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When Expectancies Are Violated: A Functional Magnetic Resonance Imaging Study
Author(s) -
Colloca Luana,
Schenk Lieven A.,
Nathan Dominic E.,
Robinson Oliver J.,
Grillon Christian
Publication year - 2019
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.1587
Subject(s) - nocebo effect , nocebo , placebo , expectancy theory , psychology , functional magnetic resonance imaging , extinction (optical mineralogy) , cognition , quantitative sensory testing , cognitive psychology , clinical psychology , medicine , audiology , neuroscience , developmental psychology , sensory system , social psychology , alternative medicine , paleontology , pathology , biology
Positive and negative expectancies drive behavioral and neurobiological placebo and nocebo effects, which in turn can have profound effects on patient improvement or worsening. However, expectations of events and outcomes are often not met in daily life and clinical practice. It is currently unknown how this affects placebo and nocebo effects. We have demonstrated that the violation of expectancies, such as when there is a discrepancy between what is expected and what is actually presented, reduces both placebo and nocebo effects while causing an extinction of placebo effects. The reduction of placebo and nocebo effects was paralleled by an activation of the left inferior parietal cortex, a brain region that redirects attention when discrepancies between sensory and cognitive events occur. Our findings highlight the importance of expectancy violation in shaping placebo and nocebo effects and open up new avenues for managing positive and negative expectations in clinical trials and practices.