Cited by 328Pain Management and Placebo EffectPain Mechanisms and TreatmentsPain Management and Treatment

Predicting Individual Differences in Placebo Analgesia: Contributions of Brain Activity during Anticipation and Pain Experience

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Wager, Tor D., Atlas, Lauren Y., Leotti, Lauren A., Rilling, James K.·2011·The Journal of Neuroscience

Abstract

Recent studies have identified brain correlates of placebo analgesia, but none have assessed how accurately patterns of brain activity can predict individual differences in placebo responses. We reanalyzed data from two fMRI studies of placebo analgesia (N= 47), using patterns of fMRI activity during the anticipation and experience of pain to predict new subjects' scores on placebo analgesia and placebo-induced changes in pain processing. We used a cross-validated regression procedure, LASSO-PCR, which provided both unbiased estimates of predictive accuracy and interpretable maps of which regions are most important for prediction. Increased anticipatory activity in a frontoparietal network and decreases in a posterior insular/temporal network predicted placebo analgesia. Patterns of anticipatory activity across the cortex predicted a moderate amount of variance in the placebo response (∼12% overall, ∼40% for study 2 alone), which is substantial considering the multiple likely contributing factors. The most predictive regions were those associated with emotional appraisal, rather than cognitive control or pain processing. During pain, decreases in limbic and paralimbic regions most strongly predicted placebo analgesia. Responses within canonical pain-processing regions explained significant variance in placebo analgesia, but the pattern of effects was inconsistent with widespread decreases in nociceptive processing. Together, the findings suggest that engagement of emotional appraisal circuits drives individual variation in placebo analgesia, rather than early suppression of nociceptive processing. This approach provides a framework that will allow prediction accuracy to increase as new studies provide more precise information for future predictive models.

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Crossref · 10.1523/jneurosci.3420-10.2011

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  • Cognitive pain relief correlates with lower pain-related activation in SI, SII, posterior insula, and parietal operculum, alongside higher activation in ACC, PFC, and insula.

    “Pain relief produced by these cognitive techniques are associated with significant reductions in pain-related brain activation (i.e., SI, SII, posterior insula, parietal operculum) and activation in higher-order brain regions, such as the ACC, PFC, and insula.86, 89, 98–110”
  • A recent study found that vmPFC activity was correlated with the strength of both expectations of analgesia and pain relief.

    “and a recent study found that vmPFC activity was correlated with the strength of both expectations of analgesia and pain relief [62].”
  • Placebo studies often involve conditioning procedures that may serve primarily to alter expectations and the meaning of pain in context.

    “While placebo studies often involve conditioning procedures, these may often serve primarily to alter expectations and the meaning of pain in context [60,61], and a recent study found that vmPFC activity was correlated with the strength of both expectations of analgesia and pain relief [62].”

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  1. Bishop CM 2006 Pattern recognition and machine learning New York Springer

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Authors
Wager, T. D., Atlas, L. Y., Leotti, L. A., & Rilling, J. K.
Affiliations
  • University of Colorado Boulder (US)
  • Columbia University (US)
  • Rutgers, The State University of New Jersey (US)
  • Emory University (US)
Corresponding author
Wager, Tor D.
Venue
The Journal of Neuroscience
Published
2011-01-12
Volume
31
Issue
2
Pages
439-452
ISSN
  • 0270-6474 (ISSN-L)
  • 1529-2401
OpenAlex
W2158440149
Cited by
328
References
96
Citations by year
2026: 11 · 2025: 19 · 2024: 25 · 2023: 26 · 2022: 13 · 2021: 16 · 2020: 22 · 2019: 18 · 2018: 20 · 2017: 27 · 2016: 18 · 2015: 24 · 2014: 23 · 2013: 29 · 2012: 24
FWCI
14.28
Type
journal article
Language
en
Open access
Locations
  • Journal of Neuroscience (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • Journal of Neuroscience Nursing
Funders
  • John D. and Catherine T. MacArthur Foundation
  • Kohlberg Foundation
  • National Institutes of Health (MH076136)
  • National Institute of Mental Health (MH076136, R01MH076136, R37MH076136)
  • National Institute on Drug Abuse (RC1DA028608, R01DA027794)
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, individual differences, pain experience, emotional appraisal, frontoparietal network, posterior insula, paralimbic regions, pain processing, nociception
MeSH terms
Analgesia, Analgesics, Brain, Cerebral Cortex, Data Interpretation, Statistical, Humans, Individuality, Magnetic Resonance Imaging, Nerve Net, Pain, Regression Analysis, Placebo Effect, Cluster Analysis, Anticipation, Psychological

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