Meta-analysis of neural systems underlying placebo analgesia from individual participant fMRI data

GND
1264970390
ORCID
0000-0002-3680-9675
Affiliation
Center for Translational Neuro- and Behavioral Sciences, Dept. of Neurology, University Hospital Essen, Essen, Germany
Zunhammer, Matthias;
GND
1264939582
ORCID
0000-0002-2942-0821
Affiliation
Center for Translational Neuro- and Behavioral Sciences, Dept. of Neurology, University Hospital Essen, Essen, Germany
Spisák, Tamás;
ORCID
0000-0002-1936-5574
Affiliation
Cognitive and Affective Neuroscience Laboratory, Department of Psychological and Brain Sciences, Dartmouth College, Hanover, USA
Wager, Tor D.;
GND
173578691
ORCID
0000-0002-9528-3204
LSF
55497
Affiliation
Center for Translational Neuro- and Behavioral Sciences, Dept. of Neurology, University Hospital Essen, Essen, Germany
Bingel, Ulrike
The brain systems underlying placebo analgesia are insufficiently understood. Here we performed a systematic, participant-level meta-analysis of experimental functional neuroimaging studies of evoked pain under stimulus-intensity-matched placebo and control conditions, encompassing 603 healthy participants from 20 (out of 28 eligible) studies. We find that placebo vs. control treatments induce small, widespread reductions in pain-related activity, particularly in regions belonging to ventral attention (including mid-insula) and somatomotor networks (including posterior insula). Behavioral placebo analgesia correlates with reduced pain-related activity in these networks and the thalamus, habenula, mid-cingulate, and supplementary motor area. Placebo-associated activity increases occur mainly in frontoparietal regions, with high between-study heterogeneity. We conclude that placebo treatments affect pain-related activity in multiple brain areas, which may reflect changes in nociception and/or other affective and decision-making processes surrounding pain. Between-study heterogeneity suggests that placebo analgesia is a multi-faceted phenomenon involving multiple cerebral mechanisms that differ across studies.

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