Neural effects of placebo analgesia in fibromyalgia patients and healthy individuals
Richards, Emily A
Gracely, John L
Bushnell, M Catherine
PublisherWolters Kluwer Health
MetadataShow full item record
AbstractABSTRACT: Placebo analgesia is hypothesized to involve top-down engagement of prefrontal regions that access endogenous pain inhibiting opioid pathways. Fibromyalgia (FM) patients have neuroanatomical and neurochemical alterations in pathways relevant to placebo analgesia. Thus, it remains unclear whether placebo analgesic mechanisms would differ in FM patients compared to healthy controls (HCs). Here, using placebo-analgesia-inducing paradigms that included verbal suggestions and conditioning manipulations, we examined whether behavioral and neural placebo analgesic responses differed between 32 FM patients and 46 age- and sex-matched HCs. Participants underwent a manipulation scan, where noxious high and low heat were paired with the control and placebo cream, respectively, and a placebo experimental scan with equal noxious heat temperatures. Before the experimental scan, each participant received saline or naloxone, an opioid receptor antagonist. Across all participants, the placebo condition decreased pain intensity and unpleasantness ratings, decreased activity within the right insula and bilateral secondary somatosensory cortex, and modulated the neurologic pain signature. There were no differences between HCs and FM patients in pain intensity ratings or neural responses during the placebo condition. Despite the perceptual and neural effects of the placebo manipulation, prefrontal circuitry was not activated during the expectation period and the placebo analgesia was unaltered by naloxone, suggesting placebo effects were driven more by conditioning than expectation. Together, these findings suggest that placebo analgesia can occur in both HCs and chronic pain FM patients, without the involvement of opioidergic prefrontal modulatory networks. Copyright © 2020 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.
Rights/TermsCopyright © 2020 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/14494
- Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms Than Placebo and Sham Mindfulness Meditation-Induced Analgesia.
- Authors: Zeidan F, Emerson NM, Farris SR, Ray JN, Jung Y, McHaffie JG, Coghill RC
- Issue date: 2015 Nov 18
- Individuals with chronic pain have the same response to placebo analgesia as healthy controls in terms of magnitude and reproducibility.
- Authors: Power A, Brown CA, Sivan M, Lenton A, Rainey T, El-Deredy W, Jones AKP, Watson A
- Issue date: 2020 Dec
- Opioid-Independent and Opioid-Mediated Modes of Pain Modulation.
- Authors: Berna C, Leknes S, Ahmad AH, Mhuircheartaigh RN, Goodwin GM, Tracey I
- Issue date: 2018 Oct 17
- Lower Placebo Responses After Long-Term Exposure to Fibromyalgia Pain.
- Authors: Kosek E, Rosen A, Carville S, Choy E, Gracely RH, Marcus H, Petzke F, Ingvar M, Jensen KB
- Issue date: 2017 Jul
- Activation of the opioidergic descending pain control system underlies placebo analgesia.
- Authors: Eippert F, Bingel U, Schoell ED, Yacubian J, Klinger R, Lorenz J, Büchel C
- Issue date: 2009 Aug 27