# placebos and pain



## poet (Nov 17, 2003)

Placebo-Induced Changes in fMRI in the Anticipation and Experience of PainTor D. Wager, James K. Rilling, Edward E. Smith, Alex Sokolik, Kenneth L. Casey, Richard J. Davidson, Stephen M. Kosslyn, Robert M. Rose, and Jonathan D. Cohen Science 2004 303: 1162-1167The experience of pain arises from both physiological and psychological factors, including one's beliefs and expectations. Thus, placebo treatments that have no intrinsic pharmacological effects may produce analgesia by altering expectations. However, controversy exists regarding whether placebos alter sensory pain transmission, pain affect, or simply produce compliance with the suggestions of investigators. In two functional magnetic resonance imaging (fMRI) experiments, we found that placebo analgesia was related to decreased brain activity in pain-sensitive brain regions, including the thalamus, insula, and anterior cingulate cortex, and was associated with increased activity during anticipation of pain in the prefrontal cortex, providing evidence that placebos alter the experience of pain.These findings extend previous ones, and parallel those regarding central changes in conversion disordersThe processes involving the neurobiopsychological interface may be very similar for both placebo effect and somatization disorders. The persons susceptible to both may share common psychophysiologic traits. tom


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## Mike NoLomotil (Jun 6, 2000)

I was indeed fascinated at this article when I saw it was coming out this week...as consideration of the findings should appropriately widen the debate about the whole concept of placebo, pain perception, and interpretation of observable central events (reactive-repsonsive) sing imaging techniques.There has been far too great a predisposition to set forth the results of brain imaging studies as if they constitute some proof in and of themselves of some central neuropathology when in fact there are a number of extrinsic and intrinisic mechanisms which can account for alterations in CNS activity of all up to and inlcuding the poorly understood so called "placebo mechanisms".This was a very very valuable investigation which should help keep the doors of objectivity open bit wider when inter[reting imaging studies in the context of altered pain and other sensorial afferent and efferent activity.MNL


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## poet (Nov 17, 2003)

The exciting thing is just the anticipation of relief produces changestom


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