Do medical devices have enhanced placebo effects?

Kaptchuk, Ted J.; Goldman, Peter; Stone, David A.; Stason, William B.

doi:10.1016/s0895-4356(00)00206-7

Cited by 411 publications

(264 citation statements)

References 56 publications

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“…While the expectation of therapeutic benefit from rTMS certainly played a major role in this effect, a possible contribution from TMS-induced sensory experience is also very likely. The latter, indeed, either by increasing, indirectly, patient's expectation (Kaptchuk et al, 2000;Tsuji and Akamatsu, 2003) or by inducing some dopamine release itself (Nieoullon et al, 1977) could have enhanced the placebo contribution.…”

Section: Discussionmentioning

confidence: 99%

“…As for rTMS, it should also be reminded that medical devices enhance the placebo effect (Kaptchuk et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

“…scalp sensation) which could not only enhance indirectly patient's expectation (Kaptchuk et al, 2000;Tsuji and Akamatsu, 2003) but also induce some dopamine release itself (Nieoullon et al, 1977), thus increasing the contribution of placebo.…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic application of transcranial magnetic stimulation in Parkinson's disease: The contribution of expectation

2006

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Repetitive transcranial magnetic stimulation (rTMS) is a valuable probe of brain function. Ever since its adoption as a research tool, there has been great interest regarding its potential clinical role. Presently, it is unclear whether rTMS will have some role as an alternative treatment for neuropsychiatric and neurological disorders such as Parkinson's disease (PD). To date, studies addressing the contribution of placebo during rTMS are missing. The placebo effect has been shown to be associated either with release of dopamine in the striatum or with changes in brain glucose metabolism. The main objective of this study was to test whether, in patients with PD, the expectation of therapeutic benefit from rTMS, which actually was delivered only as sham rTMS (placebo-rTMS) induced changes in striatal [ 11 C] raclopride binding potentials (BP) as measured with positron emission tomography (PET). Placebo-rTMS induced a significant bilateral reduction in [ 11 C] raclopride BP in dorsal and ventral striatum as compared to the baseline condition. This reduction BP is indicative of an increase in dopamine neurotransmission. The changes in [ 11 C] raclopride binding were more evident in the hemisphere contralateral to the more affected side supporting the hypothesis that the more severe the symptoms, the greater the drive for symptom relief, and therefore the placebo response. This is the first study addressing the placebo contribution during rTMS. While our results seem to confirm earlier evidence that expectation induces dopaminergic placebo effects, they also suggest the importance of placebo-controlled studies for future clinical trials involving brain stimulation techniques.

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Section: Discussionmentioning

confidence: 99%

“…As for rTMS, it should also be reminded that medical devices enhance the placebo effect (Kaptchuk et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic application of transcranial magnetic stimulation in Parkinson's disease: The contribution of expectation

2006

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“…Placebo effects can be very impressive; Evans found placebo to be as effective as a standard dose of morphine in 56% of subjects [27]. Placebo response in TENS treatment has been said to range from less than 40% to more than 60% [28]. However, Vase et al [29], studying chronic irritable bowel syndrome patients, found that the addition of a verbal suggestion for pain relief could increase the magnitude of placebo analgesia to that of an active agent.…”

Section: Specific Versus Non-specific Effects Of Tens Treatmentmentioning

confidence: 99%

Outcome of transcutaneous electrical nerve stimulation in chronic pain: short-term results of a double-blind, randomised, placebo-controlled trial

et al. 2006

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The aim of this study was to test the efficacy of shortterm transcutaneous electrical nerve stimulation (TENS) treatment in chronic pain with respect to pain intensity and patients' satisfaction with treatment results. We therefore performed a randomised controlled trial comparing TENS and sham TENS. Patients, researchers and therapists were blinded for treatment allocation. One hundred and sixty-three patients with chronic pain referred to the Pain Centre entered the study. Conventional TENS and sham TENS were applied in the segments of pain, for a period of ten days. Outcome measures were pain intensity (visual analogue scale) and patients' satisfaction with treatment result (yes or no). The proportions of patients satisfied with treatment result differed significantly for TENS compared to sham TENS (58 and 42.7% respectively, x 2 =3.8, p=0.05). However, no differences in pain intensity were found for patients treated with TENS or sham TENS. Only for patients satisfied with treatment results pain intensity gradually decrease equally both for TENS and sham TENS with repeated treatment application.

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“…Even though several studies have found that acupuncture and mock TENS are similarly credible (Petrie and Hazelman, 1985;Wood and Lewith, 1998), the placebo power of mock TENS has been shown to be dependent on how it is presented to the patient (Kaptchuk, 2000;Langley, 1984).…”

Section: Introduction Cmentioning

confidence: 99%

Description and Validation of a Noninvasive Placebo Acupuncture Procedure

Sherman

Hogeboom

Cherkin

et al. 2002

The Journal of Alternative and Complementary Medicine

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Objective: To evaluate a simulated acupuncture technique for use in randomized controlled trials assessing the efficacy of acupuncture for low-back pain.Setting: The clinic of an accredited acupuncture college in Seattle, Washington. Subjects: Acupuncture-naïve enrollees of Group Health Cooperative who had visited their primary care provider with a complaint of back pain that persisted for at least 3 months.Experimental design: In the first experiment, subjects received six insertions of real needles and six pokes with a toothpick in a guidetube in a two-period crossover design. In the second experiment, subjects were randomly assigned to receive either a complete treatment with real acupuncture needles or a simulated treatment using a toothpick in a guidetube.Outcomes: In the first experiment, we compared subjects' perceptions about which implement was used for each "insertion" while in the second, we compared the perceptions (e.g., acupuncturist's warmth and caring, the reasonableness of acupuncture as a treatment) and pain relief of those who received an acupuncture treatment using needles to those receiving simulated acupuncture.Results: In the first experiment, the toothpick insertions were perceived as slightly more like real needling than the real needling (mean ratings of 2.8 and 2.1, respectively; p 5 0.08). In the second experiment, 52% percent of those receiving the simulated needling versus 65% of those receiving real acupuncture believed they were "definitely" or "probably" receiving real acupuncture (p 5 0.33). Perceptions of acupuncture, as measured by a credibility questionnaire, were similar in the two groups. Those receiving real acupuncture were more likely to report immediate pain relief, and this was the factor most predictive of the subject's belief about which treatment they had received (p 5 0.02).Conclusions: The simulated acupuncture procedure evaluated in this study represents a reasonable control treatment for acupuncture-naïve individuals in randomized controlled trials assessing the efficacy of acupuncture for low-back pain.

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Do medical devices have enhanced placebo effects?

Cited by 411 publications

References 56 publications

Therapeutic application of transcranial magnetic stimulation in Parkinson's disease: The contribution of expectation

Therapeutic application of transcranial magnetic stimulation in Parkinson's disease: The contribution of expectation

Outcome of transcutaneous electrical nerve stimulation in chronic pain: short-term results of a double-blind, randomised, placebo-controlled trial

Description and Validation of a Noninvasive Placebo Acupuncture Procedure

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