Brain activity associated with expectancy-enhanced placebo analgesia as measured by functional magnetic resonance Imaging
Brain activity associated with expectancy-enhanced placebo analgesia as measured by functional magnetic resonance Imaging
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DOI：
10.1523/jneurosci.3556-05.2006
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发表时间：
2006-01-11
影响因子：
5.3
通讯作者：
Kaptchuk, TJ
中科院分区：
文献类型：
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作者：
Kong, J;Gollub, RL;Kaptchuk, TJ
在这项研究中，一个完善的期望操纵模型与一种新的安慰剂干预，一个验证假针灸针，研究参与安慰剂镇痛的脑网络。16名受试者完成了实验。我们发现，在安慰剂针灸治疗后，安慰剂治疗侧的主观疼痛评分降低（前减后）显著大于对照侧。当我们计算对比度时，从对照侧的相同差异中减去安慰剂侧疼痛应用期间治疗后和治疗前之间的功能性磁共振成像（fMRI）信号差异[例如，安慰剂（治疗前）-对照（治疗后）]，在双侧前扣带皮层（rACC）、外侧前额叶皮层、右前额叶、缘上回和左顶下小叶中观察到显著差异。将安慰剂侧和对照侧治疗前后的fMRI信号差异与相应的主观疼痛评分差异进行简单回归（相关）分析，结果显示双侧外侧/眶前额叶皮质、rACC、小脑、右侧梭状核、海马旁区和脑桥呈显著负相关。这些结果与之前的一项研究不同，该研究发现，当比较对施加于对照和安慰剂乳膏治疗的皮肤区域的有害刺激的反应时，疼痛敏感区域（如丘脑，丘脑和ACC）的活动减少。我们的研究结果表明，安慰剂镇痛可能是通过多种脑通路和机制配置。
In this study, a well established expectancy manipulation model was combined with a novel placebo intervention, a validated sham acupuncture needle, to investigate the brain network involved in placebo analgesia. Sixteen subjects completed the experiment. We found that after placebo acupuncture treatment, subjective pain rating reduction (pre minus post) on the placebo-treated side was significantly greater than on the control side. When we calculated the contrast that subtracts the functional magnetic resonance imaging ( fMRI) signal difference between post-treatment and pretreatment during pain application on placebo side from the same difference on control side [e.g., placebo (post - pre) - control (post - pre)], significant differences were observed in the bilateral rostral anterior cingulate cortex (rACC), lateral prefrontal cortex, right anterior insula, supramarginal gyrus, and left inferior parietal lobule. The simple regression ( correlation) analysis between each subject's fMRI signal difference of post-treatment and pretreatment difference on placebo and control side and the corresponding subjective pain rating difference showed that significant negative correlation was observed in the bilateral lateral/ orbital prefrontal cortex, rACC, cerebellum, right fusiform, parahippocampus, and pons. These results are different from a previous study that found decreased activity in pain-sensitive regions such as the thalamus, insula, and ACC when comparing the response to noxious stimuli applied to control and placebo cream-treated areas of the skin. Our results suggest that placebo analgesia may be configured through multiple brain pathways and mechanisms.