I am a
Home I AM A Search Login

Papers of the Week


Papers: 11 Mar 2023 - 17 Mar 2023

RESEARCH TYPE:
Review


Neurobiology

PAIN TYPE:
Psychological/Comorbidities


2023 Mar 14


Annu Rev Neurosci


36917820

How Instructions, Learning, and Expectations Shape Pain and Neurobiological Responses.

Authors

Atlas LY

Abstract

Treatment outcomes are strongly influenced by expectations, as evidenced by the placebo effect. Meta-analyses of clinical trials reveal that placebo effects are strongest in pain, indicating that psychosocial factors directly influence pain. In this review, I focus on the neural and psychological mechanisms by which instructions, learning, and expectations shape subjective pain. I address new experimental designs that help researchers tease apart the impact of these distinct processes and evaluate the evidence regarding the neural mechanisms by which these cognitive factors shape subjective pain. Studies reveal that expectations modulate pain through parallel circuits that include both pain-specific and domain-general circuits such as those involved in affect and learning. I then review how expectations, learning, and verbal instructions impact clinical outcomes, including placebo analgesia and responses to pharmacological treatments, and discuss implications for future work. Expected final online publication date for the , Volume 46 is July 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.