Dissociable influences of opiates and expectations on pain

Lauren Y. Atlas, Robert A. Whittington, Martin Lindquist, Joe Wielgosz, Nomita Sonty, Tor D. Wager

Research output: Contribution to journalArticle

Abstract

Placebo treatments and opiate drugs are thought to have common effects on the opioid system and pain-related brain processes. This has created excitement about the potential for expectations to modulate drug effects themselves. If drug effects differ as a function of belief, this would challenge the assumptions underlying the standard clinical trial. We conducted two studies to directly examine the relationship between expectations and opioid analgesia. We administered the opioid agonist remifentanil to human subjects during experimental thermal pain and manipulated participants' knowledge of drug delivery using an open-hidden design. This allowed us to test drug effects, expectancy (knowledge) effects, and their interactions on pain reports and pain-related responses in the brain. Remifentanil and expectancy both reduced pain, but drug effects on pain reports and fMRI activity did not interact with expectancy. Regions associated with pain processing showed drug-induced modulation during both Open and Hidden conditions, with no differences in drug effects as a function of expectation. Instead, expectancy modulated activity in frontal cortex, with a separable time course from drug effects. These findings reveal that opiates and placebo treatments both influence clinically relevant outcomes and operate without mutual interference.

Original languageEnglish (US)
Pages (from-to)8053-8064
Number of pages12
JournalJournal of Neuroscience
Volume32
Issue number23
DOIs
StatePublished - Jun 6 2012
Externally publishedYes

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Opiate Alkaloids
Pain
Pharmaceutical Preparations
Opioid Analgesics
Placebos
Brain
Frontal Lobe
Analgesia

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Atlas, L. Y., Whittington, R. A., Lindquist, M., Wielgosz, J., Sonty, N., & Wager, T. D. (2012). Dissociable influences of opiates and expectations on pain. Journal of Neuroscience, 32(23), 8053-8064. https://doi.org/10.1523/JNEUROSCI.0383-12.2012

Dissociable influences of opiates and expectations on pain. / Atlas, Lauren Y.; Whittington, Robert A.; Lindquist, Martin; Wielgosz, Joe; Sonty, Nomita; Wager, Tor D.

In: Journal of Neuroscience, Vol. 32, No. 23, 06.06.2012, p. 8053-8064.

Research output: Contribution to journalArticle

Atlas, LY, Whittington, RA, Lindquist, M, Wielgosz, J, Sonty, N & Wager, TD 2012, 'Dissociable influences of opiates and expectations on pain', Journal of Neuroscience, vol. 32, no. 23, pp. 8053-8064. https://doi.org/10.1523/JNEUROSCI.0383-12.2012
Atlas, Lauren Y. ; Whittington, Robert A. ; Lindquist, Martin ; Wielgosz, Joe ; Sonty, Nomita ; Wager, Tor D. / Dissociable influences of opiates and expectations on pain. In: Journal of Neuroscience. 2012 ; Vol. 32, No. 23. pp. 8053-8064.
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