Department of Neuroscience, University of Turin, and National Institute of Neuroscience, Turin, Italy.
Curr Opin Anaesthesiol. 2011 Oct;24(5):540-4. doi: 10.1097/ACO.0b013e328349d0c2.
In the last two decades, some of the neuroanatomical and neurophysiological substrates of the placebo effect have been elucidated. What has emerged is the multifactorial nature of the placebo effect, such that there is not a single placebo effect but many. Here we report on recent advances in our understanding of this phenomenon, with particular emphasis on its use as an experimental model to better clarify different brain mechanisms.
One of the most interesting findings in the past few years is that the placebo effect is a learning phenomenon, which is powerfully influenced by the manipulation of different variables. The involvement of opioid mechanisms is supported by several studies on pain, but also by the exploration of new fields such as memory and cognition. Nonopioid mechanisms have been described as well, for example, in pain, Parkinson's disease and anxiety. Recent evidence confirms and extends previous findings on the key role of prefrontal regions in the placebo response.
The study of the placebo effect is paying dividends and bodes well for the future. Whereas in clinical practice it can increase the efficacy of a therapy, in the experimental setting it represents an excellent tool for neuroscience.
在过去的二十年中，一些神经解剖学和神经生理学基础已经阐明了安慰剂效应。由此产生的是安慰剂效应的多因素性质，即不是单一的安慰剂效应，而是许多。在这里，我们报告了我们对这一现象的最新理解的进展，特别强调了它作为一种实验模型的使用，以更好地阐明不同的大脑机制。
过去几年中最有趣的发现之一是，安慰剂效应是一种学习现象，它受到不同变量的操纵的强烈影响。阿片类机制的参与得到了几项关于疼痛的研究的支持，但也得到了对记忆和认知等新领域的探索的支持。非阿片类机制也有描述，例如在疼痛、帕金森病和焦虑中。最近的证据证实并扩展了先前关于前额叶区域在安慰剂反应中的关键作用的发现。
安慰剂效应的研究正在取得成果，并为未来带来了希望。在临床实践中，它可以提高治疗的效果，而在实验环境中，它代表了神经科学的一个极好的工具。
