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dc.contributor.authorFrangos, Eleni
dc.contributor.authorČeko, Marta
dc.contributor.authorWang, Binquan
dc.contributor.authorRichards, Emily A
dc.contributor.authorGracely, John L
dc.contributor.authorColloca, Luana
dc.contributor.authorSchweinhardt, Petra
dc.contributor.authorBushnell, M Catherine
dc.date.accessioned2021-02-05T20:43:36Z
dc.date.available2021-02-05T20:43:36Z
dc.date.issued2021-02
dc.identifier.urihttp://hdl.handle.net/10713/14494
dc.description.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.en_US
dc.description.urihttps://doi.org/10.1097/j.pain.0000000000002064en_US
dc.language.isoenen_US
dc.publisherWolters Kluwer Healthen_US
dc.relation.ispartofPainen_US
dc.rightsCopyright © 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.en_US
dc.subjectplaceboen_US
dc.subjectchronic painen_US
dc.subjectfibromyalgiaen_US
dc.subjectfMRIen_US
dc.subjectopioiden_US
dc.subjectnaloxoneen_US
dc.subjectconditioningen_US
dc.subjectexpectationen_US
dc.titleNeural effects of placebo analgesia in fibromyalgia patients and healthy individualsen_US
dc.typeArticleen_US
dc.identifier.doi10.1097/j.pain.0000000000002064
dc.identifier.pmid32925593
dc.source.volume162
dc.source.issue2
dc.source.beginpage641
dc.source.endpage652
dc.source.countryUnited States


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