98 Nevertheless, findings have linked the activation of the amygdala to the magnitude of nocebo responses (Egorova et al., 2020) such that higher fear or anxiety seem to be linked to higher nocebo hyperalgesia. Future fMRI research could shed light on the role of fear and related physiological processes in the presentation of nocebo hyperalgesia by manipulating and directly comparing the threatening nature of the nocebo context. Limitations, future directions, and clinical implications After summarizing the results reviewed here, it is important to note that the utilization of distinct learning methods for the induction of nocebo hyperalgesia may be influence the neurobiological findings of these experimental studies. In other fields of research, such as fundamental neuroscience in the domain of learning and memory, different types of learning have been shown to employ different brain processes and a complex architecture underlying distinct learning systems 117–120. Concurrently, differences in the affective load or valence of negative suggestions 103,121 or even potentially the magnitude of induced nocebo hyperalgesic effects 122, may influence the physiological processes that are involved in the induction and evocation of nocebo responses. Few studies have systematically studied these methodological aspects of nocebo effects. The knowledge base on nocebo hyperalgesia could significantly benefit from future research focusing on replication, comparability between studies, and an examination of the influence that methodological aspects have on the neurobiological nocebo correlates. While the field of nocebo hyperalgesia is young, it is therefore also a contemporary field of science that could benefit by setting an example in replicating findings and compiling consistent and reliable results. Overall, one important future aim for nocebo studies may involve the systematic examination of learning, as this seems to be a major factor
RkJQdWJsaXNoZXIy MTk4NDMw