Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Republic of Korea.
Cham Brain Health Institute, 08807, Seoul, Republic of Korea.
Sci Rep. 2022 Aug 29;12(1):14687. doi: 10.1038/s41598-022-18181-0.
Prior experiences of successful and failed treatments are known to influence the efficacy of a newly applied treatment. However, whether that carry-over effect applies to non-pharmacological treatments is unknown. This study investigated how a failed treatment history with placebo analgesic cream affected the therapeutic outcomes of cold-pack treatment. The neural correlates underlying those effects were also explored using functional magnetic resonance imaging. The effect of the placebo analgesic cream was induced using placebo conditioning with small (44.5 °C to 43.7 °C, negative experience) and large (44.5 °C to 40.0 °C, positive experience) thermal stimuli changes. After the placebo conditioning, brain responses and self-reported evaluations of the effect of subsequent treatment with a cold-pack were contrasted between the two groups. The negative experience group reported less pain and lower anxiety scores in the cold-pack condition than the positive experience group and exhibited significantly greater activation in the right inferior parietal lobule (IPL), which is known to be involved in pain relief. These findings suggest that an unsatisfying experience with an initial pain-relief treatment could increase the expectations for the complementary treatment outcome and improve the analgesic effect of the subsequent treatment. The IPL could be associated with this expectation-induced pain relief process.
先前成功和失败治疗的经验被认为会影响新应用治疗的疗效。然而，这种延续效应是否适用于非药物治疗尚不清楚。本研究调查了安慰剂镇痛乳膏治疗失败史如何影响冷包治疗的治疗效果。还使用功能磁共振成像来探讨这些影响的神经相关性。使用小（44.5°C 至 43.7°C，负体验）和大（44.5°C 至 40.0°C，正体验）热刺激变化的安慰剂条件作用来诱导安慰剂镇痛乳膏的作用。在安慰剂条件作用之后，在两组之间对比了随后使用冷包治疗的大脑反应和自我报告的效果评估。与阳性体验组相比，阴性体验组在冷包条件下报告的疼痛和焦虑评分较低，并且右侧下顶叶（IPL）的激活显著增加，IPL 已知参与缓解疼痛。这些发现表明，初始止痛治疗的不满意体验可能会增加对补充治疗结果的期望，并提高随后治疗的镇痛效果。IPL 可能与这种期望引起的疼痛缓解过程有关。
