Meissner Karin
Institute of Medical Psychology, Ludwig-Maximilians-University Munich, Goethestrasse 31, 80336, Munich, Germany,
Handb Exp Pharmacol. 2014;225:183-203. doi: 10.1007/978-3-662-44519-8_11.
It is widely acknowledged that placebo responses are accompanied by physiological changes in the central nervous system, but little is known about placebo responses on end organ functions. The present chapter aims to fill this gap by reviewing the literature on peripheral placebo responses. Overall, there is a wide range of placebo and nocebo responses on various organ functions of the cardiovascular, the gastrointestinal system, and the respiratory system. Most of these studies used expectation paradigms to elicit placebo and nocebo responses. Expectations can affect heart rate, blood pressure, coronary diameter, gastric motility, bowel motility, and lung function. Classical conditioning can induce placebo respiratory depression after prior exposure to opioid drugs, and habitual coffee drinkers show physiological arousal in response to coffee-associated stimuli. Similar to findings in placebo pain research, peripheral placebo responses can be target specific. The autonomic nervous system is a likely candidate to mediate peripheral placebo responses. Further studies are necessary to identify the brain mechanisms and pathways involved in peripheral placebo responses.
人们普遍认为，安慰剂反应伴随着中枢神经系统的生理变化，但对于安慰剂对终末器官功能的反应却知之甚少。本章旨在通过回顾关于外周安慰剂反应的文献来填补这一空白。总体而言，在心血管、胃肠系统和呼吸系统的各种器官功能方面，存在广泛的安慰剂和反安慰剂反应。这些研究大多使用期望范式来引发安慰剂和反安慰剂反应。期望可以影响心率、血压、冠状动脉直径、胃动力、肠道动力和肺功能。经典条件作用在先前接触阿片类药物后可诱发安慰剂性呼吸抑制，而习惯性咖啡饮用者对与咖啡相关的刺激会表现出生理唤醒。与安慰剂疼痛研究的结果类似，外周安慰剂反应可能具有靶点特异性。自主神经系统可能是介导外周安慰剂反应的一个候选因素。需要进一步的研究来确定参与外周安慰剂反应的脑机制和途径。
