Neurophysiology and psychobiology of the placebo response

Curr Opin Psychiatry. 2008 Mar;21(2):189-95. doi: 10.1097/YCO.0b013e3282f50c36.

Abstract

Purpose of review: The placebo literature has substantially increased in 2006 and 2007, and more and more medical and psychological subspecialties have added empirical data to our knowledge.

Recent findings: The theoretical framework of our understanding of the placebo response needs extension to account for findings that cannot be attributed to (Pavlovian) conditioning or suggestions alone. In addition, imaging studies need to address individual responses rather than group means, and to expand beyond experimental pain research. Gender aspects have been demonstrated for the placebo response but still widely ignored, especially in neurophysiological studies. It has been shown that nocebo research needs a methodological and ethical framework that allows its exploration. Finally, analyses of clinical trial data, either as metaanalyses or as reanalyses of trial raw data, may allow us to identify factors that subsequently can be used in experimental work.

Summary: Novel findings will allow better planning of clinical drug trials, better handling of clinical trial data in the future, and finally, may eventually result in improved patient management.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain / diagnostic imaging*
  • Brain / physiopathology*
  • Cholecystokinin / physiology*
  • Depressive Disorder, Major* / diagnosis
  • Depressive Disorder, Major* / drug therapy
  • Depressive Disorder, Major* / physiopathology
  • Dopamine / physiology*
  • Humans
  • Placebo Effect*
  • Positron-Emission Tomography*
  • Receptors, Opioid, mu / physiology*

Substances

  • Receptors, Opioid, mu
  • Cholecystokinin
  • Dopamine