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Seymour J, Mathers N. Placebo stimulates neuroplasticity in depression: implications for clinical practice and research. Front Psychiatry 2024; 14:1301143. [PMID: 38268561 PMCID: PMC10806142 DOI: 10.3389/fpsyt.2023.1301143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Neither psychological nor neuroscientific investigations have been able to fully explain the paradox that placebo is designed to be inert in randomized controlled trials (RCTs), yet appears to be effective in evaluations of clinical interventions in all fields of medicine and alternative medicine. This article develops the Neuroplasticity Placebo Theory, which posits that neuroplasticity in fronto-limbic areas is the unifying factor in placebo response (seen in RCTs) and placebo effect (seen in clinical interventions) where it is not intended to be inert. Depression is the disorder that has the highest placebo response of any medical condition and has the greatest potential for understanding how placebos work: recent developments in understanding of the pathophysiology of depression suggest that fronto-limbic areas are sensitized in depression which is associated with a particularly strong placebo phenomenon. An innovative linkage is made between diverse areas of the psychology and the translational psychiatry literature to provide supportive evidence for the Neuroplasticity Placebo Theory. This is underpinned by neuro-radiological evidence of fronto-limbic change in the placebo arm of antidepressant trials. If placebo stimulates neuroplasticity in fronto-limbic areas in conditions other than depression - and results in a partially active treatment in other areas of medicine - there are far reaching consequences for the day-to-day use of placebo in clinical practice, the future design of RCTs in all clinical conditions, and existing unwarranted assertions about the efficacy of antidepressant medications. If fronto-limbic neuroplasticity is the common denominator in designating placebo as a partially active treatment, the terms placebo effect and placebo response should be replaced by the single term "placebo treatment."
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Affiliation(s)
- Jeremy Seymour
- Retired Consultant Psychiatrist, Rotherham Doncaster and South Humber NHS Trust, Rotherham, United Kingdom
| | - Nigel Mathers
- Emeritus Professor, Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom
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2
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Tresker S. An account of medical treatment, with a preliminary account of medical conditions. THEORETICAL MEDICINE AND BIOETHICS 2023; 44:607-633. [PMID: 37620606 DOI: 10.1007/s11017-023-09641-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/26/2023]
Abstract
In this article, I present a philosophical account of medical treatment. In support of this account, I offer a suggestive account of medical conditions. The account of medical treatment uses three desiderata to demarcate treatment from non-treatment. Namely, a treatment should: (1) be describable by features that enable it to be standardized and characterized as a discrete intervention, (2) target a specific medical condition, and (3) have the possibility of being effective. The account of medical conditions underlies the second desideratum and attempts to tie medical conditions closely to biological dysfunction, while also including some conditions for which biological dysfunction is absent or its presence uncertain. I offer a simple typology of treatments and show how the accounts are relevant to treatment effectiveness, disease, placebos, contested treatments, and treatment standardization.
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Affiliation(s)
- Steven Tresker
- Department of Philosophy, University of Antwerp, Rodestraat 14, Antwerp, 2000, Belgium.
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3
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Hartmann H, Banwinkler M, Riva F, Lamm C. To respond or not to respond: exploring empathy-related psychological and structural brain differences between placebo analgesia responders and non-responders. Front Psychol 2023; 14:1257522. [PMID: 37849473 PMCID: PMC10577216 DOI: 10.3389/fpsyg.2023.1257522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/14/2023] [Indexed: 10/19/2023] Open
Abstract
Introduction Placebo responsiveness is highly variable across individuals. In the domain of pain, it may range from pronounced hypoalgesia to no response at all. Which factors predict such variation awaits clarification, as the available literature is characterized by mixed and inconclusive results. Particularly interesting in this case are social factors such as empathy or prosocial behavior, as prior work has stressed the connection between feeling pain yourself and empathizing with pain observed in others. Methods In a mixed confirmatory and exploratory approach, this study investigated potential psychological and structural brain differences between placebo responders and non-responders in the domain of pain. We aggregated data of four behavioral and neuroimaging studies that had been designed to investigate the effects of placebo analgesia on empathy. Results Analyses comparing groups of placebo responders and non-responders showed significant group differences in trait characteristics, with responders reporting increased helping behavior and lower psychopathic traits compared to non-responders. Uncorrected results further showed higher pain-related empathic concern in responders vs. non-responders. These results were accompaniedby tentative group differences in brain structure: placebo analgesia non-responders exhibited increased gray matter volume in left inferior temporal and parietal supramarginal cortical areas, and an increased cortical surface area in bilateral middle temporal cortex. Discussion Together, our findings suggest that modifiability of one's pain perception by means of placebo effects is linked to personality traits characterizing social emotions and behavior. They also hint that these psychological as well as brain structural characteristics might be beneficial for the identification of placebo responders. At the same time, they stress the importance of considering contextual factors such as the study setting or paradigm when investigating the association between individual characteristics and placebo responding.
