Lidstone Sarah Christine
Neurology Residency Program, University of Toronto, Toronto, ON, Canada,
Handb Exp Pharmacol. 2014;225:139-47. doi: 10.1007/978-3-662-44519-8_8.
Our understanding of the neural mechanisms underlying the placebo effect has increased exponentially in parallel with the advances in brain imaging. This is of particular importance in the field of Parkinson's disease, where clinicians have described placebo effects in their patients for decades. Significant placebo effects have been observed in clinical trials for medications as well as more invasive surgical trials including deep-brain stimulation and stem-cell implantation. In addition to placebo effects occurring as a byproduct of randomized controlled trials, investigation of the placebo effect itself in the laboratory setting has further shown the capacity for strong placebo effects within this patient population. Neuroimaging studies have demonstrated that placebos stimulate the release of dopamine in the striatum of patients with Parkinson's disease and can alter the activity of dopamine neurons using single-cell recording. When taken together with the findings from other medical conditions discussed elsewhere in this publication, a unified mechanism for the placebo effect in Parkinson's disease is emerging that blends expectation-induced neurochemical changes and disease-specific nigrostriatal dopamine release.
随着脑成像技术的进步，我们对安慰剂效应背后神经机制的理解呈指数级增长。这在帕金森病领域尤为重要，几十年来临床医生一直在描述其患者中的安慰剂效应。在药物临床试验以及包括深部脑刺激和干细胞植入等更具侵入性的外科手术试验中都观察到了显著的安慰剂效应。除了作为随机对照试验的副产品出现的安慰剂效应外，在实验室环境中对安慰剂效应本身的研究进一步表明，该患者群体具有产生强烈安慰剂效应的能力。神经影像学研究表明，安慰剂能刺激帕金森病患者纹状体中多巴胺的释放，并可通过单细胞记录改变多巴胺神经元的活动。结合本出版物其他地方讨论的其他医学病症的研究结果，帕金森病安慰剂效应的统一机制正在形成，该机制融合了期望诱导的神经化学变化和特定疾病的黑质纹状体多巴胺释放。
