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The role of pain expectancy and its confidence in placebo hypoalgesia and nocebo hyperalgesia.
Pain
January 2025
Department of Psychology, University of Milano-Bicocca, Milano, Italy.
Placebo hypoalgesia and nocebo hyperalgesia, which exemplify the impact of expectations on pain, have recently been conceptualised as Bayesian inferential processes, yet empirical evidence remains limited. Here, we explore whether these phenomena can be unified within the same Bayesian framework by testing the predictive role of expectations and their level of precision (ie, expectation confidence) on pain, with both predictors measured at the metacognitive level. Sixty healthy volunteers underwent a pain test (ie, 8 noxious electrical stimuli) before (Baseline) and after (T0, T1, T2) receiving a sham treatment associated with hypoalgesic (placebo), hyperalgesic (nocebo), or neutral (control) verbal suggestions, depending on group allocation.
View Article and Find Full Text PDFA Computational Framework for Understanding the Impact of Prior Experiences on Pain Perception and Neuropathic Pain.
PLoS Comput Biol
October 2024
Institute of Biomedical Engineering, University of New Brunswick, Fredericton, New Brunswick, Canada.
Pain perception is influenced not only by sensory input from afferent neurons but also by cognitive factors such as prior expectations. It has been suggested that overly precise priors may be a key contributing factor to chronic pain states such as neuropathic pain. However, it remains an open question how overly precise priors in favor of pain might arise.
View Article and Find Full Text PDFStatistical learning shapes pain perception and prediction independently of external cues.
Elife
July 2024
Computational and Biological Learning Unit, Department of Engineering, University of Cambridge, Cambridge, United Kingdom.
The placebo and nocebo effects highlight the importance of expectations in modulating pain perception, but in everyday life we don't need an external source of information to form expectations about pain. The brain can learn to predict pain in a more fundamental way, simply by experiencing fluctuating, non-random streams of noxious inputs, and extracting their temporal regularities. This process is called statistical learning.
View Article and Find Full Text PDFThe downside to choice: instrumental control increases conditioned nocebo hyperalgesia.
Pain
October 2024
School of Psychology, The University of Sydney, Sydney, Australia.
Nocebo hyperalgesia is a pervasive problem in which the treatment context triggers negative expectations that exacerbate pain. Thus, developing ethical strategies to mitigate nocebo hyperalgesia is crucial. Emerging research suggests that choice has the capacity to reduce nocebo side effects, but choice effects on nocebo hyperalgesia have not been explored.
View Article and Find Full Text PDFPlacebo and nocebo effects and mechanisms associated with pharmacological interventions: an umbrella review.
BMJ Open
October 2023
Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
Objectives: This review aimed to summarise the existing knowledge about placebo and nocebo effects associated with pharmacological interventions and their mechanisms.
Design: Umbrella review, adopting the Assessment of Multiple Systematic Reviews 2 tool for critical appraisal.
Data Sources: MEDLINE/PubMed, Scopus, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trial were searched in September 2022, without any time restriction, for systematic reviews, narrative reviews, original articles.
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