Sham device
            <i>v</i>
            inert pill: randomised controlled trial of two placebo treatments

Neurofeedback, one of the primary examples of self-regulation, designates a collection of techniques that train the brain and help to improve its function. Since coming on the scene in the 1960s, electroencephalography-neurofeedback has become a treatment vehicle for a host of mental disorders; however, its clinical effectiveness remains controversial. Modern imaging technologies of the living human brain (e.g., real-time functional magnetic resonance imaging) and increasingly rigorous research protocols that utilize such methodologies begin to shed light on the underlying mechanisms that may facilitate more effective clinical applications. In this paper we focus on recent technological advances in the field of human brain imaging and discuss how these modern methods may influence the field of neurofeedback. Toward this end, we outline the state of the evidence and sketch out future directions to further explore the potential merits of this contentious therapeutic prospect.

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“…Intensity: More intensive medical procedures produce greater placebo effects (Kaptchuk et al, 2006).…”

Section: Demand Characteristicsmentioning

confidence: 99%

The self-regulating brain and neurofeedback: Experimental science and clinical promise

Thibault

Lifshitz

Raz

2016

Cortex

198

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“…Acupuncture is well known for its powerful nonspecific/placebo effect. 25 One possible interpretation could be that the analgesic effect of acupuncture did not reach a significantly different level from that of the control group, but that women receiving acupuncture may have felt that they are being given something, thus did not require more analgesic methods.…”

Section: Subtotal (95% Ci)mentioning

confidence: 99%

Acupuncture for pain relief in labour: a systematic review and meta‐analysis

Cho

Lee

Ernst

2010

BJOG

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Background Acupuncture is frequently used for pain relief in labour, but the evidence is not clear.Objectives To critically evaluate the evidence for or against acupuncture for labour pain management.Search strategy Nineteen electronic databases, including English, Korean, Japanese, and Chinese databases, were systematically searched.Selection criteria All randomised controlled trials (RCTs) involving women receiving acupuncture alone, or as an adjunct to conventional analgesia, for pain relief in labour were considered.Data collection and analysis Pain intensity on a 100-mm visual analogue scale (VAS; 0, no pain; 100, worst pain) and use of other analgesic methods were used as primary outcomes, and for statistical pooling. Maternal/fetal outcomes were secondary outcomes, and adverse events were also recorded. Risk of bias was assessed regarding randomisation, allocation concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases.Main results Ten RCTs involving 2038 women were included. VAS for pain intensity data were available in seven studies; the meta-analysis shows that acupuncture was not superior to minimal acupuncture at 1 hour (pooled mean difference )8.02; 95% CI )21.88, 5.84; I 2 = 94%) and at 2 hours ()10.15; 95% CI )23.18, 2.87; I 2 = 92%). Patients reported significantly reduced pain by 4 and 6% during electroacupuncture (EA) treatment at 15 ()4.09; 95% CI )8.05, )0.12) and 30 minutes ()5.94; 95% CI )9.83, )2.06), compared with placebo EA, but the effect was not maintained afterwards. Compared with no intervention, acupuncture reduced pain by only 11% for the first 30 minutes ()10.56; 95% CI )16.08, )5.03). In trials where acupuncture was compared with conventional analgesia, women receiving acupuncture required less meperidine (pooled risk ratio 0.20; 95% CI 0.12, 0.33) and other analgesic methods (0.75; 95% CI 0.66, 0.85). No acupuncture-related adverse events were reported. Most trials did not blind participants, care providers and/or evaluators.Author's conclusions The evidence from RCTs does not support the use of acupuncture for controlling labour pain. The primary studies are diverse and often flawed. Further research seems warranted.

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“…Invasive treatment techniques are almost always perceived by patients as profoundly meaningful, and such a strong "meaning response" [25] could contribute to symptom reduction [26,27]. Indeed, Kaptchuk et al have directly compared placebo pills and sham acupuncture in a randomised trial and found the latter to be more effective [27]. It may also be that our sham technique has physiologic activity.…”

Section: Discussionmentioning

confidence: 99%

“…Along with other groups [22][23][24], we have observed that both acupuncture forms are invasive treatments. Invasive treatment techniques are almost always perceived by patients as profoundly meaningful, and such a strong "meaning response" [25] could contribute to symptom reduction [26,27]. Indeed, Kaptchuk et al have directly compared placebo pills and sham acupuncture in a randomised trial and found the latter to be more effective [27].…”

Section: Discussionmentioning

confidence: 99%

Acupuncture for Tension-Type Headache: a Multicentre, Sham-Controlled, Patient and Observer-Blinded, Randomised Trial

Endres

Böwing²,

Diener

et al. 2008

Deutsche Zeitschrift für Akupunktur

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Acupuncture treatment is frequently sought for tension-type headache (TTH), but there is conflicting evidence as to its effectiveness. This randomised, controlled, multicentre, patient-and observerblinded trial was carried out in 122 outpatient practices in Germany on 409 patients with TTH, defined as ≥10 headache days per month of which ≤1 included migraine symptoms. Interventions were verum acupuncture according to the practice of traditional Chinese medicine or sham acupuncture consisting of superficial needling at nonacupuncture points. Acupuncture was administered by physicians with specialist acupuncture training. Ten 30-min sessions were given over a six-week period, with additional sessions available for partial response. Response was defined as >50% reduction in headache days/month at six months and no use of excluded concomitant medication or other therapies. In the intent-to-treat analysis (all 409 patients), 33% of verum patients and 27% of sham controls (p ( =0.18) were classed as responders. Verum was superior to sham for most secondary endpoints, including headache days (1.8 fewer; 95% CI 0.6, 3.0; p=0.004) and the International Headache Society response criterion (66% vs. 55% response, risk difference 12%, 95% CI: 2%-

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Sham device v inert pill: randomised controlled trial of two placebo treatments

Cited by 466 publications

References 22 publications

The self-regulating brain and neurofeedback: Experimental science and clinical promise

The self-regulating brain and neurofeedback: Experimental science and clinical promise

Acupuncture for pain relief in labour: a systematic review and meta‐analysis

Acupuncture for Tension-Type Headache: a Multicentre, Sham-Controlled, Patient and Observer-Blinded, Randomised Trial

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