Nat Commun:安慰剂镇痛相关大脑神经系统活动的荟萃分析研究

2021-03-05 xiaozeng MedSci原创

安慰剂在医学研究和临床实践中均对患者的治疗结果具有重要的贡献。因此,更好地了解其潜在机制对于优化药物开发和临床护理很重要。

安慰剂在医学研究和临床实践中均对患者的治疗结果具有重要的贡献。因此,更好地了解其潜在机制对于优化药物开发和临床护理很重要。

安慰剂镇痛是最有效的,且是目前研究中最好的安慰剂作用类型。越来越多的神经影像学研究阐明了安慰剂镇痛的大脑相关性。这些研究及发现的荟萃分析也为疼痛处理相关大脑区域的研究提供了相关证据,包括早期的疼痛控制机制,以及其他与健康行为有关的学习和社会认知形式。然而,安慰剂镇痛相关的大脑系统研究还不足。

在该研究中,研究人员对刺激强度匹配的安慰剂和对照治疗下诱发性疼痛的实验性功能性神经影像学研究进行了系统的荟萃分析,该分析包括了来自20项研究(共28项合格研究)中的603名健康参与者。

实验性安慰剂成像研究中的疼痛相关活动

研究人员发现,安慰剂与对照治疗可引起疼痛相关活动的范围减少,特别是腹侧注意网络(包括中岛,mid-insula)和躯体运动网络(包括后岛,posterior insula)区域。进一步的研究显示,行为性安慰剂镇痛与这些网络以及丘脑,缰核,扣带束和辅助运动区的疼痛相关活动减少相关。安慰剂相关的活性增加主要发生在前额顶区域,且研究之间的异质性很高。

安慰剂引起的疼痛相关活动的变化

总而言之,该研究结果揭示,安慰剂治疗会影响多个大脑区域中与疼痛相关的活动,这可能反映了伤害性疼痛和/或围绕疼痛的其他情感和决策过程的变化。上述研究之间的异质性也表明,安慰剂镇痛是一种涉及多种大脑机制的现象。


原始出处:

Zunhammer, M., Spisák, T., Wager, T.D. et al. Meta-analysis of neural systems underlying placebo analgesia from individual participant fMRI data. Nat Commun 12, 1391 (02 March 2021).

 

