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Science 20 February 2004:
Vol. 303. no. 5661, pp. 1162 - 1167
DOI: 10.1126/science.1093065
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Research Articles

Placebo-Induced Changes in fMRI in the Anticipation and Experience of Pain

Tor D. Wager,1*{dagger} James K. Rilling,2 Edward E. Smith,1 Alex Sokolik,3 Kenneth L. Casey,3 Richard J. Davidson,4 Stephen M. Kosslyn,5 Robert M. Rose,6 Jonathan D. Cohen2,7

The experience of pain arises from both physiological and psychological factors, including one's beliefs and expectations. Thus, placebo treatments that have no intrinsic pharmacological effects may produce analgesia by altering expectations. However, controversy exists regarding whether placebos alter sensory pain transmission, pain affect, or simply produce compliance with the suggestions of investigators. In two functional magnetic resonance imaging (fMRI) experiments, we found that placebo analgesia was related to decreased brain activity in pain-sensitive brain regions, including the thalamus, insula, and anterior cingulate cortex, and was associated with increased activity during anticipation of pain in the prefrontal cortex, providing evidence that placebos alter the experience of pain.

1 Department of Psychology, University of Michigan, 525 East University, Ann Arbor, MI 48109–1109, USA.
2 Center for the Study of Brain, Mind and Behavior, Princeton University, Princeton, NJ 08544, USA.
3 Department of Neurology, Veterans Affairs Medical Center, University of Michigan, Ann Arbor, MI 48109, USA.
4 Department of Psychology, University of Wisconsin, Madison, WI 53706, USA.
5 Department of Psychology, Harvard University, Cambridge, MA 02138, USA.
6 Mind Brain Body and Health Initiative, University of Texas Medical Branch, Galveston, TX 77555, USA.
7 Department of Psychology, Princeton University, Princeton, NJ 08544, USA.



{dagger} Present address: Department of Psychology, Columbia University, 1190 Amsterdam Avenue, New York, NY 10027, USA.

* To whom correspondence should be addressed. E-mail: torw{at}umich.edu, tor{at}paradox.psych.columbia.edu

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