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Affiliation(s)
- Helena Hartmann
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Clinical Neurosciences, Department of Neurology, University Hospital Essen, Essen, Germany
| | - Magdalena Banwinkler
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Federica Riva
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Claus Lamm
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
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Gurton WH, Matta GG, Gough LA, Ranchordas MK, King DG, Hurst P. Sodium Bicarbonate and Time-to-Exhaustion Cycling Performance: A Retrospective Analysis Exploring the Mediating Role of Expectation. SPORTS MEDICINE - OPEN 2023; 9:65. [PMID: 37523028 PMCID: PMC10390418 DOI: 10.1186/s40798-023-00612-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Research has shown that ingesting 0.3 g·kg-1 body mass sodium bicarbonate (NaHCO3) can improve time-to-exhaustion (TTE) cycling performance, but the influence of psychophysiological mechanisms on ergogenic effects is not yet understood. OBJECTIVE This study retrospectively examined whether changes in TTE cycling performance are mediated by positive expectations of receiving NaHCO3 and/or the decline in blood bicarbonate during exercise. METHODS In a randomised, crossover, counterbalanced, double-blind, placebo-controlled design, 12 recreationally trained cyclists (maximal oxygen consumption, 54.4 ± 5.7 mL·kg·min-1) performed four TTE cycling tests 90 min after consuming: (1) 0.3 g·kg-1 body mass NaHCO3 in 5 mL·kg-1 body mass solution, (2) 0.03 g·kg-1 body mass sodium chloride in solution (placebo), (3) 0.3 g·kg-1 body mass NaHCO3 in capsules and (4) cornflour in capsules (placebo). Prior to exercise, participants rated on 1-5 Likert type scales how much they expected the treatment they believe had been given would improve performance. Capillary blood samples were measured for acid-base balance at baseline, pre-exercise and post-exercise. RESULTS Administering NaHCO3 in solution and capsules improved TTE compared with their respective placebos (solution: 27.0 ± 21.9 s, p = 0.001; capsules: 23.0 ± 28.1 s, p = 0.016). Compared to capsules, NaHCO3 administered via solution resulted in a higher expectancy about the benefits on TTE cycling performance (Median: 3.5 vs. 2.5, Z = 2.135, p = 0.033). Decline in blood bicarbonate during exercise was higher for NaHCO3 given in solution compared to capsules (2.7 ± 2.1 mmol·L-1, p = 0.001). Mediation analyses showed that improvements in TTE cycling were indirectly related to expectancy and decline in blood bicarbonate when NaHCO3 was administered in solution but not capsules. CONCLUSIONS Participants' higher expectations when NaHCO3 is administered in solution could result in them exerting themselves harder during TTE cycling, which subsequently leads to a greater decline in blood bicarbonate and larger improvements in performance. KEY POINTS Ingesting 0.3 g·kg-1 body mass sodium bicarbonate in solution and capsules improved time-to-exhaustion cycling performance Positive expectancy about the benefits of sodium bicarbonate and decline in blood bicarbonate were higher when sodium bicarbonate was administered in solution compared with capsules Improvements in time-to-exhaustion cycling performance for sodium bicarbonate administered in solution were related to expectancy and the enhanced extracellular buffering response.
