The Temporal Modulation of Nocebo Hyperalgesia in a Model of Sustained Pain

Camerone, Eleonora Maria; Battista, Simone; Carlino, Elisa; Sansone, Lucia Grazia; Buzzatti, Luca; Scafoglieri, Aldo; Testa, Marco

doi:10.3389/fpsyt.2022.807138

Cited by 3 publications

(1 citation statement)

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“…Different approaches have been used to trigger pain amelioration or exacerbation: the two most common procedures are (1) the use of positive or negative expectations and (2) the use of conditioning approaches [ 11 , 12 ]. In the first case, inert treatments are administered along with verbal information that a real treatment is delivered: using this approach, participants or patients are made to believe that a treatment is administered and a positive or negative effect is expected [ 16 , 17 , 18 , 19 ]. In the second case, using conditioning protocols, a real treatment is administered for different trials and subsequently replaced by an inert treatment: using this approach, participants or patients experience a positive effect when the active treatment is administered, and they expect the same effect when the inert treatment is delivered unbeknownst to them [ 20 , 21 , 22 ].…”

Section: State Of the Artmentioning

confidence: 99%

The Biology of Placebo and Nocebo Effects on Experimental and Chronic Pain: State of the Art

Rossettini,

Campaci,

Bialosky

et al. 2023

JCM

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(1) Background: In recent years, placebo and nocebo effects have been extensively documented in different medical conditions, including pain. The scientific literature has provided strong evidence of how the psychosocial context accompanying the treatment administration can influence the therapeutic outcome positively (placebo effects) or negatively (nocebo effects). (2) Methods: This state-of-the-art paper aims to provide an updated overview of placebo and nocebo effects on pain. (3) Results: The most common study designs, the psychological mechanisms, and neurobiological/genetic determinants of these phenomena are discussed, focusing on the differences between positive and negative context effects on pain in experimental settings on healthy volunteers and in clinical settings on chronic pain patients. Finally, the last section describes the implications for clinical and research practice to maximize the medical and scientific routine and correctly interpret the results of research studies on placebo and nocebo effects. (4) Conclusions: While studies on healthy participants seem consistent and provide a clear picture of how the brain reacts to the context, there are no unique results of the occurrence and magnitude of placebo and nocebo effects in chronic pain patients, mainly due to the heterogeneity of pain. This opens up the need for future studies on the topic.

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Section: State Of the Artmentioning

confidence: 99%

The Biology of Placebo and Nocebo Effects on Experimental and Chronic Pain: State of the Art

Rossettini,

Campaci,

Bialosky

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

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Differential neural activity predicts the long-term stability of the effects of positive and negative expectations on pain

Wolf,

Wittkamp,

Rose

2024

Sci Rep

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Expectations modulating pain perception is a well-researched phenomenon, but less is known about the persistence of expectation effects over longer time-courses. In this preregistered study, we examined the persistence of positive (placebo) and negative (nocebo) expectation effects over one week and investigated whether neural activity on day 1 (fMRI) can predict the stability of these effects one week later (n = 41). We tested whether expectations were reflected in EEG oscillatory activity at the second measurement. Both positive and negative pain modulation effects persisted over the tested time-period and did not undergo extinction. Expectations of higher compared to lower pain led to larger theta-to-alpha EEG activity. Most interestingly, differential neural activity in fMRI was correlated with persistent expectations. Individual differences in the persistence of positive expectation effects were related to reduced amygdala activity and enhanced activity in the anterior insula and dorsolateral prefrontal cortex (DLPFC) during the first session. In contrast, persistence of negative expectation effects was predicted by enhanced thalamus activity. Our findings indicate relatively stable placebo and nocebo effects over longer time courses, but this persistence is based on different neural areas for positive and negative expectations.

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The role of pain expectancy and its confidence in placebo hypoalgesia and nocebo hyperalgesia

Camerone,

Tosi,

Romano

2024

Pain

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Placebo hypoalgesia and nocebo hyperalgesia, which exemplify the impact of expectations on pain, have recently been conceptualised as Bayesian inferential processes, yet empirical evidence remains limited. Here, we explore whether these phenomena can be unified within the same Bayesian framework by testing the predictive role of expectations and their level of precision (ie, expectation confidence) on pain, with both predictors measured at the metacognitive level. Sixty healthy volunteers underwent a pain test (ie, 8 noxious electrical stimuli) before (Baseline) and after (T0, T1, T2) receiving a sham treatment associated with hypoalgesic (placebo), hyperalgesic (nocebo), or neutral (control) verbal suggestions, depending on group allocation. Trial-by-trial expectations, their precision, and perceived pain were measured. Skin conductance response (SCR) was also recorded as an autonomic response marker. Bayesian linear mixed models analyses revealed that, for both placebo and nocebo, pain was predicted by expectations alone and by their interaction with expectations precision. In addition, the discrepancy between expected and perceived pain was predicted by expectation precision, with greater alignment between expected and perceived pain when precision was higher. This suggests that both placebo and nocebo responses are well described from a Bayesian perspective. A main effect of time for SCR was observed, suggesting habituation to painful stimuli. Our data provide evidence indicating that both placebo hypoalgesia and nocebo hyperalgesia can be unified within the same Bayesian framework in which not only expectations but also their level of precision, both measured at the metacognitive level, are key determinants of the pain inferential process.

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The Temporal Modulation of Nocebo Hyperalgesia in a Model of Sustained Pain

Cited by 3 publications

References 61 publications

The Biology of Placebo and Nocebo Effects on Experimental and Chronic Pain: State of the Art

The Biology of Placebo and Nocebo Effects on Experimental and Chronic Pain: State of the Art

Differential neural activity predicts the long-term stability of the effects of positive and negative expectations on pain

The role of pain expectancy and its confidence in placebo hypoalgesia and nocebo hyperalgesia

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