Neuromodulation of placebo and nocebo effects

 描述（由申请人提供）：人们对通过非侵入性脑神经调节技术增强人类潜力越来越感兴趣。经颅直流电刺激（tDCS）是一种神经调节技术，因其成本低、安全、耐受性好、临床适用且能够引起长期行为后遗症而显示出巨大的前景。 安慰剂和反安慰剂效应是临床护理和疗效研究的重要组成部分。通过直接调节某些大脑区域的兴奋性来利用这些效应将对医学实践和神经科学产生显着的影响。该提案的目的是探索 tDCS 诱导的右背外侧前额叶皮层 (rDLPFC) 的兴奋性变化如何调节健康人群和患者群体的安慰剂镇痛和反安慰剂痛觉过敏。 在实验 1 中，我们将研究增强/抑制 rDLPFC 兴奋性对健康人群安慰剂/反安慰剂反应神经回路的调节作用。在实验 2 中，我们将通过增加 rDLPFC 的兴奋性来关注慢性腰痛 (cLBP) 患者安慰剂效应的神经机制。此外，我们还将探讨提高热痛镇痛预期是否可以促进 cLBP 患者的临床改善。 增强和抑制人类特定大脑区域的兴奋性并研究其对人类行为的影响的能力是了解大脑功能和电路的关键。使用 tDCS 等设备使我们能够从观察转向对神经因果关系更加机械的理解。这项研究取得的结果将为在临床实践和研究中利用自我控制能力优化安慰剂和反安慰剂效应、促进新的疼痛管理方法的开发以及阐明人脑与行为之间的关系提供新的思路。

 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.