Kong Jian, Benedetti Fabrizio
Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Building 120, 2nd street, Suite 101C, Charlestown, MA, 02129, USA,
Handb Exp Pharmacol. 2014;225:3-15. doi: 10.1007/978-3-662-44519-8_1.
Placebo and nocebo effects are essential components of medical practice and efficacy research, and can be regarded as a special case of context learning. A fundamental function of the central nervous system is to configure the way in which previous learned context becomes linked to corresponding responses. These responses could be either automatic procedures with little flexibility or highly adaptive procedures modified by associated contexts and consequences. Placebo and nocebo effects may represent a typical example of the combination of the two: conditioning effect, which is an inflexible, instinctual, and automatic response, and cognitive expectancy effect, which is a flexible adaptive response modified by prevailing conscious context. Given the fact that contextual learning originates in the brain, neuroimaging tools have been widely used to study placebo and nocebo effects. In addition, pretest resting state fMRI may be a valuable biomarker to predict placebo responses.
安慰剂和反安慰剂效应是医学实践和疗效研究的重要组成部分，可被视为情境学习的一个特例。中枢神经系统的一个基本功能是配置先前学习的情境与相应反应相联系的方式。这些反应既可以是几乎没有灵活性的自动程序，也可以是由相关情境和结果所改变的高度适应性程序。安慰剂和反安慰剂效应可能代表了两者结合的一个典型例子：条件作用效应，这是一种不灵活、本能的自动反应，以及认知预期效应，这是一种由当前意识情境所改变的灵活适应性反应。鉴于情境学习起源于大脑，神经成像工具已被广泛用于研究安慰剂和反安慰剂效应。此外，预测试静息态功能磁共振成像可能是预测安慰剂反应的一个有价值的生物标志物。
