The biochemical bases of the placebo effect |
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Authors: | de la Fuente-Fernández Raúl Stoessl A Jon |
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Institution: | 1.Division of Neurology, Hospital A. Marcide, Estrada San Pedro - Catabois s/n, 15405, Ferrol, A Coru?a, Spain ;2.Pacific Parkinson’s Research Centre, University of British Columbia, Vancouver, B.C., Canada ; |
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Abstract: | A great variety of medical conditions are subject to the placebo effect. Although there is mounting evidence to suggest that
the placebo effect is related to the expectation of clinical benefit, little is still known about the biochemical bases underlying
placebo responses. Positron emission tomography studies have recently shown that the placebo effect in Parkinson’s disease,
pain, and depression is related to the activation of the limbic circuitry. The observation that placebo administration induces
the release of dopamine in the ventral striatum of patients with Parkinson’s disease suggests a link between the placebo effect
and reward mechanisms. In addition to Parkinson’s disease, the placebo-reward model may also apply to other disorders. However,
the relative contribution of the different neurotransmitters and neuropeptides that are known to be involved in modulating
the activity of the limbic system may be disease-specific. Thus, while the placebo-induced clinical benefit observed in Parkinson’s
disease would mostly reflect the release of dopamine in the dorsal striatum, the activation of opioid and serotonin pathways
could be particularly implicated in mediating placebo responses encountered in pain and depression, respectively.
An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research
Today,” held in Warsaw, Poland on 12–13 April, 2003. |
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Keywords: | placebo effect reward dopamine opioid serotonin |
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