Interactions between brain and spinal cord mediate value effects in nocebo hyperalgesia
Abstract
Price modulates early pain processing: Patients in randomized clinical trials frequently stop taking their drug, complaining of side effects. However, it turns out that some of these subjects are part of the placebo group and thus never received any active medication. This is a case of the nocebo effect seriously interfering with medical treatment. Tinnermann et al. investigated whether value information such as the price of a medication can further modulate behavioral nocebo effects and the underlying neural network dynamics (see the Perspective by Colloca). They used brain imaging to characterize the circuits involved in nocebo hyperalgesia within the descending pain pathway from the prefrontal cortex to the spinal cord. Their findings revealed how value information increased the nocebo effect. Science , this issue p. 105 ; see also p. 44
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Expectations could modulate reinforcement signals, and if such manipulations affect the reinforcement signal used in calculating prediction errors, it would short-circuit learning by suppressing cue-inconsistent prediction errors.
“If these manipulations affect the reinforcement signal used in calculating prediction errors, it would short-circuit learning by suppressing cue-inconsistent prediction errors.”
From Social information creates self-fulfilling prophecies in judgments of pain, vicarious pain, and cognitive effort (2026) · cites this paper as [47]
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- Authors
- Tinnermann, A., Geuter, S., Sprenger, C., Finsterbusch, J., & Büchel, C.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- University of Colorado Boulder (US)
- University of Cambridge (GB)
- Corresponding author
- Tinnermann, A.
- Venue
- Science
- Published
- 2017-10-06
- Volume
- 358
- Issue
- 6359
- Pages
- 105-108
- ISSN
- 0036-8075 (ISSN-L)
- 1095-9203
- OpenAlex
- W2763143648
- Cited by
- 208
- References
- 54
- Citations by year
- 2026: 13 · 2025: 28 · 2024: 13 · 2023: 23 · 2022: 22 · 2021: 41 · 2020: 18 · 2019: 23 · 2018: 24 · 2017: 3
- FWCI
- 10.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Science (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Research Council (award313542, ERC-2010-AdG_20100407)
- Deutsche Forschungsgemeinschaft (award313541, SFB936/A06, award343338, GE 2774/1-1)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- nocebo hyperalgesia, drug value, price labeling, prefrontal cortex, brainstem, spinal cord, neuronal interactions, pain processing, placebo effect, expectations
- MeSH terms
- Adult, Brain Stem, Pharmaceutical Preparations, Female, Humans, Hyperalgesia, Male, Pain Measurement, Placebos, Spinal Cord, Prefrontal Cortex, Young Adult, Pain Perception, Functional Neuroimaging, Skin Cream, Drug-Related Side Effects and Adverse Reactions, Nocebo Effect
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