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Affiliation(s)
- William H Gurton
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, UK
- Sport and Physical Activity Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Guilherme G Matta
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, UK
| | - Lewis Anthony Gough
- Human Performance and Health Research Group, Centre for Life and Sport Sciences, Birmingham City University, Birmingham, UK
| | - Mayur Krachna Ranchordas
- Sport and Physical Activity Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK.
| | - David G King
- School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Philip Hurst
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, UK
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Guzek D, Kołota A, Lachowicz K, Skolmowska D, Stachoń M, Głąbska D. Effect of Vitamin D Supplementation on Depression in Adults: A Systematic Review of Randomized Controlled Trials (RCTs). Nutrients 2023; 15:951. [PMID: 36839310 PMCID: PMC9963956 DOI: 10.3390/nu15040951] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/28/2023] [Accepted: 02/11/2023] [Indexed: 02/17/2023] Open
Abstract
Vitamin D is a nutrient potentially beneficial in the treatment of depression. The study aimed to carry out a systematic review of the studies assessing the influence of vitamin D supplementation on depression within Randomized Controlled Trials (RCTs). The systematic review was prepared on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020155779). The peer-reviewed studies available within PubMed or Web of Science databases until September 2021 were taken into account. The number of screened records was 8514, and 8 records were included. Two independent researchers conducted screening, including, reporting, and risk of bias assessment using the revised Cochrane risk-of-bias tool for randomized trials. The included studies presented a population of patients with major depressive disorders or general depression, as well as bipolar depression or postpartum depression. The majority of included studies were conducted for 8 weeks or 12 weeks, while one study was conducted for 6 months. Within the large number of included studies, a daily dose of 1500 IU, 1600 IU, or 2800 IU was applied, while within some studies, a vitamin D dose of 50,000 IU was applied weekly or biweekly. Among applied psychological measures of depression, there were various tools. In spite of the fact that the majority of included studies (five studies) supported the positive effect of vitamin D supplementation for the psychological measure of depression, for three studies the positive influence was not supported. A medium risk of bias was indicated for six studies, while a high risk of bias was defined for only two studies, due to deviations from the intended interventions and in measurement of the outcome, as well as for one study, also arising from the randomization process and due to missing outcome data. Based on conducted assessment, it should be emphasized that there are only four studies supporting the positive influence of vitamin D supplementation for the psychological measure of depression of the medium risk of bias, while two studies of a medium risk of bias did not support it. Taking this into account, the conducted systematic review is not a strong confirmation of the effectiveness of vitamin D supplementation in the treatment of depression.
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Affiliation(s)
- Dominika Guzek
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Aleksandra Kołota
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Katarzyna Lachowicz
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Dominika Skolmowska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Małgorzata Stachoń
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Dominika Głąbska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
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6
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Beyond tingles: An exploratory qualitative study of the Autonomous Sensory Meridian Response (ASMR). PLoS One 2022; 17:e0277962. [PMID: 36454810 PMCID: PMC9714747 DOI: 10.1371/journal.pone.0277962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
This qualitative exploratory study investigated the embodied experiences and the meanings of Autonomous Sensory Meridian Response (ASMR) from the viewer's perspective. ASMR research has been sparse and largely quantitative, assuming it to be a predominantly fixed physiological response of "tingles", despite the acronym being rooted in pseudoscience. A qualitative research design was adopted to facilitate the exploratory nature of the study in this under-researched area. In contrast to the mostly survey-based research on ASMR, this study employed semi-structured interviews as a means to understand the lived experience of ASMR and to promote participant agency. Six self-identifying ASMR consumers were recruited using a mixture of snowball and opportunity sampling. Semi-structured interviews were conducted both in person and using Skype to facilitate transnational data collection. Interview transcripts were analysed using an inductive, data-driven approach to thematic analysis. The analysis suggests that ASMR is felt to provide a social environment of comfort rather than a solely physiological-based experience. Three key themes emerged: who and what defines ASMR? (reflecting the variety of what was classed as ASMR and what content was consumed to produce the response); "real" intimacy tailored to me (reflecting the idiosyncratic perception of intimacy made possible through ASMR); and emotional relief on my terms (reflecting the role of ASMR in self-soothing). The present data reflect a rich, complex experience of the ASMR consumer, pointing to potential wider applications and informing further research.
