100 reliable risk factors for its formation. Considering the mechanisms of action of nocebo hyperalgesia may significantly aid the process of preventing or counteracting nocebo effects in pain patients. We conducted a comprehensive review of the currently known neurobiological correlates of nocebo hyperalgesia. Functional studies showed that pain-related activity might be amplified already in the spinal cord and further modulated by higher cognitive representations. Electrophysiological findings, though limited, also pointed towards involvement of cognitive-affective processes. Neurochemical findings were not consistent on whether cortisol may play a role in nocebo hyperalgesia. These findings are an important step in identifying the neurobiological mechanisms through which nocebo effects may exacerbate pain. Nevertheless, one major limitation arising from the compilation of neurobiological findings from the nocebo literature is the inconsistency in methods and results. Future studies in this field should consider not only the pressing need for consistency and reproduction of findings, but also the need for transparency about what findings reflect. Traceable and consistent methods and results in neurobiological nocebo studies are necessary in order for a reliable picture to be drawn. A better understanding of nocebo effects on pain might eventually lead to the development of methods to identify, minimize or prevent nocebo effects on pain.
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