The brain systems underlying placebo analgesia are insufficiently understood. Here we performed a systematic, participant-level meta-analysis of experimental functional neuroimaging studies of evoked pain under stimulus-intensity-matched placebo and control conditions, encompassing 603 healthy participants from 20 (out of 28 eligible) studies. We find that placebo vs. control treatments induce small, widespread reductions in pain-related activity, particularly in regions belonging to ventral attention (including mid-insula) and somatomotor networks (including posterior insula). Behavioral placebo analgesia correlates with reduced pain-related activity in these networks and the thalamus, habenula, mid-cingulate, and supplementary motor area. Placebo-associated activity increases occur mainly in frontoparietal regions, with high between-study heterogeneity. We conclude that placebo treatments affect pain-related activity in multiple brain areas, which may reflect changes in nociception and/or other affective and decision-making processes surrounding pain. Between-study heterogeneity suggests that placebo analgesia is a multi-faceted phenomenon involving multiple cerebral mechanisms that differ across studies.
Meta-analysis of neural systems underlying placebo analgesia from individual participant fMRI data / Zunhammer, M.; Spisak, T.; Wager, T. D.; Bingel, U.; Atlas, L.; Benedetti, F.; Buchel, C.; Choi, J. C.; Colloca, L.; Duzzi, D.; Eippert, F.; Ellingsen, D. -M.; Elsenbruch, S.; Geuter, S.; Kaptchuk, T. J.; Kessner, S. S.; Kirsch, I.; Kong, J.; Lamm, C.; Leknes, S.; Lui, F.; Mullner-Huber, A.; Porro, C. A.; Rutgen, M.; Schenk, L. A.; Schmid, J.; Theysohn, N.; Tracey, I.; Wrobel, N.; Zeidan, F.. - In: NATURE COMMUNICATIONS. - ISSN 2041-1723. - 12:1(2021), pp. N/A-N/A. [10.1038/s41467-021-21179-3]
Meta-analysis of neural systems underlying placebo analgesia from individual participant fMRI data
Lui F.;Porro C. A.;
2021
Abstract
The brain systems underlying placebo analgesia are insufficiently understood. Here we performed a systematic, participant-level meta-analysis of experimental functional neuroimaging studies of evoked pain under stimulus-intensity-matched placebo and control conditions, encompassing 603 healthy participants from 20 (out of 28 eligible) studies. We find that placebo vs. control treatments induce small, widespread reductions in pain-related activity, particularly in regions belonging to ventral attention (including mid-insula) and somatomotor networks (including posterior insula). Behavioral placebo analgesia correlates with reduced pain-related activity in these networks and the thalamus, habenula, mid-cingulate, and supplementary motor area. Placebo-associated activity increases occur mainly in frontoparietal regions, with high between-study heterogeneity. We conclude that placebo treatments affect pain-related activity in multiple brain areas, which may reflect changes in nociception and/or other affective and decision-making processes surrounding pain. Between-study heterogeneity suggests that placebo analgesia is a multi-faceted phenomenon involving multiple cerebral mechanisms that differ across studies.File | Dimensione | Formato | |
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