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7
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Smith EA, Horan WP, Demolle D, Schueler P, Fu DJ, Anderson AE, Geraci J, Butlen-Ducuing F, Link J, Khin NA, Morlock R, Alphs LD. Using Artificial Intelligence-based Methods to Address the Placebo Response in Clinical Trials. INNOVATIONS IN CLINICAL NEUROSCIENCE 2022; 19:60-70. [PMID: 35382067 PMCID: PMC8970233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The placebo response is a highly complex psychosocial-biological phenomenon that has challenged drug development for decades, particularly in neurological and psychiatric disease. While decades of research have aimed to understand clinical trial factors that contribute to the placebo response, a comprehensive solution to manage the placebo response in drug development has yet to emerge. Advanced data analytic techniques, such as artificial intelligence (AI), might be needed to take the next leap forward in mitigating the negative consequences of high placebo-response rates. The objective of this review was to explore the use of techniques such as AI and the sub-discipline of machine learning (ML) to address placebo response in practical ways that can positively impact drug development. This examination focused on the critical factors that should be considered in applying AI and ML to the placebo response issue, examples of how these techniques can be used, and the regulatory considerations for integrating these approaches into clinical trials.
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Affiliation(s)
- Erica A Smith
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - William P Horan
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Dominique Demolle
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Peter Schueler
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Dong-Jing Fu
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Ariana E Anderson
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Joseph Geraci
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Florence Butlen-Ducuing
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Jasmine Link
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Ni A Khin
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Robert Morlock
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
| | - Larry D Alphs
- Drs. Smith and Demolle are with Cognivia in Mont St. Guibert, Belgium
- Dr. Horan is with VeraSci in Durham, North Carolina
- Drs. Horan and Anderson are with the University of California at Los Angeles in Los Angeles, California
- Dr. Schueler is with ICON Clinical Research in Langen, Germany
- Dr. Fu is with Janssen Reasearch and Development, LLC, in Titusville, New Jersey
- Dr. Geraci is with Nurosene Health, Inc. in Toronto, Ontario; Queen's University in Kingston, Ontario; and the Center for Biotechnology and Genomics Medicine, Medical College of Georgia, in Augusta, Georgia
- Dr. Butlen-Ducuing is with European Medicines Agency in Amsterdam, Netherlands
- Ms. Link is with Boehringer Ingelheim Pharma GmbH and Company KG in Baden Württenberg, Germany
- Dr. Khin is with Neurocrine Biosciences, Inc. in San Diego, California
- Dr. Morlock is with YourCareChoice in Ann Arbor, Michigan
- Dr. Alphs is with Denovo Biopharma, LLC in San Diego, California (at the time of writing, he was with Newron Pharmaceuticals in Morriston, New Jersey)
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8
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Arends RM, Grintjes KJT, van den Heuvel TJ, Foeken-Verwoert EGJ, Schene AH, van der Ven AJAM, Schellekens AFA. Effectiveness of a group intervention to reduce sexual transmission risk behavior among MSM living with HIV: a non-randomized controlled pilot study. AIDS Care 2021; 34:515-526. [PMID: 34851810 DOI: 10.1080/09540121.2021.2002252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ABSTRACTWith an annual incidence of about 1.5 million new infections, HIV is an ongoing public health concern. Sexual transmission risk behavior (STRB) is a main driver of the HIV epidemic in most Western countries, particularly among specific populations such as men who have sex with men (MSM). This quasi-experimental pilot study examined the effectiveness of a ten-session group intervention, aiming to reduce STRB among a high-risk subpopulation of MSM living with HIV. Self-reported STRB, impulsivity, mental health symptoms, and functional impairment were compared between the intervention group (n = 12) and a control group (n = 16). At baseline, participants in the intervention group had higher levels of STRB, impulsivity, mental health problems, and functional impairment, compared to the control group. A significant time-by-group interaction effect revealed that after the intervention, STRB, impulsivity, and functional impairment reduced in the intervention group to levels comparable to the control group. These findings suggest that a targeted behavioral intervention might be an effective strategy to reduce persistent STRB and related factors in MSM living with HIV. Future studies should confirm these findings in larger samples, using randomized designs.
