Nocebo and pain: An overview of the psychoneurobiological mechanisms.

Autor:	Blasini M; Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA., Corsi N; Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA.; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy., Klinger R; University Medical Center Hamburg-Eppendorf (UKE), Center for Anesthesiology and Intensive Care Medicine, Department of Anesthesiology, Pain Therapy and Pain Psychology, Hamburg, Germany., Colloca L; Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA.; Department of Anesthesiology/Psychiatry, School of Medicine, University of Maryland, Baltimore; Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA.
Jazyk:	angličtina
Zdroj:	Pain reports [Pain Rep] 2017 Mar-Apr; Vol. 2 (2).
DOI:	10.1097/PR9.0000000000000585
Abstrakt:	Introduction: Nocebo effects are defined as adverse events related to negative expectations and learning processes that are involved in the modulation of the descending pain pathways. Research over the last couple of decades has illustrated that behavioral, psychoneurobiological and functional changes occur during nocebo-induced pain processing. Objectives: We aimed to review published human and non-human research on algesia and hyperalgesia resulting from negative expectations and nocebo effects. Methods: Herein, we searched and comprehensively reviewed scientific literature providing informative knowledge about the psychoneurobiological bases of the nocebo effect in the field of pain with an emphasis on how pain processes are shaped by both cognitive and non-cognitive factors. Results: Negative expectations are formed through verbal suggestions of heightened pain, prior nociceptive and painful experiences and observation of pain in others. Susceptibility to the nocebo effect can be also influenced by genetic variants, conscious and nonconscious learning processes, personality traits and psychological factors. Moreover, providers' behaviors, environmental cues and the appearance of medical devices can induce negative expectations that dramatically influence pain perception and processing in a variety of pain modalities and patient populations. Conclusion: Importantly, we concluded that nocebo studies outline how individual expectations may lead to physiological changes underpinning the central integration and processing of magnified pain signaling. Further research is needed to develop strategies that can identify nocebo-vulnerable pain patients in order to optimize the psychosocial and therapeutic context in which the clinical encounter occurs, with the ultimate purpose of improving clinical outcomes. Competing Interests: Conflict of interests: No conflicts of interest to be claimed.
Databáze:	MEDLINE
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