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Psychological and biological mechanisms of placebo and nocebo effects

Pharmacological treatments for pain have primarily focused on dampening ascending neurotransmission and on opioid-receptor mediated therapies. Placebo and nocebo effects and their underlying endogenous modulatory mechanisms account in part for patients’ outcomes variability. Placebo and nocebo effects have emerged as useful models to assess individual endogenous pain modulatory systems. Indeed, neurobiological studies have identified dopaminergic, opioidergic, vasopressinergic, and endocannabinoidergic pathways as promising systems contributing to pain modulation. Different systems and mechanisms trigger placebo effects and nocebo effects that highly influence pain processing, pain outcomes, and well-being. This lecture illustrates critical mechanisms of placebo and nocebo effects that can inform the design of clinical trials, methodology for discovering new therapeutic targets, and advancement of personalized pain and symptom management.

Luana Colloca

  • Dr. Luana Colloca has conducted pioneering groundbreaking studies that have advanced scientific understanding of the psychoneurobiological bases of endogenous systems for pain modulation in humans including the discovery that social learning shapes placebo effects and that the vasopressin system is involved in the enhancement of placebo effects with a dimorphic effect.
  • Currently, Luana leads an NIH-funded team at University of Maryland investigating the placebo/nocebo effect, how expectancy shapes pain response, social learning and pain.
  • More recently, Colloca team has been working with virtual reality technology and clinical pain care to develop better management plans for acute post-operative pain.
  • Dr. Colloca holds an MD, a master degree in Bioethics and a PhD in Neuroscience.
  • She completed a post-doc training at the Karolinska Institute in Stockholm, Sweden and a senior research fellowship at the National Institutes of Health in Bethesda, USA.
  • Dr. Colloca received several prestigious awards including the Wall Patrick International Award for basic research on pain mechanisms by the International Association for Study of Pain (IASP).
  • Dr. Colloca uses an integrative approach including psychopharmacological, psychobiological, brain mapping and behavioral approaches.
  • Her research has been published in top-ranked international journals including Biological Psychiatry, Pain, JAMA, and Lancet Neurology.
  • Her research has raised interest giving more than 160 invited talks and has been featured on The National Geographic, The New Scientist, Washington Post, Science daily, Boston Globe, The New Yorker, Nature, The Guardian, The Wall Street Journal, News and World Reports and USA Today.

Luana Colloca

  • Dr. Luana Colloca has conducted pioneering groundbreaking studies that have advanced scientific understanding of the psychoneurobiological bases of endogenous systems for pain modulation in humans including the discovery that social learning shapes placebo effects and that the vasopressin system is involved in the enhancement of placebo effects with a dimorphic effect.
  • Currently, Luana leads an NIH-funded team at University of Maryland investigating the placebo/nocebo effect, how expectancy shapes pain response, social learning and pain.
  • More recently, Colloca team has been working with virtual reality technology and clinical pain care to develop better management plans for acute post-operative pain.
  • Dr. Colloca holds an MD, a master degree in Bioethics and a PhD in Neuroscience.
  • She completed a post-doc training at the Karolinska Institute in Stockholm, Sweden and a senior research fellowship at the National Institutes of Health in Bethesda, USA.
  • Dr. Colloca received several prestigious awards including the Wall Patrick International Award for basic research on pain mechanisms by the International Association for Study of Pain (IASP).
  • Dr. Colloca uses an integrative approach including psychopharmacological, psychobiological, brain mapping and behavioral approaches.
  • Her research has been published in top-ranked international journals including Biological Psychiatry, Pain, JAMA, and Lancet Neurology.
  • Her research has raised interest giving more than 160 invited talks and has been featured on The National Geographic, The New Scientist, Washington Post, Science daily, Boston Globe, The New Yorker, Nature, The Guardian, The Wall Street Journal, News and World Reports and USA Today.

Psychological and biological mechanisms of placebo and nocebo effects

Pharmacological treatments for pain have primarily focused on dampening ascending neurotransmission and on opioid-receptor mediated therapies. Placebo and nocebo effects and their underlying endogenous modulatory mechanisms account in part for patients’ outcomes variability. Placebo and nocebo effects have emerged as useful models to assess individual endogenous pain modulatory systems. Indeed, neurobiological studies have identified dopaminergic, opioidergic, vasopressinergic, and endocannabinoidergic pathways as promising systems contributing to pain modulation. Different systems and mechanisms trigger placebo effects and nocebo effects that highly influence pain processing, pain outcomes, and well-being. This lecture illustrates critical mechanisms of placebo and nocebo effects that can inform the design of clinical trials, methodology for discovering new therapeutic targets, and advancement of personalized pain and symptom management.