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createdName=fangcong, createdTime=Sun Sep 19 20:59:32 CST 2021, time=2021-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1703724, encodeId=db111e0372453, content=<a href='/topic/show?id=a8db4394487' target=_blank style='color:#2F92EE;'>#大脑神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43944, encryptionId=a8db4394487, topicName=大脑神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5d2b30558460, createdName=yangwen5719, createdTime=Sat Dec 25 23:59:32 CST 2021, time=2021-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1709626, encodeId=e59f1e0962646, content=<a href='/topic/show?id=a919849e3ff' target=_blank style='color:#2F92EE;'>#脑神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84973, 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channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Wed Dec 29 05:59:32 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946113, encodeId=e5d394611363, content=镇痛镇静很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/uJHHFibmUWLtiby2aXxic9KNk6AKKCJE9dO6PLvfMXbmmiamYgSDz1seVwBmAic7D8YLmJ2T6wC8qtbxj9EUSyBibUtg/132, createdBy=d9c45276788, createdName=zhangbin1983, createdTime=Sun Mar 07 11:03:49 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283169, encodeId=ed001283169fd, content=<a href='/topic/show?id=4fade445192' target=_blank style='color:#2F92EE;'>#神经系统#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74451, encryptionId=4fade445192, topicName=神经系统)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02f5179, createdName=luoxiaog, createdTime=Sun Mar 07 10:59:32 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304396, encodeId=7259130439672, content=<a href='/topic/show?id=81724580886' target=_blank style='color:#2F92EE;'>#安慰剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45808, encryptionId=81724580886, topicName=安慰剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Mar 07 10:59:32 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355355, encodeId=d4711355355f2, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Mar 07 10:59:32 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-11-09 siiner
  5. [GetPortalCommentsPageByObjectIdResponse(id=2087941, encodeId=7ce8208e94104, content=<a href='/topic/show?id=490750196b' target=_blank style='color:#2F92EE;'>#COMMUN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5019, encryptionId=490750196b, topicName=COMMUN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7931272, createdName=liuli5079, createdTime=Thu May 06 17:59:32 CST 2021, time=2021-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836968, encodeId=1458183696819, content=<a href='/topic/show?id=1f188e230c5' target=_blank style='color:#2F92EE;'>#荟萃分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87230, encryptionId=1f188e230c5, topicName=荟萃分析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, 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channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Wed Dec 29 05:59:32 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946113, encodeId=e5d394611363, content=镇痛镇静很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/uJHHFibmUWLtiby2aXxic9KNk6AKKCJE9dO6PLvfMXbmmiamYgSDz1seVwBmAic7D8YLmJ2T6wC8qtbxj9EUSyBibUtg/132, createdBy=d9c45276788, createdName=zhangbin1983, createdTime=Sun Mar 07 11:03:49 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283169, encodeId=ed001283169fd, content=<a href='/topic/show?id=4fade445192' target=_blank style='color:#2F92EE;'>#神经系统#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74451, encryptionId=4fade445192, topicName=神经系统)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02f5179, createdName=luoxiaog, createdTime=Sun Mar 07 10:59:32 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304396, encodeId=7259130439672, content=<a href='/topic/show?id=81724580886' target=_blank style='color:#2F92EE;'>#安慰剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45808, encryptionId=81724580886, topicName=安慰剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Mar 07 10:59:32 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355355, encodeId=d4711355355f2, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Mar 07 10:59:32 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-08-14 liye789132251
  6. [GetPortalCommentsPageByObjectIdResponse(id=2087941, encodeId=7ce8208e94104, content=<a href='/topic/show?id=490750196b' target=_blank style='color:#2F92EE;'>#COMMUN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5019, encryptionId=490750196b, topicName=COMMUN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7931272, createdName=liuli5079, createdTime=Thu May 06 17:59:32 CST 2021, time=2021-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836968, encodeId=1458183696819, content=<a href='/topic/show?id=1f188e230c5' target=_blank style='color:#2F92EE;'>#荟萃分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87230, encryptionId=1f188e230c5, topicName=荟萃分析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, 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channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Wed Dec 29 05:59:32 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946113, encodeId=e5d394611363, content=镇痛镇静很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/uJHHFibmUWLtiby2aXxic9KNk6AKKCJE9dO6PLvfMXbmmiamYgSDz1seVwBmAic7D8YLmJ2T6wC8qtbxj9EUSyBibUtg/132, createdBy=d9c45276788, createdName=zhangbin1983, createdTime=Sun Mar 07 11:03:49 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283169, encodeId=ed001283169fd, content=<a href='/topic/show?id=4fade445192' target=_blank style='color:#2F92EE;'>#神经系统#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74451, encryptionId=4fade445192, topicName=神经系统)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02f5179, createdName=luoxiaog, createdTime=Sun Mar 07 10:59:32 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304396, encodeId=7259130439672, content=<a href='/topic/show?id=81724580886' target=_blank style='color:#2F92EE;'>#安慰剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45808, encryptionId=81724580886, topicName=安慰剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Mar 07 10:59:32 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355355, encodeId=d4711355355f2, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Mar 07 10:59:32 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-12-29 venlin
  7. 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    2021-03-07 zhangbin1983

    镇痛镇静很重要

    0

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    2021-03-07 zhaojie88

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JAHA:急性冠脉综合症患者焦虑和疼痛药物治疗与创伤后应激障碍症状风险的关系

尽管苯二氮卓类药物在ACS期间有短期抗焦虑作用,但可能会增加ACS诱导的PTSS风险,从而影响患者的生活质量和预后。

Nat Med:持续实验和临床疼痛的神经影像生物标记物

Choong-Wan Woo等发现一种可用于鉴别持续性疼痛实验和临床特沟通的神经影像生物标志物。

病人疼痛是正常,必须忍?专家说熬不过疼痛而轻生的患者都错了!

严峻的现实是,随着人口老龄化、不良的生活习惯和行为、慢性疾病人数的暴增,导致慢性疼痛的患者越来越多。