Neural correlates of placebo effect: Review and future implications

Year 2017, Volume: 2 Issue: 2, 49 - 54, 15.08.2017

Sezin Öner

https://doi.org/10.25000/acem.307231

Cited By: 1

Abstract

Experimental
and clinical research has documented expectancy related symptom improvement in
a variety of conditions, leading to a growing interest in the placebo effect.
Despite significant treatment outcomes, placebo-induced effects have been
regarded as nonspecific psychological factors associated with the subjective
experience of healing that operates different than the actual drug agent .
However, neuroimaging research revealed more complex regulation of the placebo
response, which indicates a top-down regulation of the symptom improvement enhanced
by the expectancy effects. It appears that, placebo response is not solely
function of higher order control processes, but also involves diverse
disease-specific neurobiological mechanisms. In the current review, neural
mechanisms underlying placebo effect have been addressed focusing on the
analgesia, Parkinson’s disease and major depression. Along with the opiate
system, dopaminergic and serotonergic functions in the brain are discussed in
relation with the three target conditions. Last, potential implications of the
placebo research are discussed with respect to experimental and clinical
practice. 

Keywords

placebo effect, pain, antidepressants, Parkinson's disease, treatment expectancy

Plasebo etkisinin nöral temelleri: Geçmiş bulguların gözden geçirilmesi ve çıkarsamalar

Abstract

İyileşme
beklentisi ile ilişkili hastalığa-özgü semptomlardaki iyileşme literatürde
sıkça gösterildiğinden plasebo etkisine olan ilgi giderek artmaktadır. Her ne
kadar tedavi etkinliği plasebo gruplarında belirgin olsa da, bu etkinin asıl
maddeden ziyade, hastanın iyileşme beklentisi ve öznel iyilik
değerlendirmesinin bir sonucu olarak düşünülmektedir. Öte yandan, beyin
görüntüleme çalışmaları daha karmaşık bir sürecin var olduğuna işaret
etmektedir. Denetimli kontrol mekanizmalarının yönettiği plasebo etkisinin
iyileşme beklentisi ile güçlendiği görüşü giderek ağırlık kazanmaktadır. Bu
bağlamda görünen odur ki, plasebo etkisi tek bir sistem üzerinden değil,
hastalık temelli mekanizmalar aracılığı ile ortaya çıkmaktadır. Bu derleme
çalışmasında da, plasebo etkisinin nöral boyutlarının sıkça incelendiği ağrı,
Parkinson ve depresyon olgularına ilişkin bulgulara odaklanılmış ve opiat
sistemi ile dopaminerjik ve serotonerjik işlevler incelenmiştir. Bu doğrultuda
da, geçmiş bulguların gözden geçirilmesinin ardından plasebo etkisinin gelecek
çalışmalardaki rolü tartışılmıştır.

Keywords

Plasebo etkisi, ağrı, antidepresanlar, Parkinson, tedavi beklentisi

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