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Neuropsychological mechanisms of observational learning in human placebo effects

  • Theoretical and Methodological Perspective
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Abstract

Scientific evidence indicates that placebo effects are psychoneurobiological events involving the contribution of distinct central nervous systems and peripheral physiological mechanisms that influence pain perception and other symptoms. Placebo effects can occur without formal conditioning and direct prior experience because crucial information can be acquired through observational learning. Observation of benefits in another person results in placebo effects of a magnitude like those induced by directly experiencing an analgesic benefit. Understanding the psychological mechanisms of observationally induced placebo effects is a complex and multifaceted endeavor. While previous reviews have highlighted various frameworks and models to understand these phenomena, the underlying biological mechanisms have been overlooked. We summarize critically current understanding of its behavioral and neural mechanisms. Understanding the neural mechanisms of hypoalgesia driven by observation can serve as a foundation for future development of novel theoretical and methodological approaches and ultimately, applications.

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Abbreviations

TPJ:

Temporoparietal Junction

DLPFC:

Dorsolateral prefrontal cortex

PAG:

Periaqueductal gray

µ-opioid receptors:

MOPr

VAS:

Visual analog scale

fMRI:

Functional magnetic resonance imaging

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Funding

This work was funded by MPowering the State Initiatives: Strategic Partnership Grant (LC), the National Center for Complementary and Integrative Health (NCCIH, R01 AT011347, LC and NCCIH, R01 AT010333, LC). JW is supported by the National Institute for Dental Craniofacial Research (NIDCR, R21DE032532) and LW is supported by the University of Maryland Baltimore, Institute for Clinical & Translational Research (ICTR) TL1 program (5TL1TR003100-05).

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Authors and Affiliations

  1. Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA

    Nandini Raghuraman, Jewel N. White, Lakota Watson, Carmen-Édith Belleï-Rodriguez, Roni Shafir, Yang Wang & Luana Colloca

  2. Graduate Program in Life Sciences, Program in Epidemiology and Human Genetics, University of Maryland School of Medicine, Baltimore, MD, USA

    Nandini Raghuraman

  3. Placebo Beyond Opinions Center, University of Maryland School of Nursing, Baltimore, USA

    Nandini Raghuraman, Jewel N. White, Roni Shafir, Yang Wang & Luana Colloca

  4. Graduate Program in Life Sciences, Program in Neuroscience, University of Maryland School of Medicine, Baltimore, USA

    Jewel N. White & Lakota Watson

  5. Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA

    Yang Wang & Luana Colloca

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Correspondence to Luana Colloca.

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Raghuraman, N., White, J.N., Watson, L. et al. Neuropsychological mechanisms of observational learning in human placebo effects. Psychopharmacology (2024). https://doi.org/10.1007/s00213-024-06608-7

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