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When Expectancies Are Violated: A Functional Magnetic Resonance Imaging Study

Colloca, L; Schenk, LA; Nathan, DE; Robinson, OJ; Grillon, C; (2019) When Expectancies Are Violated: A Functional Magnetic Resonance Imaging Study. Clinical Pharmacology & Therapeutics , 106 (6) pp. 1246-1252. 10.1002/cpt.1587. Green open access

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Abstract

Positive and negative expectancies drive behavioral and neurobiological placebo and nocebo effects, which in turn can have profound effects on patient improvement or worsening. However, expectations of events and outcomes are often not met in daily life and clinical practice. It is currently unknown how this affects placebo and nocebo effects. We have demonstrated that the violation of expectancies, such as when there is a discrepancy between what is expected and what is actually presented, reduces both placebo and nocebo effects while causing an extinction of placebo effects. The reduction of placebo and nocebo effects was paralleled by an activation of the left inferior parietal cortex, a brain region that redirects attention when discrepancies between sensory and cognitive events occur. Our findings highlight the importance of expectancy violation in shaping placebo and nocebo effects and open up new avenues for managing positive and negative expectations in clinical trials and practices.

Type: Article
Title: When Expectancies Are Violated: A Functional Magnetic Resonance Imaging Study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/cpt.1587
Publisher version: https://doi.org/10.1002/cpt.1587
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Learning, placebo analgesia, pain, translational medicine; therapeutics
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Institute of Cognitive Neuroscience
URI: https://discovery.ucl.ac.uk/id/eprint/10083826
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