Neuroimaging placebo effects: new tools generate new questions.
Neuroimaging placebo effects: new tools generate new questions.
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神经影像安慰剂效应：新工具产生新问题。
DOI：
10.1038/clpt.2009.126
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发表时间：
2009
影响因子：
6.7
通讯作者：
London,ED
中科院分区：
文献类型：
--
作者：
Jarcho,JM;Mayer,EA;London,ED
安慰剂在历史上被定义为导致症状改善的惰性物质（例如，糖或面包丸），但现在更广泛地描述为包括在治疗环境中有助于症状改善的活性和非活性治疗的背景方面。这些情境可能与环境有关，包括药丸的大小和颜色、医生的举止或治疗的侵入性和成本。背景也可以由患者的先前经验或关于治疗功效的期望生成。安慰剂效应是对治疗的这些背景方面的认知，行为或生物反应。尽管安慰剂效应可能对临床试验造成困扰，但它们仍然是临床医生的重要工具，并且通常被证明对患者有益。尽管安慰剂效应有效，但科学界倾向于将其视为噪音，而不是潜在的研究主题。然而，一个重大的范式转变产生了新的兴趣，调查神经认知和神经化学机制，驱动安慰剂效应。这种重新关注的时间与越来越多的神经影像学工具重叠，允许调查这些无法通过自我报告或观察单独评估的潜在机制。
Placebos were historically defined as inert substances (eg, sugar or bread pills) that cause symptom improvement but are now characterized more broadly to include contextual aspects of both active and inactive treatments that contribute to symptom improvement in therapeutic settings. These contexts may be associated with the environment, including the size and color of a pill, a doctor’s demeanor, or the invasiveness and cost of a treatment. The context may also be generated by the patient’s prior experience or expectations about the efficacy of a treatment. Placebo effects are cognitive, behavioral, or biological responses to these contextual aspects of treatment.Although placebo effects may be a nuisance for clinical trials, they remain an important tool for clinicians and often prove beneficial for patients. Despite their efficacy, the scientific community has tended to regard placebo effects as noise rather than a potential topic of research. However, a major paradigm shift has generated renewed interest in investigating neurocognitive and neurochemical mechanisms that drive placebo effects. The timing of this renewed interest overlaps with increasing access to neuroimaging tools, allowing for investigation of these underlying mechanisms that cannot be readily assessed via self-report or observation alone.