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Thirty Years of Neuroscientific Investigation of Placebo and Nocebo: The Interesting, the Good, and the Bad

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ANNUAL REVIEWS
DOI: 10.1146/annurev-pharmtox-052120-104536

关键词

placebo; nocebo; neurobiological mechanisms; clinical trials; medical practice; ethics

资金

  1. Innovative Clinical Training, Trials, and Healthcare Worldwide Initiative
  2. Nerve and Muscle Center of Texas

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Over the past 30 years, there has been significant research on the placebo effect using a neuroscientific approach. This research has identified biological mechanisms of both the placebo and nocebo effects and has important implications in clinical trials and medical practice. The contribution of neuroscience has drawn attention to the role of psychobiological factors in therapeutic outcomes.
Over the past 30 years there has been a surge of research on the placebo effect using a neuroscientific approach. The interesting aspects of this effort are related to the identification of several biological mechanisms of both the placebo and nocebo effects, the latter of which is defined as a negative placebo effect. Some important translational implications have emerged both in the setting of clinical trials and in routine medical practice. One of the principal contributions of neuroscience has been to draw the attention of the scientific and medical communities to the important role of psychobiological factors in therapeutic outcomes, be they drug related or not. Indeed, many biological mechanisms triggered by placebos and nocebos resemble those modulated by drugs, suggesting a possible interaction between psychological factors and drug action. Unfortunately, this new knowledge regarding placebos has the potential of being dangerously exploited by pseudoscience.

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