Neuromodulation of placebo and nocebo effects

 描述（由申请人提供）：人们越来越关注通过非侵入性脑神经调节技术来增强人类潜能。经颅直流电刺激（tDCS）是一种神经调节技术，具有成本低、安全、耐受性好、临床适用和能够诱导长期行为后效等优点，具有很大的应用前景。 安慰剂和nocebo效应是临床护理和疗效研究的关键组成部分。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重大影响。本提案的目的是探讨如何在右背外侧前额叶皮层（rDLPFC）的兴奋性变化诱导tDCS可以调节安慰剂镇痛和nocebo痛觉过敏的健康和患者人群。 在实验1中，我们将研究在健康人群中增强/抑制rDLPFC的兴奋性对安慰剂/反安慰剂反应相关神经回路的调节作用。在实验2中，我们将集中在慢性下腰痛（cLBP）患者的安慰剂效应的神经机制，通过增加的rDLPFC的兴奋性。此外，我们还将探讨提高热痛的镇痛预期是否可以提高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理解大脑功能和电路的关键。使用tDCS等设备可以让我们从观察前进到对神经因果关系的更机械的理解。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.