The placebo effect—a positive psychophysiological response attributed to inert treatments—is an important yet seemingly misunderstood phenomenon in the conventional development of novel therapeutics and predictors of treatment response. Advances in molecular and functional neuroimaging have offered precise ways to characterize the neural basis of the placebo analgesia in humans. As a result, the formation of biological placebo effects is now being linked to the concept of resiliency mechanisms, partially determined by genetic factors, and uncovered by the cognitive emotional integration of the expectations created by the therapeutic environment and its maintenance through learning mechanisms. Still, further work needs to extend this research into clinical conditions where the rates of placebo responses are high and its neurobiological mechanisms have been largely unexplored (for example, mood and anxiety disorders, persistent pain syndromes, Parkinson disease). The delineation of these processes within and across diseases would point to biological targets that have not been contemplated in traditional drug development and that are associated with improvements in symptoms, and as this body of literature is starting to show, pathophysiological mechanisms.
For more information on this topic, please refer to the article by Peciña and Zubieta on pages 416–423.
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