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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| Published in | Science (American Association for the Advancement of Science) Vol. 358; no. 6359; pp. 105 - 108 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
American Association for the Advancement of Science
06.10.2017
The American Association for the Advancement of Science |
| Subjects | |
| Online Access | Get full text |
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| Abstract | 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. |
|---|---|
| AbstractList | Patients in randomized clinical trials frequently stop taking their drug, complaining of side effects. However, it turns out that some of these subjects are part of the placebo group and thus never received any active medication. This is a case of the nocebo effect seriously interfering with medical treatment. Tinnermann
et al.
investigated whether value information such as the price of a medication can further modulate behavioral nocebo effects and the underlying neural network dynamics (see the Perspective by Colloca). They used brain imaging to characterize the circuits involved in nocebo hyperalgesia within the descending pain pathway from the prefrontal cortex to the spinal cord. Their findings revealed how value information increased the nocebo effect.
Science
, this issue p.
105
; see also p.
44
Expensive medication increases the nocebo effect and modulates pain projections from the prefrontal cortex down to the spinal cord.
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. 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.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. 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. Patients in randomized clinical trials frequently stop taking their drug, complaining of side effects. However, it turns out that some of these subjects are part of the placebo group and thus never received any active medication. This is a case of the nocebo effect seriously interfering with medical treatment. Tinnermann et al. investigated whether value information such as the price of a medication can further modulate behavioral nocebo effects and the underlying neural network dynamics (see the Perspective by Colloca). They used brain imaging to characterize the circuits involved in nocebo hyperalgesia within the descending pain pathway from the prefrontal cortex to the spinal cord. Their findings revealed how value information increased the nocebo effect.Science, this issue p. 105; see also p. 44 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. |
| Author | Finsterbusch, J. Tinnermann, A. Büchel, C. Geuter, S. Sprenger, C. |
| Author_xml | – sequence: 1 givenname: A. surname: Tinnermann fullname: Tinnermann, A. – sequence: 2 givenname: S. surname: Geuter fullname: Geuter, S. – sequence: 3 givenname: C. surname: Sprenger fullname: Sprenger, C. – sequence: 4 givenname: J. surname: Finsterbusch fullname: Finsterbusch, J. – sequence: 5 givenname: C. surname: Büchel fullname: Büchel, C. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28983051$$D View this record in MEDLINE/PubMed |
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| Snippet | Value information about a drug, such as the price tag, can strongly affect its therapeutic effect. We discovered that value information influences adverse... Patients in randomized clinical trials frequently stop taking their drug, complaining of side effects. However, it turns out that some of these subjects are... |
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| SubjectTerms | 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 |
| Title | Interactions between brain and spinal cord mediate value effects in nocebo hyperalgesia |
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