Cited by 97Pain Management and Placebo EffectPain Mechanisms and TreatmentsPain Management and Treatment

Placebo analgesia: findings from brain imaging studies and emerging hypotheses

Kong, J., Kaptchuk, T.J., Polich, G., Kirsch, I., Gollub, R.L.·2007·Reviews in the Neurosciences

Abstract

Placebo analgesia is one of the most robust and best-studied placebo effects. With the help of brain imaging tools, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), our understanding of the brain's role in placebo analgesia has been greatly expanded. Previous studies suggest that multiple mechanisms may underlie the phenomenon of placebo analgesia. This review posits a theoretical framework for interpreting the results of the neuroimaging literature of placebo analgesia. According to this framework, placebo treatment may exert an analgesic effect on at least three stages of pain processing, by 1) influencing pre-stimulus expectation of pain relief, 2) modifying pain perception, and 3) distorting post-stimulus pain rating. Importantly, change in one such stage may hasten change in another, and furthermore, contribution from any or all of the three stages may vary by circumstance, or between individuals. The literature suggests that multiple brain regions, including the anterior cingulate cortex, anterior insula, prefrontal cortex and periaqueductal grey, play a pivotal role in these processes.

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Crossref · 10.1515/revneuro.2007.18.3-4.173

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119 of 119 references verified0 citation errors · 0 not checkable

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  • An inert treatment could function through three interrelated processes to produce placebo and nocebo effects.

    “Theoretically, an inert treatment could function through three interrelated processes to produce placebo and nocebo effects (Amanzio et al., 2013; Kong et al., 2007).”

    From Distinct neural representations of placebo and nocebo effects (2015) · cites this paper as Kong et al., 2007

  • In the third stage, after the pain stimulus ends and subjects evaluate pain intensity, memory of previous experience or context may subconsciously distort decision-making.

    “Finally, in the third stage, when the pain stimulus has ended and when subjects are required to evaluate the pain intensity, memory of previous experience/context may subconsciously distort the decision-making process, a construct we have described as selective distortion of pain intensity evaluation (Kong et al., 2007).”

    From Distinct neural representations of placebo and nocebo effects (2015) · cites this paper as Kong et al., 2007

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Authors
Kong, J., Kaptchuk, T. J., Polich, G., Kirsch, I., & Gollub, R. L.
Affiliations
Harvard University (US)
Venue
Reviews in the Neurosciences
Published
2007-01
Volume
18
Issue
3-4
Pages
173-90
ISSN
  • 0334-1763 (ISSN-L)
  • 2191-0200
OpenAlex
W1997667062
Cited by
97
References
119
Citations by year
2025: 3 · 2024: 8 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 1 · 2016: 2 · 2015: 7 · 2014: 6 · 2013: 7 · 2012: 5
FWCI
0.79
Type
journal article
Language
en
Open access
closed
Locations
  • Reviews in the Neurosciences (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Center for Complementary and Integrative Health (K01AT003883)
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
placebo analgesia, placebo effect, pain processing, pain anticipation, pain perception, pain scores, anterior cingulate cortex, anterior insula, prefrontal cortex, periaqueductal gray
MeSH terms
Analgesia, Animals, Brain, Humans, Magnetic Resonance Imaging, Neural Pathways, Pain, Perception, Placebo Effect, Pain Threshold, Positron-Emission Tomography, Pain Management

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