nocebo Responses." Neuron, vol. 59, no. 2, 2008, pp. 195-206.
Enck P, Benedetti F, Schedlowski M. New insights into the placebo and nocebo responses. Neuron. 2008;59(2):195-206.
Enck, P., Benedetti, F., & Schedlowski, M. (2008). New insights into the placebo and nocebo responses. Neuron, 59(2), 195-206. https://doi.org/10.1016/j.neuron.2008.06.030
Enck P, Benedetti F, Schedlowski M. New Insights Into the Placebo and Nocebo Responses. Neuron. 2008 Jul 31;59(2):195-206. PubMed PMID: 18667148.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New insights into the placebo and nocebo responses. AU - Enck,Paul, AU - Benedetti,Fabrizio, AU - Schedlowski,Manfred, PY - 2008/01/22/received PY - 2008/06/07/revised PY - 2008/06/30/accepted PY - 2008/8/1/pubmed PY - 2008/8/30/medline PY - 2008/8/1/entrez SP - 195 EP - 206 JF - Neuron JO - Neuron VL - 59 IS - 2 N2 - In modern medicine, the placebo response or placebo effect has often been regarded as a nuisance in basic research and particularly in clinical research. The latest scientific evidence has demonstrated, however, that the placebo effect and the nocebo effect, the negative effects of placebo, stem from highly active processes in the brain that are mediated by psychological mechanisms such as expectation and conditioning. These processes have been described in some detail for many diseases and treatments, and we now know that they can represent both strength and vulnerability in the course of a disease as well as in the response to a therapy. However, recent research and current knowledge raise several issues that we shall address in this review. We will discuss current neurobiological models like expectation-induced activation of the brain reward circuitry, Pavlovian conditioning, and anxiety mechanisms of the nocebo response. We will further explore the nature of the placebo responses in clinical trials and address major questions for future research such as the relationship between expectations and conditioning in placebo effects, the existence of a consistent brain network for all placebo effects, the role of gender in placebo effects, and the impact of getting drug-like effects without drugs. SN - 1097-4199 UR - https://www.unboundmedicine.com/medline/citation/18667148/New_insights_into_the_placebo_and_nocebo_responses_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0896-6273(08)00585-0 DB - PRIME DP - Unbound Medicine ER -