Understanding placebo and nocebo responses for pain management.

Understanding placebo and nocebo responses for pain management.
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DOI:
10.1007/s11916-014-0419-2
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发表时间:
2014-06
影响因子:
3.7
通讯作者:
Grillon, Christian
Grillon, Christian
中科院分区:
医学3区
文献类型:
--
作者:
Colloca, Luana;Grillon, Christian

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安慰剂镇痛使个体仅仅凭借预期的益处而体验到疼痛的缓解。当安慰剂跟随积极有效的止痛药给药时,疼痛也会减轻。事实上,研究表明,安慰剂模拟了积极治疗的作用,并促进了人类和动物体内阿片类药物的内源性释放。最后,社会支持和观察学习也会产生镇痛效果。因此,不同的心理因素和情况诱导镇痛的期望,促进自上而下的疼痛控制系统的激活沿着内源性介质的释放,这些介质在安慰剂诱导的益处中至关重要。最近在脑成像领域的科学研究为理解预期引起的疼痛调制的认知机制和神经生物学基础开辟了新的途径。深入了解自上而下的疼痛调节机制对个性化和优化疼痛管理具有巨大的意义。
Placebo analgesia makes individuals experience relief of their pain simply by virtue of the anticipation of a benefit. A reduction of pain can occur also when placebos follow the administration of active and effective painkillers. In fact, studies indicate that placebos mimic the action of active treatments and promote the endogenous release of opioids in both humans and animals. Finally, social support and observational learning also lead to analgesic effects. Thus, different psychological factors and situations induce expectations of analgesia facilitating the activation of the top-down systems for pain control along with the release of endogenous mediators crucially involved in placebo-induced benefits. Recent scientific investigation in the field of brain imaging is opening new avenues to understanding the cognitive mechanisms and neurobiological substrates of expectation-induced pain modulation. Gaining deeper knowledge of top-down mechanisms of pain modulation has enormous implications for personalizing and optimizing pain management.
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