Tags

Type your tag names separated by a space and hit enter

Neural mechanisms mediating positive and negative treatment expectations in visceral pain: a functional magnetic resonance imaging study on placebo and nocebo effects in healthy volunteers.
Pain. 2013 Nov; 154(11):2372-2380.PAIN

Abstract

To elucidate placebo and nocebo effects in visceral pain, we conducted a functional magnetic resonance imaging (fMRI) study to analyze effects of positive and negative treatment expectations in a rectal pain model. In 36 healthy volunteers, painful rectal distensions were delivered after intravenous application of an inert substance combined with either positive instructions of pain relief (placebo group) or negative instructions of pain increase (nocebo group), each compared to neutral instructions. Neural activation during cued-pain anticipation and pain was analyzed along with expected and perceived pain intensity. Expected and perceived pain intensity were significantly increased in the nocebo group and significantly decreased in the placebo group. In the placebo group, positive expectations significantly reduced activation of the somatosensory cortex during anticipation and of the insula, somatosensory cortex, and amygdala during pain delivery when compared to neutral expectations. Within the nocebo group, negative expectations led to significantly increased insula activation during painful stimulation. Direct group contrasts during expectation modulation revealed significantly increased distension-induced activation within the somatosensory cortex in the nocebo group. In conclusion, the experience and neural processing of visceral pain can be increased or decreased by drug-specific expectations. This first brain imaging study on nocebo effects in visceral pain has implications for the pathophysiology and treatment of patients with chronic abdominal complaints such as irritable bowel syndrome.

Authors+Show Affiliations

Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23867733

Citation

Schmid, Julia, et al. "Neural Mechanisms Mediating Positive and Negative Treatment Expectations in Visceral Pain: a Functional Magnetic Resonance Imaging Study On Placebo and Nocebo Effects in Healthy Volunteers." Pain, vol. 154, no. 11, 2013, pp. 2372-2380.
Schmid J, Theysohn N, Ga F, et al. Neural mechanisms mediating positive and negative treatment expectations in visceral pain: a functional magnetic resonance imaging study on placebo and nocebo effects in healthy volunteers. Pain. 2013;154(11):2372-2380.
Schmid, J., Theysohn, N., Ga, F., Benson, S., Gramsch, C., Forsting, M., Gizewski, E. R., & Elsenbruch, S. (2013). Neural mechanisms mediating positive and negative treatment expectations in visceral pain: a functional magnetic resonance imaging study on placebo and nocebo effects in healthy volunteers. Pain, 154(11), 2372-2380. https://doi.org/10.1016/j.pain.2013.07.013
Schmid J, et al. Neural Mechanisms Mediating Positive and Negative Treatment Expectations in Visceral Pain: a Functional Magnetic Resonance Imaging Study On Placebo and Nocebo Effects in Healthy Volunteers. Pain. 2013;154(11):2372-2380. PubMed PMID: 23867733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neural mechanisms mediating positive and negative treatment expectations in visceral pain: a functional magnetic resonance imaging study on placebo and nocebo effects in healthy volunteers. AU - Schmid,Julia, AU - Theysohn,Nina, AU - Ga,Florian, AU - Benson,Sven, AU - Gramsch,Carolin, AU - Forsting,Michael, AU - Gizewski,Elke R, AU - Elsenbruch,Sigrid, Y1 - 2013/07/16/ PY - 2013/04/15/received PY - 2013/06/26/revised PY - 2013/07/11/accepted PY - 2013/7/23/entrez PY - 2013/7/23/pubmed PY - 2014/5/29/medline KW - Expectations KW - Functional magnetic resonance imaging KW - Nocebo KW - Placebo KW - Rectal distension KW - Visceral pain SP - 2372 EP - 2380 JF - Pain JO - Pain VL - 154 IS - 11 N2 - To elucidate placebo and nocebo effects in visceral pain, we conducted a functional magnetic resonance imaging (fMRI) study to analyze effects of positive and negative treatment expectations in a rectal pain model. In 36 healthy volunteers, painful rectal distensions were delivered after intravenous application of an inert substance combined with either positive instructions of pain relief (placebo group) or negative instructions of pain increase (nocebo group), each compared to neutral instructions. Neural activation during cued-pain anticipation and pain was analyzed along with expected and perceived pain intensity. Expected and perceived pain intensity were significantly increased in the nocebo group and significantly decreased in the placebo group. In the placebo group, positive expectations significantly reduced activation of the somatosensory cortex during anticipation and of the insula, somatosensory cortex, and amygdala during pain delivery when compared to neutral expectations. Within the nocebo group, negative expectations led to significantly increased insula activation during painful stimulation. Direct group contrasts during expectation modulation revealed significantly increased distension-induced activation within the somatosensory cortex in the nocebo group. In conclusion, the experience and neural processing of visceral pain can be increased or decreased by drug-specific expectations. This first brain imaging study on nocebo effects in visceral pain has implications for the pathophysiology and treatment of patients with chronic abdominal complaints such as irritable bowel syndrome. SN - 1872-6623 UR - https://www.unboundmedicine.com/medline/citation/23867733/Neural_mechanisms_mediating_positive_and_negative_treatment_expectations_in_visceral_pain:_a_functional_magnetic_resonance_imaging_study_on_placebo_and_nocebo_effects_in_healthy_volunteers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/00006396-201311000-00019 DB - PRIME DP - Unbound Medicine ER -