Placebo effects: clinical aspects and neurobiology

Oken, B. S.

doi:10.1093/brain/awn116

Cited by 237Pain Management and Placebo EffectTranscranial Magnetic Stimulation StudiesStatistical Methods in Clinical Trials

Placebo effects: clinical aspects and neurobiology

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Oken, B. S.·2008·Brain

DOI 10.1093/brain/awn116PMC PMC2725026

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Abstract

Placebo effects are beneficial health outcomes not related to the relatively direct biological effects of an intervention and can be elicited by an agent that, by itself, is inert. Understanding these placebo effects will help to improve clinical trial design, especially for interventions such as surgery, CNS-active drugs and behavioural interventions which are often non-blinded. A literature review was performed to retrieve articles discussing placebo implications of clinical trials, the neurobiology of placebo effects and the implications of placebo effect for several disorders of neurological relevance. Recent research in placebo analgesia and other conditions has demonstrated that several neurotransmitter systems, such as opiate and dopamine, are involved with the placebo effect. Brain regions including anterior cingulate cortex, dorsolateral prefrontal cortex and basal ganglia have been activated following administration of placebo. A patient's expectancy of improvement may influence outcomes as much as some active interventions and this effect may be greater for novel interventions and for procedures. Maximizing this expectancy effect is important for clinicians to optimize the health of their patient. There have been many relatively acute placebo studies that are now being extended into clinically relevant models of placebo effect.

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It is possible that parents and children may have reported improvements due to the placebo effect related to the expectation of a beneficial effect from receiving a therapy.
“It is certainly possible that parents and children may have reported improvements due to the placebo effect related to the expectation of a beneficial effect from receiving a therapy [93].”
From Pilot study of probiotic/colostrum supplementation on gut function in children with autism and gastrointestinal symptoms (2019) · cites this paper as [93]

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“…process has been strongly implicated in the placebo effect, the observation that inert compounds can have clinical efficacy in individuals who strongly expect to experience therapeutic benefits (Oken 2008); furthermore, such expectations also influence visual perception (Sterzer et al. 2008).”
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Self-citation

Authors: Oken, B. S.
Affiliations: Oregon Health & Science University (US)
Corresponding author: Oken, B. S.
Venue: Brain
Publisher: Oxford University Press (OUP)
Published: 2008-06-21
Volume: 131
Issue: 11
Pages: 2812-2823
ISSN: 0006-8950 (ISSN-L)
1460-2156
DOI: 10.1093/brain/awn116
PMC: PMC2725026
OpenAlex: W1985337898
Cited by: 237
References: 175
Citations by year: 2026: 8 · 2025: 9 · 2024: 7 · 2023: 12 · 2022: 13 · 2021: 8 · 2020: 17 · 2019: 13 · 2018: 19 · 2017: 14 · 2016: 11 · 2015: 5 · 2014: 19 · 2013: 25 · 2012: 15
FWCI: 1.06
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Brain (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Center for Complementary and Integrative Health (U19AT002656)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
Keywords: placebo effect, placebo analgesia, neurobiology of placebo, clinical trial design, blinding, expectancy effects, opioid system, dopamine, anterior cingulate cortex, dorsolateral prefrontal cortex, basal ganglia, placebo surgery
MeSH terms: Analgesia, Brain, Humans, Models, Psychological, Physician-Patient Relations, Research Design, Stress, Psychological, Placebo Effect, Controlled Clinical Trials as Topic

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