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PATHOPHYSIOLOGY

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Wager TD, Rilling JK, Smith EE, Sokolik A, Casey KL, Davidson RJ, Kosslyn SM, Rose RM, Cohen JD. Placebo-induced changes in FMRI in the anticipation and experience of pain. Science. 2004;303:1162-1167.

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 effect, 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.

Comments: Please see comments on the above abstract, with additional comments under Migraine Treatment after the abstracts by Vickers et al and Wonderling et al.
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Document Type: Research Article

Publication date: September 1, 2004

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