Cavanna Andrea Eugenio, Strigaro Gionata, Monaco Francesco
Department of Neurology, Amedeo Avogadro University, Novara, Italy.
Funct Neurol. 2007 Apr-Jun;22(2):89-94.
The potential of placebo treatments to alleviate a variety of medical conditions has long been recognised. Although the placebo effect is widely known, the physiological mechanisms underlying this phenomenon are not well understood. This review focuses on the existing evidence for placebo responses in different neurological conditions, including pain, Parkinson's disease, depression, sleep and immune-mediated disorders. Special attention is paid to the neural changes associated with placebo treatments, as revealed by in vivo neurophysiological and functional neuroimaging studies. Converging evidence suggests that placebo analgesia is linked to the activation of the endogenous opioid analgesia network, whilst dopaminergic pathways seem to play a central role in the placebo effect in movement disorders and neuroimmunomodulation. Further research on the placebo response is needed, both to improve the efficacy of its application in clinical practice and to shed more light on the complexity of mind-body interactions.
安慰剂治疗缓解多种医疗状况的潜力早已得到认可。尽管安慰剂效应广为人知，但这种现象背后的生理机制却尚未得到充分理解。本综述聚焦于不同神经疾病（包括疼痛、帕金森病、抑郁症、睡眠及免疫介导疾病）中安慰剂反应的现有证据。体内神经生理学和功能性神经影像学研究揭示了与安慰剂治疗相关的神经变化，对此给予了特别关注。越来越多的证据表明，安慰剂镇痛与内源性阿片类镇痛网络的激活有关，而多巴胺能通路似乎在运动障碍和神经免疫调节的安慰剂效应中起核心作用。需要对安慰剂反应进行进一步研究，以提高其在临床实践中的应用效果，并更深入地了解身心相互作用的复杂性。
