Spinal and supraspinal mechanisms of placebo analgesia

Eippert, Falk; Büchel, Christian

doi:10.1016/B978-0-12-397928-5.00007-6

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Spinal and supraspinal mechanisms of placebo analgesia

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https://www.sciencedirect.com/science/article/pii/B9780123979285000076
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Eippert, F., & Büchel, C. (2013). Spinal and supraspinal mechanisms of placebo analgesia. In L. Colloca, M. A. Flaten, & K. Meissner (Eds.), Placebo and Pain: From Bench to Bedside (pp. 53-71). Amsterdam: Academic Press. doi:10.1016/B978-0-12-397928-5.00007-6.

Cite as: https://hdl.handle.net/21.11116/0000-0001-78FC-D

Abstract

Placebo analgesia is an illustrative example of the impact that psychological factors can have on the experience of pain. While this form of pain modulation is mediated by multiple neurobiological mechanisms, one influential explanation posits that a descending pain control system contributes to placebo effects in pain. Here, we first give an overview of descending pain control as established in animal studies, focusing on an opioid-dependent system that includes the periaqueductal gray (PAG) and rostral ventromedial medulla (RVM) as core regions and controls nociceptive processing already at the level of the spinal cord. We then review functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) studies that provide evidence for an involvement of this system in placebo analgesia. Finally, we have a look at the role of the spinal cord in placebo analgesia, focusing on spinal fMRI studies.