Interactions between brain and spinal cord mediate value effects in nocebo hyperalgesia

Value information about a drug, such as the price tag, can strongly affect its therapeutic effect. We discovered that value information influences adverse treatment outcomes in humans even in the absence of an active substance. Labeling an inert treatment as expensive medication led to stronger noce...

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Bibliographic Details
Published inScience (American Association for the Advancement of Science) Vol. 358; no. 6359; pp. 105 - 108
Main Authors Tinnermann, A., Geuter, S., Sprenger, C., Finsterbusch, J., Büchel, C.
Format Journal Article
LanguageEnglish
Published United States American Association for the Advancement of Science 06.10.2017
The American Association for the Advancement of Science
Subjects
Adult
Brain
Brain stem
Brain Stem - physiology
Clinical trials
Cognitive ability
Drug-Related Side Effects and Adverse Reactions - psychology
Drugs
Female
Functional Neuroimaging
Humans
Hyperalgesia
Hyperalgesia - psychology
Labeling
Male
Medical research
Medical Services
Medical treatment
Neural networks
Neuroimaging
Nocebo Effect
Nocebos
Outcomes of Treatment
Pain
Pain Measurement
Pain perception
Pain Perception - drug effects
Pain Perception - physiology
Pharmaceutical Preparations - economics
Placebo effect
Placebos - adverse effects
Prefrontal cortex
Prefrontal Cortex - physiology
Side effects
Skin Cream - administration & dosage
Spinal cord
Spinal Cord - physiology
Young Adult
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Summary:Value information about a drug, such as the price tag, can strongly affect its therapeutic effect. We discovered that value information influences adverse treatment outcomes in humans even in the absence of an active substance. Labeling an inert treatment as expensive medication led to stronger nocebo hyperalgesia than labeling it as cheap medication. This effect was mediated by neural interactions between cortex, brainstem, and spinal cord. In particular, activity in the prefrontal cortex mediated the effect of value on nocebo hyperalgesia. Value furthermore modulated coupling between prefrontal areas, brainstem, and spinal cord, which might represent a flexible mechanism through which higher-cognitive representations, such as value, can modulate early pain processing.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0036-8075
1095-9203
1095-9203
DOI:10.1126/science.aan1221