Mia Thomaidou

20 electrophysiological methods reveal biomarkers of nocebo effects. The aim of this dissertation was to further the knowledge on the neurochemical, electrophysiological, and cognitive-emotional processes that underlie nocebo hyperalgesia, with a specific focus on cognition, emotion, and brain plasticity. In Chapter 2 we explore the state of the art in behavioral nocebo research with a systematic review and meta-analysis of nocebo literature on somatosensory sensations, including pain. We aim to address the efficacy of different experimental learning methods for the induction of nocebo effects. We systematically summarize results from dozens of studies that investigated these effects, and we discuss the implications of their findings. This meta-analysis showed that across sensations, the magnitude of nocebo responses is affected by the type of learning, with classical conditioning being more potent than verbal suggestions alone. We discuss the lack of explanatory or moderation factors found in the literature. Our analysis served to illuminate the extent to which learning processes induce nocebo effects on different sensations and what the practical and theoretical implications of a lack of moderating factors identified may be for research and clinical practice. In Chapter 3, we review the neurobiological literature on nocebo hyperalgesia. This comprehensive review article summarizes neurobiological findings from studies that utilized (f)MRI, EEG, magnetoencephalography (MEG), as well as pharmacological and biochemical measures. The review provides a comprehensive overview and serves to highlight consistent neural correlates of nocebo hyperalgesia across a variety of different experimental nocebo models. In this way, this overview aims to provide an up-to-date picture of the biobehavioral correlates of nocebo effects. We outline the evidence from this field and give an overview of similarities and differences between nocebo research and learning/memory research.

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