Personality differences in brain network mechanisms for placebo analgesia and nocebo hyperalgesia in experimental pain: a functional magnetic resonance imaging study.
Personality differences in brain network mechanisms for placebo analgesia and nocebo hyperalgesia in experimental pain: a functional magnetic resonance imaging study.
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实验性疼痛中安慰剂镇痛和反安慰剂痛觉过敏的脑网络机制的人格差异：一项功能性磁共振成像研究
DOI：
10.21037/atm-20-5123
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发表时间：
2021-03
影响因子：
--
通讯作者：
Wu W
中科院分区：
文献类型：
--
作者：
Shi Y;Wang Y;Zeng Y;Zhan H;Huang S;Cai G;Yang J;Wu W
背景安慰剂和反安慰剂反应越来越受到临床和科学研究人员的关注。目前研究中不一致的结论表明，不同的因素可能影响安慰剂和反安慰剂的反应。越来越多的证据表明，性格差异可能会影响这两种反应的机制。在本研究中，我们基于功能连接分析（FC）和格兰杰因果分析（GCA）探讨了安慰剂和反安慰剂反应的神经信号特征。方法34名健康受试者接受条件诱导训练，建立安慰剂和反安慰剂反应。每位参与者完成以下实验流程：基线扫描、实验腰痛模型建立、急性疼痛状态扫描、安慰剂反应或反安慰剂反应扫描。我们在每次扫描后收集视觉模拟量表（VAS）数据。对不同人格组的功能磁共振成像（fMRI）数据进行FC分析和多元GCA （mGCA）。结果安慰剂组和反安慰剂组的疼痛评分在不同人格间有统计学差异。不同人格的两种反应的神经信号也有统计学上的差异。结论本研究结果表明，外向型和内向型受试者可能分别经历安慰剂镇痛效应和反安慰剂过敏效应。在安慰剂反应下，外向型和内向型参与者的大脑网络都发生了显著变化。情绪控制的变化和腹内侧前额叶皮层的不活动可能构成安慰剂镇痛的大部分人格差异。感觉传导系统（SCS）调节和情绪回路释放的差异可能是影响反安慰剂痛觉过敏人格差异的重要因素。
Background Placebo and nocebo responses have been increasingly gaining the attention of clinical and scientific researchers. Inconsistent conclusions from current studies indicate that different factors potentially affect both placebo and nocebo responses. Increasing evidence suggests that personality differences may affect the mechanisms of both two responses. In the present work, we explored the characteristics of neural signals of placebo and nocebo responses based on functional connectivity (FC) analysis and Granger causality analysis (GCA). Methods A total of 34 healthy participants received conditional induction training to establish placebo and nocebo responses. Every participant completed the following experimental workflow, including scanning of baseline, experimental low back pain model establishment, scanning of acute pain status, and scanning of placebo response or nocebo response. We collect visual analogue scale (VAS) data after each scanning. Functional magnetic resonance imaging (fMRI) data from different personality groups were subjected to FC analysis and multivariate GCA (mGCA). Results Pain scores for placebo and nocebo responses were statistically different across different personality. There are also statistically differences in the neural signals of two responses across different personality. Conclusions The findings of the present study indicated that extroverted and introverted participants are likely to experience placebo analgesic effects and nocebo hyperalgesia effects, respectively. Both extroverted and introverted participants showed significant changes in brain networks under placebo response. Variation in emotional control and ventromedial prefrontal cortex inactivity may constitute the bulk of the personality differences in placebo analgesia. Differences in the regulation of the sensory conduction system (SCS) and release of the emotional circuit could be important factors affecting personality differences in nocebo hyperalgesia.