Facilitation of pain in the human spinal cord by nocebo treatment.
Many aspects, including negative emotions or expectations, can influence the experience of pain. A nocebo treatment for instance, can raise pain perception. It is well known that these interventions can lead to increased cortical activations but the underlying processes remain unknown. The aim of this paper was to test the hypothesis of a spinal cord involvement in spinal pain transmission. To test this a nocebo-heat paradigm and fMRI was used.
Twenty-three subjects were led to believe that a nocebo cream applied to their forearm would increase heat perception and that application of a control cream had no effects. Importantly, both creams used in this study were identical and did not have an active ingredient. Application of the nocebo cream increased pain ratings compared to a normal cream, lowered pain thresholds and increased the BOLD signal in the spinal cord.
The results give interesting insights into the top-down modulations induced by the psychosocial en behavioural elements and stress the importance of pain beliefs and expectations in clinical practice > From Geuter et al., J Neurosci 33 (2013) 13784–13790. All rights reserved to the authors.
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