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

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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

DOI 10.1523/jneurosci.3420-10.2011PMC PMC3735131

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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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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.
ORCID: Wager, Tor D.
Atlas, Lauren Y.
Leotti, Lauren A.
Rilling, James K.
Venue: The Journal of Neuroscience
Publisher: Society for Neuroscience
Published: 2011-01-12
Volume: 31
Issue: 2
Pages: 439-452
ISSN: 0270-6474 (ISSN-L)
1529-2401
DOI: 10.1523/jneurosci.3420-10.2011
PMC: PMC3735131
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: hybrid
doi.org
Licence: cc-by-nc-sa
creativecommons.org/licenses/by-nc-sa/4.0/ (vor, 181 d)
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 (medical) › 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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Predicting Individual Differences in Placebo Analgesia: Contributions of Brain Activity during Anticipation and Pain Experience

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