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How Instructions, Learning, and Expectations Shape Pain and Neurobiological Responses.
Atlas, Lauren Y.
Afiliación
  • Atlas LY; National Center for Complementary and Integrative Health and National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA; email: lauren.atlas@nih.gov.
Annu Rev Neurosci ; 46: 167-189, 2023 07 10.
Article en En | MEDLINE | ID: mdl-36917820
Treatment outcomes are strongly influenced by expectations, as evidenced by the placebo effect. Meta-analyses of clinical trials reveal that placebo effects are strongest in pain, indicating that psychosocial factors directly influence pain. In this review, I focus on the neural and psychological mechanisms by which instructions, learning, and expectations shape subjective pain. I address new experimental designs that help researchers tease apart the impact of these distinct processes and evaluate the evidence regarding the neural mechanisms by which these cognitive factors shape subjective pain. Studies reveal that expectations modulate pain through parallel circuits that include both pain-specific and domain-general circuits such as those involved in affect and learning. I then review how expectations, learning, and verbal instructions impact clinical outcomes, including placebo analgesia and responses to pharmacological treatments, and discuss implications for future work.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Analgesia / Motivación Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Annu Rev Neurosci Año: 2023 Tipo del documento: Article

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Analgesia / Motivación Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Annu Rev Neurosci Año: 2023 Tipo del documento: Article