Placebo hypoalgesia: above and beyond expectancy and conditioning

Okusogu, Chika; Colloca, Luana

doi:10.1016/j.cobeha.2018.10.008

Cited by 10 publications

(9 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Expectancies that influence therapeutic response can also be generated by pre-existing beliefs triggered by verbal information, social observation, or other information sources (Kirsch et al, 2014; Okusogu and Colloca, 2019). In a systematic review of risk factors involved in the development of nocebo effects, the strongest factors were verbal suggestions that treatment exposure triggers symptoms, observation of others experiencing symptoms with treatment, and higher expectations of symptoms (Webster et al, 2016).…”

Section: Basic Mechanistic Knowledge Informing Clinical Researchmentioning

confidence: 99%

The Clinical Implications of Nocebo Effects for Biosimilar Therapy

2019

Self Cite

View full text Add to dashboard Cite

Nocebo effects encompass negative responses to inert interventions in the research setting and negative outcomes with active treatments in the clinical research or practice settings, including new or worsening symptoms and adverse events, stemming from patients' negative expectations and not the pharmacologic action of the treatment itself. Numerous personality, psychosocial, neurobiological, and contextual/environmental factors contribute to the development of nocebo effects, which can impair quality of life and reduce adherence to treatment. Biologics are effective agents widely used in autoimmune disease, but their high cost may limit access for patients. Biosimilar products have gained regulatory approval based on quality, safety, and efficacy comparable to that of originator biologics in rigorous study programs. In this review, we identified gaps in patients' and healthcare professionals' awareness, understanding, and perceptions of biosimilars that may result in negative expectations and nocebo effects, and may diminish their acceptance and clinical benefits. We also examined features of nocebo effects with biosimilar treatment that inform research and clinical practices. Namely, when biosimilars are introduced to patients as possible treatment options, we recommend adoption of nocebo-reducing strategies to avoid negative expectations, including delivery of balanced information on risk-benefit profiles, framing information to focus on positive attributes, and promoting shared decision-making processes along with patient empowerment. Healthcare professionals confident in their knowledge of biosimilars and aware of bias-inducing factors may help reduce the risk of nocebo effects and improve patients' adherence in proposing biosimilars as treatment for autoimmune diseases such as rheumatoid arthritis and inflammatory bowel disease.

show abstract

Section: Basic Mechanistic Knowledge Informing Clinical Researchmentioning

confidence: 99%

The Clinical Implications of Nocebo Effects for Biosimilar Therapy

2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…While verbal suggestions are an easily implementable way to improve analgesic responses, it has been shown that prior positive therapeutic experiences could have more robust effects and better predict placebo response than verbal expectation ratings (37)(38)(39). One way to achieve such positive experience is to use conditioning paradigms, where medically connoted procedures (conditioned stimulus) are coupled to a pain stimulus (unconditioned stimulus), in which the intensity is surreptitiously reduced from baseline levels (40)(41)(42). Indeed, previous studies suggest that conditioning procedures can lead to longer-lasting effects and more significant placebo hypoalgesia when compared to methods such as verbal suggestion (40,43,44).…”

Section: Introductionmentioning

confidence: 99%

Conditioning to Enhance the Effects of Repetitive Transcranial Magnetic Stimulation on Experimental Pain in Healthy Volunteers

et al. 2022

View full text Add to dashboard Cite

ObjectiveIn this proof-of-concept study we sought to explore whether the combination of conditioning procedure based on a surreptitious reduction of a noxious stimulus (SRPS) could enhance rTMS hypoalgesic effects [i.e., increase heat pain threshold (HPT)] and augment intervention expectations in a healthy population.MethodsForty-two healthy volunteers (19–35 years old) were enrolled in a randomized crossover-controlled study and were assigned to one of two groups: (1) SRPS and (2) No SRPS. Each participant received two consecutive sessions of active or sham rTMS over the M1 area of the right hand on two visits (1) active, (2) sham rTMS separated by at least one-week interval. HPT and the temperature needed to elicit moderate heat pain were measured before and after each rTMS intervention on the right forearm. In the SRPS group, conditioning consisted of deliberately decreasing thermode temperature by 3°C following intervention before reassessing HPT, while thermode temperature was held constant in the No SRPS group. Intervention expectations were measured before each rTMS session.ResultsSRPS conditioning procedure did not enhance hypoalgesic effects of rTMS intervention, neither did it modify intervention expectations. Baseline increases in HPT were found on the subsequent intervention session, suggesting variability of this measure over time, habituation or a possible “novelty effect.”ConclusionUsing a SRPS procedure in healthy volunteers did not enhance rTMS modulating effects on experimental pain sensation (i.e., HPT). Future studies are therefore needed to come up with a conditioning procedure which allows significant enhancement of rTMS pain modulating effects in healthy volunteers.

show abstract

“…Assuming that our ERP analyses are sensitive to the differential recruitment of the dopaminergic and opioid systems, this finding is surprising since previous literature suggested that conditioned PA are supported by striatal regions of the dopaminergic reward system while the opioid system mainly underlie unconditioned PA (see for reviews de la Fuente-Fern andez, 2009;Peciña et al, 2014;Okusogu & Colloca, 2019).…”

Section: Discussionmentioning

confidence: 87%

Experience with opioids does not modify the brain network involved in expectations of placebo analgesia

Wicht

Mouthon

Chabwine

et al. 2022

Eur J of Neuroscience

View full text Add to dashboard Cite

Placebo analgesia (PA) is defined as a psychobiological phenomenon triggered by the information surrounding an analgesic drug instead of its inherent pharmacological properties. PA is hypothesized to be formed through either verbal suggestions or conditioning. The present study aims at disentangling the neural correlates of expectations effects with or without conditioning through prior experience using the model of PA. We addressed this question by recruiting two groups of individuals holding comparable verbally-induced expectations regarding morphine analgesia but either (i) with or (ii) without prior experience with opioids. We then contrasted the two groups' neurocognitive response to acute heat-pain induction following the injection of sham morphine using electroencephalography (EEG). Topographic ERP analyses of the N2 and P2 pain evoked potential components allowed to test the hypothesis that PA involves distinct neural networks when induced by expectations with or without prior experience.

show abstract

Placebo hypoalgesia: above and beyond expectancy and conditioning

Cited by 10 publications

References 48 publications

The Clinical Implications of Nocebo Effects for Biosimilar Therapy

The Clinical Implications of Nocebo Effects for Biosimilar Therapy

Conditioning to Enhance the Effects of Repetitive Transcranial Magnetic Stimulation on Experimental Pain in Healthy Volunteers

Experience with opioids does not modify the brain network involved in expectations of placebo analgesia

Contact Info

Product

Resources

About