The Effect of Treatment Expectation on Drug Efficacy: Imaging the Analgesic Benefit of the Opioid Remifentanil
Abstract
An individual’s expectation that a pain treatment will or will not work can alter both its subjective effectiveness and the pain-related activity in the brain.
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Chronic pain patients show higher self-reported negative affect than pain-free controls across all such indices.
“Recent systematic reviews indicate that chronic pain patients, relative to pain-free controls, show elevations in all of these indices of self-reported negative affect 33–35.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [34]
A negative expectation can weaken a treatment's therapeutic benefit.
“Physicians and clinical investigators have found that positive expectancy of relief can enhance the therapeutic effect of treatment and negative expectancy can diminish it (Atlas and Wager, 2012; Atlas et al., 2012; Bingel et al., 2011; Carlino et al., 2014; Finniss and Benedetti, 2005; Finniss et al., 2010; Tracey, 2010).”
From Distinct neural representations of placebo and nocebo effects (2015) · cites this paper as Bingel et al., 2011
A positive expectation that a treatment will relieve pain can strengthen that treatment's therapeutic benefit.
“Physicians and clinical investigators have found that positive expectancy of relief can enhance the therapeutic effect of treatment and negative expectancy can diminish it (Atlas and Wager, 2012; Atlas et al., 2012; Bingel et al., 2011; Carlino et al., 2014; Finniss and Benedetti, 2005; Finniss et al., 2010; Tracey, 2010).”
From Distinct neural representations of placebo and nocebo effects (2015) · cites this paper as Bingel et al., 2011
Previous neuroimaging studies have shown that nocebo effects are mediated by the hippocampus and regions involved in anticipatory anxiety processing.
“Previous neuroimaging studies have also shown that nocebo effects are mediated by the hippocampus and regions involved in anticipatory anxiety processing (Bingel et al., 2011; Kong et al., 2008; Ploghaus et al., 2001).”
From Distinct neural representations of placebo and nocebo effects (2015) · cites this paper as Bingel et al., 2011
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- Authors
- Bingel, U., Wanigasekera, V., Wiech, K., Ni Mhuircheartaigh, R., Lee, M. C., Ploner, M., & Tracey, I.
- Affiliations
- University of Oxford (GB)
- Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences (Division of Anaesthetics), University of Oxford, OX3 9DU Oxford, UK.
- University of Cambridge (GB)
- Technical University of Munich (DE)
- Corresponding author
- Bingel, Ulrike
- Venue
- Science Translational Medicine
- Published
- 2011-02-16
- Volume
- 3
- Issue
- 70
- Pages
- 70ra14-70ra14
- ISSN
- 1946-6234 (ISSN-L)
- 1946-6242
- OpenAlex
- W2111663549
- Cited by
- 810
- References
- 10
- Citations by year
- 2026: 35 · 2025: 41 · 2024: 58 · 2023: 43 · 2022: 42 · 2021: 57 · 2020: 110 · 2019: 54 · 2018: 60 · 2017: 53 · 2016: 47 · 2015: 43 · 2014: 59 · 2013: 52 · 2012: 33
- FWCI
- 26.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Science Translational Medicine (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM (Technical University of Munich) (submittedVersion)
- Funders
- Wellcome Trust (83259)
- 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 Opioid Use
- Keywords
- treatment expectancy, remifentanil, opioid analgesia, placebo effect, hyperalgesia, pain perception, endogenous pain modulation, hippocampus, mu-opioid receptor
- MeSH terms
- Remifentanil, Adult, Analgesics, Opioid, Brain, Female, Humans, Magnetic Resonance Imaging, Male, Pain, Piperidines, Young Adult
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