Doctor trustworthiness influences pain and its neural correlates in virtual medical interactions.
Doctor trustworthiness influences pain and its neural correlates in virtual medical interactions.
复制标题
医生的可信度会影响虚拟医疗互动中的疼痛及其神经相关性。
DOI：
10.1093/cercor/bhac281
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Losin,ElizabethAReynolds
中科院分区：
文献类型：
--
作者：
Anderson,StevenR;Gianola,Morgan;Medina,NataliaA;Perry,JennaM;Wager,TorD;Losin,ElizabethAReynolds
信任是医患关系的重要组成部分，与提高患者满意度和健康结果相关。以前，我们报告说，病人的信任和相似的感觉，对他们的临床医生预测减少诱发疼痛的痛苦热刺激。在本研究中，我们研究了这种效应的大脑机制。我们使用了以前使用数据驱动的计算建模方法开发的面部刺激，这些方法在感知的可信度方面有所不同，并将它们叠加在穿着医生服装的身体上。在功能性磁共振成像期间，参与者（n = 42）与这些医生进行了一系列虚拟医疗互动，在此期间，他们接受了疼痛的热刺激作为疼痛诊断程序的模拟。参与者报告说，当接受来自低信任医生的疼痛热刺激时，疼痛会增加，这伴随着疼痛相关大脑区域和多变量疼痛预测神经标记物的活动增加。研究结果表明，患者对医生的信任可能对疼痛产生切实的影响，并指出通过调节与疼痛的感觉-歧视和情感-动机维度相关的脑回路，与信任相关的疼痛减少的潜在大脑基础。
Trust is an important component of the doctor-patient relationship and is associated with improved patient satisfaction and health outcomes. Previously, we reported that patient feelings of trust and similarity toward their clinician predicted reductions in evoked pain in response to painful heat stimulations. In the present study, we investigated the brain mechanisms underlying this effect. We used face stimuli previously developed using a data-driven computational modeling approach that differ in perceived trustworthiness and superimposed them on bodies dressed in doctors' attire. During functional magnetic resonance imaging, participants (n = 42) underwent a series of virtual medical interactions with these doctors during which they received painful heat stimulation as an analogue of a painful diagnostic procedure. Participants reported increased pain when receiving painful heat stimulations from low-trust doctors, which was accompanied by increased activity in pain-related brain regions and a multivariate pain-predictive neuromarker. Findings suggest that patient trust in their doctor may have tangible impacts on pain and point to a potential brain basis for trust-related reductions in pain through the modulation of brain circuitry associated with the sensory-discriminative and affective-motivational dimensions of pain.