The placebo-reward hypothesis: dopamine and the placebo effect

de la Fuente-Fernández, Raúl

doi:10.1016/s1353-8020(09)70785-0

Cited by 95Pain Management and Placebo EffectNeurotransmitter Receptor Influence on BehaviorParkinson's Disease Mechanisms and Treatments

The placebo-reward hypothesis: dopamine and the placebo effect

de la Fuente-Fernández, Raúl·2009·Parkinsonism & Related Disorders

DOI 10.1016/s1353-8020(09)70785-0

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Abstract

Based on the observation that the placebo effect in Parkinson's disease was mediated by the release of endogenous dopamine in both the dorsal and ventral striatum, in 2002 we formally proposed the placebo-reward hypothesis. This hypothesis establishes a link between the placebo effect and reward mechanisms, and predicts that the activation of the ventral striatum should be present in any placebo response, in any medical condition. In keeping with this prediction, functional neuroimaging studies have shown placebo-induced activation of the reward circuitry in Parkinson's disease, depression, and pain. In fact, recent evidence suggests that the release of dopamine in the ventral striatum likely triggers the activation of the endogenous opioid system in placebo analgesia. The placebo-reward hypothesis also supports the notion that the expectation of clinical benefit plays a major role in the placebo effect. Probability and trust, two key factors involved in shaping expectations, must therefore be essential to the development of placebo responses. The ventral loop of the basal ganglia circuitry (anterior cingulate cortex-ventral striatum-ventral pallidum- mediodorsal nucleus of the thalamus -anterior cingulate cortex) is a fundamental component of the neuroanatomy of the placebo effect.

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Outcome expectancies are central in the placebo response, in which individuals expect that pharmacological and other interventions will lead to beneficial outcomes.
“Outcome expectancies are central in the placebo response in which individuals expect that pharmacological and other interventions will lead to beneficial outcomes (Ashor, 2011;de la Fuente-Fernandez, 2009;Lidstone et al., 2010;Wager & Atlas, 2015).”
From Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning (2016) · cites this paper as de la Fuente-Fernandez, 2009

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The placebo response as a reward mechanism
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The placebo effect in Parkinson's disease.
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The Biochemical Bases for Reward
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Authors: de la Fuente-Fernández, R.
Venue: Parkinsonism & Related Disorders
Publisher: Elsevier BV
Published: 2009-12
Volume: 15
Pages: S72-S74
ISSN: 1353-8020 (ISSN-L)
DOI: 10.1016/s1353-8020(09)70785-0
OpenAlex: W2120231177
Cited by: 95
References: 26
Citations by year: 2026: 1 · 2025: 6 · 2024: 3 · 2023: 5 · 2022: 6 · 2021: 2 · 2020: 8 · 2019: 6 · 2018: 15 · 2017: 6 · 2016: 6 · 2015: 2 · 2014: 5 · 2013: 5 · 2012: 7
FWCI: 2.90
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Parkinsonism & Related Disorders (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
Keywords: placebo effect
MeSH terms: Animals, Cognition, Corpus Striatum, Dopamine, Biological Evolution, Humans, Models, Biological, Neural Pathways, Reward, Placebo Effect, Opioid Peptides

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The placebo-reward hypothesis: dopamine and the placebo effect

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