Manipulating placebo analgesia and nocebo hyperalgesia by changing brain excitability.
Adult
Analgesia
/ methods
Analysis of Variance
Brain
/ diagnostic imaging
Double-Blind Method
Female
Humans
Hyperalgesia
/ physiopathology
Magnetic Resonance Imaging
/ methods
Male
Nocebo Effect
Pain
/ physiopathology
Pain Management
/ methods
Placebo Effect
Prefrontal Cortex
/ diagnostic imaging
Surveys and Questionnaires
Transcranial Direct Current Stimulation
/ methods
Young Adult
dorsolateral prefrontal cortex
expectancy manipulation
mechanistic manipulation
placebo and nocebo effects
transcranial direct current stimulation
Journal
Proceedings of the National Academy of Sciences of the United States of America
ISSN: 1091-6490
Titre abrégé: Proc Natl Acad Sci U S A
Pays: United States
ID NLM: 7505876
Informations de publication
Date de publication:
11 05 2021
11 05 2021
Historique:
entrez:
4
5
2021
pubmed:
5
5
2021
medline:
15
12
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 33941677
pii: 2101273118
doi: 10.1073/pnas.2101273118
pmc: PMC8126770
pii:
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NCCIH NIH HHS
ID : R01 AT008563
Pays : United States
Déclaration de conflit d'intérêts
Competing interest statement: J.K. holds equity in a startup company (MNT) and a pending patent to develop new peripheral neuromodulation tools, but declares no conflict of interest. All other authors declare no conflict of interest.
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