Zandonai Thomas, Chiamulera Cristiano
Department of Pharmacology, Pediatrics, and Organic Chemistry, Miguel Hernández University of Elche, Sant Joan, 03550 Alicante, Spain.
Addiction Science Laboratory, Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy.
Sensors (Basel). 2025 Aug 24;25(17):5268. doi: 10.3390/s25175268.
In this perspective article, we introduce Ecocebo as a novel concept describing the modulatory effects of physical environments, whether natural or built, on drug effect. Positioned as a spatial component of the placebo effect, Ecocebo is grounded in evidence-based design principles and proposes that environmental features such as natural light, greenery, spatial geometry, and calming esthetics can significantly influence sensory, emotional, and cognitive processes. These environmental factors may enhance or modify pharmacological responses, especially for analgesics, anxiolytics, and antidepressants. We highlighted how exposure to restorative spaces can reduce pain perception, stress, and the need for medication, paralleling findings in placebo research where contextual and sensory cues influence brain regions linked to emotion and pain regulation. We propose virtual reality (VR) as the most suitable methodological tool to study Ecocebo in controlled and ecologically valid settings. VR allows for the precise manipulation of spatial features and real-time monitoring of physiological and psychological responses. We also propose integrating VR with neuromodulation techniques to investigate brain-environment-drug interactions. Finally, we addressed key methodological challenges such as defining control conditions and standardizing the measurement of presence. This perspective opens new directions for the integration of non-pharmacological and pharmacological interventions and personalized therapeutic environments to optimize clinical outcomes.
在这篇观点文章中，我们引入“生态安慰剂”这一新颖概念，它描述了自然或人造的物理环境对药物效果的调节作用。作为安慰剂效应的空间组成部分，“生态安慰剂”基于循证设计原则，提出诸如自然光、绿植、空间几何形状和平静美学等环境特征可显著影响感觉、情绪和认知过程。这些环境因素可能增强或改变药理反应，尤其是对于镇痛药、抗焦虑药和抗抑郁药。我们强调了置身于恢复性空间如何能够减轻疼痛感知、压力以及对药物的需求，这与安慰剂研究中的发现相似，即在安慰剂研究中，情境和感觉线索会影响与情绪和疼痛调节相关的脑区。我们提出虚拟现实（VR）是在可控且生态有效的环境中研究“生态安慰剂”最合适的方法工具。VR能够精确操控空间特征，并实时监测生理和心理反应。我们还提议将VR与神经调节技术相结合，以研究脑 - 环境 - 药物的相互作用。最后，我们探讨了关键的方法学挑战，如定义对照条件和规范存在感的测量。这一观点为整合非药物和药物干预以及个性化治疗环境以优化临床结果开辟了新方向。
