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The "inexpensive" cream (on top) and "expensive" cream used in the study. Photo: Alexandra Tinnermann / Institute of Systems Neuroscience in Hamburg, Germany

Most people know about the placebo effect — when a person perceives, and then often receives, a beneficial health impact from a treatment that actually isn't directly addressing their condition. Studies have also shown people's perception of a higher-priced drug is that it will provide its remedy better.

Now, in a new study published Thursday, the flip side of that coin — called the nocebo effect — has been seen in people who reported worse side effects when given what they thought was a higher priced medicine.

Why this matters: "Understanding how nocebo effects work means that health care providers could actively use this knowledge in their way of talking to patients, how they explain things to patients and also which information to mention and to avoid in order to minimize the effect," one of the study authors, Alexandra Tinnermann, told Axios.

Study details: The team told 49 participants they were testing a prescription cream to relieve itch, and that one possible side effect was local skin sensitization, which could lead to increased pain perception. The group was divided into two groups — one to take an expensive-looking cream in a fancier box and the other to take a less expensive cream in a generic-looking box (both creams had no active ingredients).

The researchers then treated the participants with painful heat stimuli and recorded the neural activation in the brain and spinal cord.

Their findings: The participants who used the "expensive" cream reported a higher rate of pain that became more pronounced over time, compared to the participants using the "cheaper" cream. The researchers also determined the altered sensations due to perceived price were associated with differences in two particular brain regions (the periaqueductal gray and rostral anterior cingulate cortex).

Luana Colloca, a neuroscientist at the University of Maryland who was not part of this study, told Axios the study is interesting in how it shows the role the spinal cord and the two brain areas plays in switching pain on and off and the very real impact a person's perception can have on their pain levels.

"It's important [for clinicians and trial researchers] to know the words they use, the way they communicate, their behavior can raise perception of the side effects," says Colloca, who also wrote a perspective published with the study. She warned that in the past, misleading information about side effects led people to discontinue their treatment resulting in some of them dying from heart attacks or strokes.

Go deeper: Listen to a podcast of an interview with Tinnermann (at 10:01) and a YouTube video about the study.

Go deeper

Tech scrambles to derail inauguration threats

Illustration: Sarah Grillo/Axios

Tech companies are sharing more information with law enforcement in a frantic effort to prevent violence around the inauguration, after the government was caught flat-footed by the Capitol siege.

Between the lines: Tech knows it will be held accountable for any further violence that turns out to have been planned online if it doesn't act to stop it.

Dave Lawler, author of World
5 hours ago - World

Uganda's election: Museveni declared winner, Wine claims fraud

Wine rejected the official results of the election. Photo: Sumy Sadruni/AFP via Getty

Yoweri Museveni was declared the winner of a sixth presidential term on Saturday, with official results giving him 59% to 35% for Bobi Wine, the singer-turned-opposition leader.

Why it matters: This announcement was predictable, as the election was neither free nor fair and Museveni had no intention of surrendering power after 35 years. But Wine — who posed a strong challenged to Museveni, particularly in urban areas, and was beaten and arrested during the campaign — has said he will present evidence of fraud. The big question is whether he will mobilize mass resistance in the streets.

Off the Rails

Episode 1: A premeditated lie lit the fire

Photo illustration: Sarah Grillo/Axios. Photo: Chip Somodevilla/Getty Images

Beginning on election night 2020 and continuing through his final days in office, Donald Trump unraveled and dragged America with him, to the point that his followers sacked the U.S. Capitol with two weeks left in his term. Axios takes you inside the collapse of a president with a special series.

Episode 1: Trump’s refusal to believe the election results was premeditated. He had heard about the “red mirage” — the likelihood that early vote counts would tip more Republican than the final tallies — and he decided to exploit it.

"Jared, you call the Murdochs! Jason, you call Sammon and Hemmer!”