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26th Napa Pain Conference

NPC26-Sa6-A - The Neuroscience of Pain Perception

Aug 17, 2019 4:00pm ‐ Aug 17, 2019 5:30pm


The Neuroscience of Pain Perception

Mindfulness Based Stress Reduction (MBSR) & the Placebo Response

Target Audience: Clinicians & researchers addressing acute or chronic pain

Learning Objectives

As a result of participating in this activity, learners will be better able to:

  • Apply an understanding of the roles that conditioning and expectations play in modulating the pain experience to the care of persons with chronic pain


Understanding the Placebo Response Through fMRI

Tor D. Wager, PhD

Mindfulness Meditation–based Pain Relief

Fadel Zeidan, PhD


The construction and modulation of pain is mediated by sensory, cognitive, and affective factors, rendering the treatment of chronic pain difficult and often a financial burden.

Mindfulness meditation significantly attenuates pain through multiple, unique mechanisms.

Placebo effects are beneficial effects that are attributable to the brain–mind responses to the context in which a treatment is delivered rather than to the specific actions of the drug. They are mediated by diverse processes — including learning, expectations and social cognition — and can influence various clinical and physiological outcomes related to health.

Additional Reading

  • Cormier, S., Lavigne, G. L., Choinière, M., & Rainville, P. (2016). Expectations predict chronic pain treatment outcomes. Pain, 157(2), 329-338
  • Keltner, J. R., Furst, A., Fan, C., Redfern, R., Inglis, B., & Fields, H. L. (2006). Isolating the modulatory effect of expectation on pain transmission: a functional magnetic resonance imaging study. Journal of Neuroscience, 26(16), 4437-4443
  • Amanzio, M., & Benedetti, F. (1999). Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specific subsystems. Journal of Neuroscience, 19(1), 484-494
  • Scott, D. J., Stohler, C. S., Egnatuk, C. M., Wang, H., Koeppe, R. A., & Zubieta, J. K. (2008). Placebo and nocebo effects are defined by opposite opioid and dopaminergic responses. Archives of General Psychiatry, 65(2), 220-231
  • Wager, T. D., & Atlas, L. Y. (2015). The neuroscience of placebo effects: connecting context, learning and health. Nature Reviews Neuroscience, 16(7), 403
  • Zeidan, F., & Vago, D. (2016). Mindfulness meditation–based pain relief: a mechanistic account. Annals of the New York Academy of Sciences, 1373(1), 114
  • Su, I. W., Wu, F. W., Liang, K. C., Cheng, K. Y., Hsieh, S. T., Sun, W. Z., & Chou, T. L. (2016). Pain perception can be modulated by mindfulness training: a resting-state fMRI study. Frontiers in Human Neuroscience, 10, 570
  • McCracken, L. M. (1998). Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain, 74(1), 21-27
  • Tetreault, P., Mansour, A., Vachon-Presseau, E., Schnitzer, T. J., Apkarian, A. V., & Baliki, M. N. (2016). Brain connectivity predicts placebo response across chronic pain clinical trials. PLoS Biology, 14(10), e1002570.


  • Tor Wager, PhD, Diana L. Taylor Distinguished Professor in Neuroscience, Dartmouth College
  • Fadel Zeidan, PhD, Director, Brain Mechanisms of Pain & Health Lab, UC San Diego

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