New insights into the placebo and nocebo responses

被引:391
作者
Enck, Paul [1 ]
Benedetti, Fabrizio [2 ,3 ]
Schedlowski, Manfred [4 ]
机构
[1] Univ Hosp, Dept Internal Med Psychosomat Med & Psychotherapy, D-72076 Tubingen, Germany
[2] Univ Turin, Sch Med, Dept Neurosci, I-10125 Turin, Italy
[3] Natl Inst Neurosci, I-10125 Turin, Italy
[4] Univ Duisburg Essen, Fac Med, Inst Med Psychol & Behav Immunobiol, D-47048 Essen, Germany
关键词
D O I
10.1016/j.neuron.2008.06.030
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
In modern medicine, the placebo response or placebo effect has often been regarded as a nuisance in basic research and particularly in clinical research. The latest scientific evidence has demonstrated, however, that the placebo effect and the nocebo effect, the negative effects of placebo, stem from highly active processes in the brain that are mediated by psychological mechanisms such as expectation and conditioning. These processes have been described in some detail for many diseases and treatments, and we now know that they can represent both strength and vulnerability in the course of a disease as well as in the response to a therapy. However, recent research and current knowledge raise several issues that we shall address in this review. We will discuss current neurobiological models like expectation-induced activation of the brain reward circuitry, Pavlovian conditioning, and anxiety mechanisms of the nocebo response. We will further explore the nature of the placebo responses in clinical trials and address major questions for future research such as the relationship between expectations and conditioning in placebo effects, the existence of a consistent brain network for all placebo effects, the role of gender in placebo effects, and the impact of getting drug-like effects without drugs.
引用
收藏
页码:195 / 206
页数:12
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