Neuromodulation of placebo and nocebo effects

安慰剂和反安慰剂效应的神经调节

• 批准号: 8962495
• 负责人: JIAN KONG
• 金额: $ 75.93万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8962495
• 关键词: Absence of pain sensation; Acute Pain; Affective; Analgesics; Anterior; Anxiety; Area; Basic Science; Behavior; Behavioral; Brain; Brain region; Chronic low back pain; Clinical; Clinical Research; Cognition; Cognitive; Control Groups; Cream; Development; Devices; Dorsal; Effectiveness; Etiology; Expectancy; Functional Magnetic Resonance Imaging; Goals; Gray unit of radiation dose; Health; Heating; Hippocampus (Brain); Human; Hyperalgesia; Insula of Reil; Lateral; Light; Measures; Medical; Modeling; Neurosciences; Outcome; Pain; Pain Management Method; Pain Research; Patients; Placebo Effect; Placebos; Population; Prefrontal Cortex; Process; Rest; Self-control as a personality trait; Signal Transduction; Somatosensory Cortex; Suggestion; System; Techniques; behavioral response; brain behavior; cingulate cortex; clinical care; clinical efficacy; clinical practice; cognitive modulation of pain; conditioning; cost; executive function; insight; interest; method development; neural circuit; neuromechanism; neuroregulation; patient population; relating to nervous system; research study; response; tool

 DESCRIPTION (provided by applicant): There is a growing interest in the enhancement of human potential by means of non-invasive brain neuromodulatory techniques. Transcranial direct current stimulation (tDCS) is a type of neuromodulatory technique that shows great promise as it is low cost, safe, well tolerated, clinically applicable and capable of inducing long-term behavioral after-effects. Placebo and nocebo effects are a critical component of clinical care and efficacy studies. Harnessing these effects by directly modulating the excitability of certain brain regions will have a significantly high impact on both medical practice and neuroscience. The goal of this proposal is to explore how excitability changes in the right dorsolateral prefrontal cortex (rDLPFC) induced by tDCS can modulate placebo analgesia and nocebo hyperalgesia in both healthy and patient populations. In Experiment 1, we will investigate the modulation effects of enhancing/inhibiting excitability of the rDLPFC on the neural circuitry underlying placebo / nocebo responses in a healthy population. In Experiment 2, we will focus on the neural mechanisms underlying the placebo effect in chronic low back pain (cLBP) patients by increasing the excitability of the rDLPFC. Furthermore, we will also explore whether boosted analgesic expectancy of heat pain can enhance clinical improvement in cLBP patients. The ability to enhance and inhibit excitability of specific brain regions in humans and investigate its effect on human behavior is key to understanding brain function and circuitry. Using devices such as tDCS allows us to move forward from observation to a more mechanistic understanding of neural causation. The results achieved in this study will shed new light on harnessing the self-control capacities to optimize the placebo and nocebo effects in clinical practice and research, facilitating development of new pain management methods, and elucidating the relationship between the human brain and behavior.

 描述(申请人提供)：人们对通过非侵入性的脑神经调节技术来增强人类潜能越来越感兴趣。经颅直流电刺激(TDC)是一种具有成本低、安全、耐受性好、临床适用、可诱发长期行为后遗症的神经调节技术。安慰剂和NOCEBO效应是临床护理和疗效研究的重要组成部分。通过直接调节大脑某些区域的兴奋性来利用这些效应，将对医疗实践和神经科学产生重大影响。本研究的目的是探讨tdcs诱导的右侧背外侧前额叶皮质(RDLPFC)兴奋性变化如何调节健康人群和患者群体的安慰剂止痛和痛觉过敏症。 在实验1中，我们将研究增强/抑制rDLPFC的兴奋性对健康人群中安慰剂/NOCEBO反应的神经回路的调制作用。在实验2中，我们将重点研究慢性下腰痛(CLBP)患者通过增加rDLPFC的兴奋性来实现安慰剂效应的神经机制。此外，我们还将探讨提高热痛的止痛预期是否可以促进cLBP患者的临床改善。增强和抑制人类大脑特定区域的兴奋性并研究其对人类行为的影响的能力是理解大脑功能和电路的关键。通过使用tdcs等设备，我们可以从观察到对神经因果关系的更机械化的理解。这项研究的结果将为在临床实践和研究中利用自我控制能力来优化安慰剂和非安慰剂的效果，促进新的疼痛管理方法的开发，以及阐明人脑和行为之间的关系提供新的线索。