The dynamic mechanisms of placebo induced analgesia: Evidence of sustained and transient regional involvement.
The dynamic mechanisms of placebo induced analgesia: Evidence of sustained and transient regional involvement.
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DOI：
10.1016/j.pain.2008.07.025
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发表时间：
2008-10-31
期刊：
影响因子：
7.4
通讯作者：
Robinson ME
中科院分区：
文献类型：
--
作者：
Craggs JG;Price DD;Perlstein WM;Verne NG;Robinson ME
以前，我们证明了安慰剂镇痛（PA）伴随着疼痛刺激期间神经活动的减少。这项研究调查了在PA过程中神经活动增加的大脑区域。文献将PA与两种潜在的作用机制联系起来；一种是持续的（例如，在PA期间参与），另一种是暂时的（例如，反馈机制）。我们认为，PA是由两种互补的疼痛调节机制共同作用的结果，这两种机制被fMRI数据确定为条件或时间*条件相互作用的主要影响。具有持续活动的机制应该激活事件记忆形成所需的情绪调节回路。具有短暂活动的机制应在安慰剂暗示的背景下处理刺激物的认知和评价信息，以确认其设定的期望。为了确定与这些机制相关的区域，我们重新分析了基线(B)和PA两种情况下的fMRI数据。结果支持这两种机制的存在，确定为两个具有不同时间特征的神经网络。持续活动的区域主要涉及颞叶和海马旁皮层。相反，具有短暂活动的大脑区域包括左半球的语言中心，右半球的额叶区域通常与执行功能有关。总之，这些机制可能参与镇痛过程，然后简单地监测系统的意外刺激，有效地为其他过程释放资源。与疼痛调节相关的大脑区域具有不同的时间分布，这与PA的多维性是一致的，并强调了继续研究这种结构的必要性。
Previously, we demonstrated that placebo analgesia (PA) accompanies reductions in neural activity during painful stimulation. This study investigated areas of the brain where neural activity increased during PA. The literature has associated PA with two potential mechanisms of action; one sustained (e.g., engaged for the duration of PA), the other, transitory (e.g., a feedback mechanism). We propose that PA results from the engagement of two complementary pain-modulation mechanisms that are identified with fMRI data as a main-effect for condition or a time*condition interaction. The mechanism with sustained activity should activate the emotional regulation circuitry needed for memory formation of the event. The mechanism with transient activity should process cognitive and evaluative information of the stimuli in the context of the placebo suggestion to confirm the expectations set by it. To identify regions involved with these mechanisms, we re-analyzed fMRI data from two conditions, baseline (B) and PA. Results support the presence of both mechanisms, identified as two neural-networks with different temporal characteristics. Regions with sustained activity primarily involved the temporal and parahippocampal cortices. Conversely, brain regions with transient activity included linguistic centers in the left hemisphere, and frontal regions of the right hemisphere generally associated with executive functioning. Together, these mechanisms likely engage analgesic processes and then simply monitor the system for unexpected stimuli, effectively liberating resources for other process. That brain regions associated with pain modulation have different temporal profiles is consistent with the multidimensionality of PA and highlights the need for continued investigation of this construct.
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影响因子：
29.4
作者：
WHITEHEAD, WE;CHESKIN, LJ;SCHUSTER, MM
通讯作者：
SCHUSTER, MM
影响因子：
5.7
作者：
Craggs, Jason G.;Price, Donald D.;Robinson, Michael M.
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影响因子：
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作者：
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通讯作者：
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影响因子：
7.4
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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