安慰剂治疗会影响与情感和认知过程相关的大脑系统,但不会影响感知性疼痛
Rotem Botvinik-Nezer1,2, Bogdan Petre3, Marta Ceko4
1Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel. rotemb9@gmail.com.
Nature communications
|July 17, 2024
概括
安慰剂治疗有效地通过影响认知和情感大脑过程来减少疼痛感知,而不是通过改变直接的感知信号来减少疼痛感知. 这种理解对于开发更好的疼痛管理策略至关重要.
科学领域:
- 神经科学是一个神经科学.
- 疼痛研究 疼痛研究
- 医疗成像医学成像
背景情况:
- 目前的止痛药治疗常常表现出类似于安慰剂的疗效.
- 了解安慰剂机制对于推进疼痛治疗开发和临床实践至关重要.
研究的目的:
- 为了调查安慰剂止痛药是否调节可感知过程.
- 为了确定安慰剂效应是否在不同的疼痛类型 (有条件和无条件) 中概括.
主要方法:
- 这是一项大规模的功能磁共振成像 (fMRI) 研究,共有392名参与者.
- 预先注册的分析来评估安慰剂对热和机械疼痛的影响.
- 通过使用已确定的疼痛特征来检查大脑活动,例如神经性疼痛特征 (NPS) 和刺激强度独立疼痛特征 (SIIPS).
主要成果:
- 安慰剂止痛疗法对有条件的热性疼痛有很强的效果,对无条件的机械性疼痛有很强的效果.
- 在可感知大脑区域 (NPS,脊othalamic通路) 没有观察到fMRI活动的减少,有强有力的证据支持无效效应.
- 安慰剂减少了SIIPS和调节与动机和价值相关的大脑区域的活动,表明认知和情感驱动因素.
- 意想不到的是,安慰剂增加了无条件机械疼痛的一些脊柱体区域的活性.
结论:
- 安慰剂镇痛主要源于认知和情感过程,而不是直接调节 nociception.
- 像SIIPS这样的神经标志物可以帮助区分安慰剂对 nociception 和评估性疼痛组件的影响.
- 研究结果突出了针对认知和情感途径的潜力,以加强疼痛管理.
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