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Neuroimaging of Pain pp 153–170Cite as

Anticipation and Placebo Analgesia

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Abstract

The neural substrates of the anticipatory phase of an impending stimulus have been studied in the context of pain with neuromapping techniques, including both positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The neural response during the anticipatory phase is complex since it can be affected by many factors, including certainty and uncertainty, dispositional anxiety and pathology, which have been the topic of many past studies. Importantly, the anticipation of pain is affected by positive and negative expectancies , namely the placebo and nocebo phenomena which serve as great examples of how expectancies created during the anticipatory phase can modulate pain perception. Here we critically discuss the literature on the neural activity throughout the anticipatory phase preceding a noxious stimulus and during the delivery of a stimulus when placebo and nocebo effects modulate pain. Understanding the processes during the anticipatory phase and the placebo and nocebo effects can help increase knowledge of both acute and chronic pain mechanisms, identify biological predictors of variability in clinical pain phenotypes and ultimately contribute to new therapeutic approaches.

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Abbreviations

Amy:

Amygdala

ACC:

Anterior cingulate cortex

rACC, sACC or pgACC (respectively):

Rostral or subgenual or pregenual ACC

INS:

Insular cortex

MCC:

Midcingulate cortex

NAcc:

Nucleus accumbens

OFC:

Orbitofrontal cortex

PAG:

Periaqueductal gray

PFC:

Prefrontal cortex

DLPFC:

Dorsolateral prefrontal cortex

vmPFC:

Ventral medial prefrontal cortex

SI:

Primary somatosensory cortex

RVM:

Rostral ventral medulla

Th:

Thalamus

VTA:

Ventral tegmental area

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Acknowledgements

This project was supported by University of Maryland Baltimore (LC), the National Institute of Dental and Craniofacial Research (NIDCR; R01DE025946-01, LC) and International Association for Study of Pain (Early Research Grant [LC]).

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Authors and Affiliations

  1. Uniformed Services University of the Health Sciences, School of Nursing, Bethesda, MD, USA

    Dominic E. Nathan

  2. Pain and Translational Symptom Science, University of Maryland Baltimore, School of Nursing, Baltimore, USA

    Taylor M. Ludman & Luana Colloca

  3. UM Center to Advance Chronic Pain Research, Baltimore, MD, USA

    Taylor M. Ludman & Luana Colloca

  4. Department of Anesthesiology, University of Maryland Baltimore, School of Medicine, 655 W. Lombard Street, Baltimore, MD, USA

    Luana Colloca

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  1. Dominic E. Nathan
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  2. Taylor M. Ludman
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  3. Luana Colloca
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Correspondence to Luana Colloca .

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  1. University of Cagliari, Cagliari, Italy

    Luca Saba

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Nathan, D.E., Ludman, T.M., Colloca, L. (2017). Anticipation and Placebo Analgesia. In: Saba, L. (eds) Neuroimaging of Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-48046-6_7

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