Abstract
The placebo response is universally observed in clinical trials of pain treatments, yet the individual characteristics rendering a patient a ‘placebo responder’ remain unclear. Here, in chronic back pain patients, we demonstrate using MRI and fMRI that the response to placebo ‘analgesic’ pills depends on brain structure and function. Subcortical limbic volume asymmetry, sensorimotor cortical thickness, and functional coupling of prefrontal regions, anterior cingulate, and periaqueductal gray were predictive of response. These neural traits were present before exposure to the pill and most remained stable across treatment and washout periods. Further, psychological traits, including interoceptive awareness and openness, were also predictive of the magnitude of response. These results shed light on psychological, neuroanatomical, and neurophysiological principles determining placebo response in RCTs in chronic pain patients, and they suggest that the long-term beneficial effects of placebo, as observed in clinical settings, are partially predictable.
| Original language | English (US) |
|---|---|
| Article number | 3397 |
| Journal | Nature communications |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| State | Published - Dec 1 2018 |
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ASJC Scopus subject areas
- Chemistry(all)
- Biochemistry, Genetics and Molecular Biology(all)
- Physics and Astronomy(all)
Cite this
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Brain and psychological determinants of placebo pill response in chronic pain patients. / Vachon-Presseau, Etienne; Berger, Sara E.; Abdullah, Taha B.; Huang, Lejian; Cecchi, Guillermo A.; Griffith, James W; Schnitzer, Thomas J; Apkarian, Apkar.
In: Nature communications, Vol. 9, No. 1, 3397, 01.12.2018.Research output: Contribution to journal › Article
TY - JOUR
T1 - Brain and psychological determinants of placebo pill response in chronic pain patients
AU - Vachon-Presseau, Etienne
AU - Berger, Sara E.
AU - Abdullah, Taha B.
AU - Huang, Lejian
AU - Cecchi, Guillermo A.
AU - Griffith, James W
AU - Schnitzer, Thomas J
AU - Apkarian, Apkar
PY - 2018/12/1
Y1 - 2018/12/1
N2 - The placebo response is universally observed in clinical trials of pain treatments, yet the individual characteristics rendering a patient a ‘placebo responder’ remain unclear. Here, in chronic back pain patients, we demonstrate using MRI and fMRI that the response to placebo ‘analgesic’ pills depends on brain structure and function. Subcortical limbic volume asymmetry, sensorimotor cortical thickness, and functional coupling of prefrontal regions, anterior cingulate, and periaqueductal gray were predictive of response. These neural traits were present before exposure to the pill and most remained stable across treatment and washout periods. Further, psychological traits, including interoceptive awareness and openness, were also predictive of the magnitude of response. These results shed light on psychological, neuroanatomical, and neurophysiological principles determining placebo response in RCTs in chronic pain patients, and they suggest that the long-term beneficial effects of placebo, as observed in clinical settings, are partially predictable.
AB - The placebo response is universally observed in clinical trials of pain treatments, yet the individual characteristics rendering a patient a ‘placebo responder’ remain unclear. Here, in chronic back pain patients, we demonstrate using MRI and fMRI that the response to placebo ‘analgesic’ pills depends on brain structure and function. Subcortical limbic volume asymmetry, sensorimotor cortical thickness, and functional coupling of prefrontal regions, anterior cingulate, and periaqueductal gray were predictive of response. These neural traits were present before exposure to the pill and most remained stable across treatment and washout periods. Further, psychological traits, including interoceptive awareness and openness, were also predictive of the magnitude of response. These results shed light on psychological, neuroanatomical, and neurophysiological principles determining placebo response in RCTs in chronic pain patients, and they suggest that the long-term beneficial effects of placebo, as observed in clinical settings, are partially predictable.
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UR - http://www.scopus.com/inward/citedby.url?scp=85053278068&partnerID=8YFLogxK
U2 - 10.1038/s41467-018-05859-1
DO - 10.1038/s41467-018-05859-1
M3 - Article
VL - 9
JO - Nature Communications
JF - Nature Communications
SN - 2041-1723
IS - 1
M1 - 3397
ER -