Placebo-Induced Changes in fMRI in the Anticipation and Experience of Pain

• Published in: Science (American Association for the Advancement of Science) Vol. 303; no. 5661; pp. 1162 - 1167
• Main Authors: Wager, Tor D., Rilling, James K., Smith, Edward E., Sokolik, Alex, Casey, Kenneth L., Davidson, Richard J., Kosslyn, Stephen M., Rose, Robert M., Cohen, Jonathan D.
• Format: Journal Article
• Language: English
• Published: Washington, DC American Association for the Advancement of Science 20.02.2004; The American Association for the Advancement of Science
• Subjects: Analgesia; Analgesics; Anatomical correlates of behavior; Behavioral psychophysiology; Beliefs; Biological and medical sciences; Brain; Brain - physiology; Brain Hemisphere Functions; Brain Mapping; Cerebral Cortex - physiology; Cognitive Processes; Cream; Drug therapy; Electroshock; Evidence; Experimentation; Feedback (Response); Frontal Lobe - physiology; Fundamental and applied biological sciences. Psychology; Gyrus Cinguli - physiology; Hot Temperature; Humans; Magnetic Resonance Imaging; Mesencephalon - physiology; Midbrain; Opioid analgesics; Pain; Physiological aspects; Placebo Effect; Placebos; Placebos - pharmacology; Prefrontal Cortex - physiology; Psychological aspects; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Sensory Experience; Thalamus; Thalamus - physiology; Time Factors; United States; Human; Analgesia; Pain; Cingulate cortex; Central nervous system; Thalamus; Anticipation; Prefrontal cortex; Acquired experience; Nuclear magnetic resonance imaging; Encephalon
• ISSN: 0036-8075; 1095-9203
• DOI: 10.1126/science.1093065

The 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.