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Placebo improves pleasure and pain through opposite modulation of sensory processing

Artikel i vetenskaplig tidskrift
Författare Dan-Mikael Ellingsen
Johan Wessberg
M. Eikemo
Jaquette Liljencrantz
T. Endestad
Håkan Olausson
Siri Leknes
Publicerad i Proceedings of the National Academy of Sciences of the United States of America
Volym 110
Nummer/häfte 44
Sidor 17993-17998
ISSN 0027-8424
Publiceringsår 2013
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för fysiologi
Sidor 17993-17998
Språk en
Länkar dx.doi.org/10.1073/pnas.1305050110
Ämnesord expectancy, neuroimaging, hedonic feelings, INDIVIDUAL-DIFFERENCES, INDUCED EXPECTATIONS, OPIOID ACTIVITY, BRAIN, IMAGES, SOCIAL TOUCH, ANALGESIA, PLEASANT, RELIEF, CORTEX, REWARD
Ämneskategorier Neurovetenskaper

Sammanfattning

Placebo analgesia is often conceptualized as a reward mechanism. However, by targeting only negative experiences, such as pain, placebo research may tell only half the story. We compared placebo improvement of painful touch (analgesia) with placebo improvement of pleasant touch (hyperhedonia) using functional MRI and a crossover design. Somatosensory processing was decreased during placebo analgesia and increased during placebo hyperhedonia. Both placebo responses were associated with similar patterns of activation increase in circuitry involved in emotion appraisal, including the pregenual anterior cingulate, medial orbitofrontal cortex, amygdala, accumbens, and midbrain structures. Importantly, placebo-induced coupling between the ventromedial prefrontal cortex and periaqueductal gray correlated with somatosensory decreases to painful touch and somatosensory increases to pleasant touch. These findings suggest that placebo analgesia and hyperhedonia are mediated by activation of shared emotion appraisal neurocircuitry, which down-or upregulates early sensory processing, depending on whether the expectation is reduced pain or increased pleasure.

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