Placebo-induced analgesia in an operant pain model in rats

Nolan, Todd A.; Price, Donald D.; Caudle, Robert M.; Murphy, Niall P.; Neubert, John K.

doi:10.1016/j.pain.2012.04.026

Cited by 53 publications

(35 citation statements)

References 65 publications

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“…Interestingly, all these opioid-mediated placebo responses have also been investigated in rodents, and similar mechanisms have been described (150,247,354). For example, Guo et al (150) used the hot-plate test in an attempt to measure the reaction time of mice to a nociceptive stimulus (hot plate) after different types of pharmacological conditioning.…”

Section: Both Endogenous Opioids and Endocannabinoids May Take Part Imentioning

confidence: 99%

Placebo and the New Physiology of the Doctor-Patient Relationship

Benedetti

2013

Physiological Reviews

351

320

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Modern medicine has progressed in parallel with the advancement of biochemistry, anatomy, and physiology. By using the tools of modern medicine, the physician today can treat and prevent a number of diseases through pharmacology, genetics, and physical interventions. Besides this materia medica, the patient's mind, cognitions, and emotions play a central part as well in any therapeutic outcome, as investigated by disciplines such as psychoneuroendocrinoimmunology. This review describes recent findings that give scientific evidence to the old tenet that patients must be both cured and cared for. In fact, we are today in a good position to investigate complex psychological factors, like placebo effects and the doctor-patient relationship, by using a physiological and neuroscientific approach. These intricate psychological factors can be approached through biochemistry, anatomy, and physiology, thus eliminating the old dichotomy between biology and psychology. This is both a biomedical and a philosophical enterprise that is changing the way we approach and interpret medicine and human biology. In the first case, curing the disease only is not sufficient, and care of the patient is of tantamount importance. In the second case, the philosophical debate about the mind-body interaction can find some important answers in the study of placebo effects. Therefore, maybe paradoxically, the placebo effect and the doctor-patient relationship can be approached by using the same biochemical, cellular and physiological tools of the materia medica, which represents an epochal transition from general concepts such as suggestibility and power of mind to a true physiology of the doctor-patient interaction. I.WHAT I. WHAT IS A PLACEBO RESPONSE? A. Placebos Were Introduced to Validate the Efficacy of Medical TreatmentsAncient physicians have always used bizarre and odd treatments to cure their patients, with scarce, if any, knowledge of anatomy and physiology. As the anatomical and physiological details of both the animal and the human body started emerging, the need of a scientific explanation of many medical treatments became an imperative objective of physicians and the scientific community. An important historical period whereby scientific skepticism emerged about the efficacy of some medical remedies is approximately in the second half of 1700 and involved treatments like mesmerism, perkinism, and homeopathy (178).To take mesmerism as an example, this was introduced in the second half of 1700 by Franz Anton Mesmer, who claimed to have discovered a healing fluid which he called animal magnetism. To assess the very nature and the efficacy of mesmerism in treating many diseases and symptoms, Louis XVI appointed a commission that was headed by Benjamin Franklin. This commission performed what can be considered one of the first blind assessments and sham (placebo) interventions in the history of medicine. Some women were blindfolded and asked where the mesmeric energy was being applied. As reported by the members of the commission th...

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Section: Both Endogenous Opioids and Endocannabinoids May Take Part Imentioning

confidence: 99%

Placebo and the New Physiology of the Doctor-Patient Relationship

Benedetti

2013

Physiological Reviews

351

320

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“…In vivo receptor-binding techniques show that a placebo activates m-opioid neurotransmission in the dorsolateral prefrontal cortex, the anterior cingulate cortex, the insula, and the nucleus accumbens (Wager et al, 2007;Zubieta et al, 2005). Although all of these studies have been performed in humans, more recent studies in rodents confirm these pharmacological findings (Guo et al, 2010;Nolan et al, 2012;Zhang et al, 2013). For example, by using different antagonists of different subtypes of opioid receptors (m, d, k), Zhang et al (2013) found that placebo analgesia is mediated specifically by the m opioid receptors only.…”

Section: Introductionmentioning

confidence: 97%

Placebo Effects: From the Neurobiological Paradigm to Translational Implications

Benedetti

2014

Neuron

247

205

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Today we are witnessing a new science of placebo, a complex discipline that encompasses several experimental approaches and translational implications. Modern neurobiological tools have been used to answer important questions in placebo research, such as the top-down modulation of sensory and motor systems as well as the influence of cognition, emotions, and learning on symptoms, diseases, and responses to treatments. What we have learned is that there is not one single placebo effect, but many. This review highlights the translational implications of this new knowledge, ranging from clinical trial design to medical practice to social and ethical issues.

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“…Support for an opioidergic pathway derives from a large body of literature reporting evidence of reversal of placebo analgesia with an opioid antagonist. 20 This has been shown in a recent operant rat model based on conditioning of a placebo response 21 and human studies. 22 Based on functional MRI, areas of the central nervous system have been identified which appear to be involved in placebo analgesia in response to rectal distention.…”

Section: Neurobiological Approaches To M Anaging Placebo Effectmentioning

confidence: 81%

Placebo Effect in Clinical Trial Design for Irritable Bowel Syndrome

Shah¹,

Pimentel²

2014

J Neurogastroenterol Motil

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Ongoing efforts to improve clinical trial design in irritable bowel syndrome have been hindered by high placebo response rates and ineffective outcome measures. We assessed established strategies to minimize placebo effect as well as the various approaches to placebo effect which can affect trial design. These include genetic markers such as catechol-O-methyltransferase, opioidergic and dopaminergic neurobiologic theory, pre-cebo effect centered on expectancy theory, and side effect unblinding grounded on conditioning theory. We reviewed endpoints used in the study of IBS over the past decade including adequate relief and subjective global relief, emphasizing their weaknesses in fully evaluating the IBS condition, specifically their motility effects based on functional net value and relative benefit-harm based on dropouts due to adverse events. The focus of this review is to highlight ongoing efforts to improve clinical trial design which can lead to better outcomes in a real-world setting.

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Placebo-induced analgesia in an operant pain model in rats

Cited by 53 publications

References 65 publications

Placebo and the New Physiology of the Doctor-Patient Relationship

Placebo and the New Physiology of the Doctor-Patient Relationship

Placebo Effects: From the Neurobiological Paradigm to Translational Implications

Placebo Effect in Clinical Trial Design for Irritable Bowel Syndrome

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