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Affiliation(s)
- Rachel M Arends
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Karin J T Grintjes
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Thom J van den Heuvel
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,GGNet, Scelta, Nijmegen, Netherlands
| | | | - Aart H Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Arnt F A Schellekens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, Netherlands
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9
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O'Brien M. Pain coping skills training un-locks patient-centered pain care during the COVID- 19 lockdown. Pain Manag Nurs 2021; 23:504-516. [PMID: 34952797 PMCID: PMC8580817 DOI: 10.1016/j.pmn.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/25/2021] [Accepted: 10/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND In 2020, the COVID-19 virus sparked a crisis constituting a nationwide public health emergency that rapidly altered the provision of healthcare services for all Americans. Infectious disease mitigation led to widespread lockdowns of perceived nonessential services, programs, and non-emergent healthcare interventions. This lockdown exacerbated the public health dyad of uncontrolled pain and the opioid epidemic, which was already in a crisis state. Current literature supports the management of uncontrolled pain with a biopsychosocial approach, empowering patients to explore self-care to enhance activities of daily living. Pain Coping Skills Training (PCST) delivers real-life strategies that improve quality of life and strengthen self-efficacy. Self-efficacy has been identified as a patient outcome measure that demonstrates improved patient-perceived function and quality of life despite pain intensity. Studies have shown that nurse practitioners (APRN) are well-positioned to provide PCST to chronic pain sufferers. METHODS A pretest-posttest design was utilized for this project to enhance pain self- efficacy through an APRN-led community-based intervention. INTERVENTION Community-dwelling adults treated in a specialty pain management practice were self-selected to participate in a 6-week telehealth delivered PCST Program. This APRN delivered program presented basic pain education and a broad range of evidence-based nonpharmacologic pain management self-care tools. The primary outcome was improved Pain Self-efficacy measured with the pain self-efficacy questionnaire (PSEQ), with secondary outcomes of improved perceived pain intensity and function measured with the pain, enjoyment, and general activity (PEG) scale tracked weekly. RESULTS Baseline PSEQ and weekly PEG scores were obtained and compared to scores after the program. Collateral data points included confidence in using complementary and alternative nonpharmacologic interventions, satisfaction with the program, and a qualitative patient statement regarding pre-and post-intervention participation. CONCLUSIONS This project concluded that a Nurse Practitioner delivered PCST program via telehealth technology could provide community-dwelling adults with an intervention that improves pain self-efficacy, enhances self-reported PEG measures, and meets the social distancing requirements that continue to impact patients during the COVID-19 pandemic.
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Affiliation(s)
- Marie O'Brien
- Wilmington University, Wilmington, DE; Coordinator Integrative Pain Management Program, Mather Hospital Northwell Health, Port Jefferson, NY.
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10
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Iolascon G, Moretti A. Myths and Truths about Placebo Effect in Rehabilitation for Musculoskeletal Pain. Adv Ther 2021; 38:4995-5001. [PMID: 34476754 PMCID: PMC8478741 DOI: 10.1007/s12325-021-01894-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/12/2021] [Indexed: 02/08/2023]
Abstract
This commentary provides the authors' point of view about the biopsychosocial perspective of placebo effect on musculoskeletal pain in the rehabilitation field.
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Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, Via de Crecchio, 6, 80138, Naples, Italy.
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, Via de Crecchio, 6, 80138, Naples, Italy
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11
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Speldewinde GC, Panwar CE. Patient Expectancy Does Not Predict Success or Failure of Thermal Neurotomy for Persistent Zygapophysial and Sacroiliac Joint Pain. PAIN MEDICINE 2021; 22:1930-1939. [PMID: 33830246 DOI: 10.1093/pm/pnab133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The placebo effect is important in determining the outcome of the treatment of pain for which expectancy and context are the main contributors. The variable success of thermal neurotomy spinal pain procedures is often seen as evidence of the placebo effect. Conversely, proponents of pain procedures explain poorer outcomes by technical procedure deficiencies, including inadequate diagnosis. This cohort study set out to determine whether patient expectancy is a contributing factor in the outcome of thermal neurotomy to the cervical, thoracic, and lumbar zygapophysial and sacroiliac joints. DESIGN This single-practitioner, single-site retrospective analysis of prospectively gathered cohort data of 549 patients evaluated the impact of patient preprocedure expectancy (rated on a simple 0-10 or 0-4 numerical rating scale) on outcomes in a large consecutive series of patients who had undergone thermal neurotomy treatment between 2009 and 2019. In addition, a portion of patients were asked to what extent they hoped for or desired a good outcome. RESULTS Successful pain relief (≥75% reduction from baseline) was not associated with a higher preprocedure expectancy than were failed procedures. Hope and desire demonstrated no impact on the positive or negative impact of the procedure. CONCLUSIONS Altogether, patient expectation of outcome, hope, and desire are not associated with the outcome of effective pain relief by thermal neurotomy that has been performed to the appropriate and commonly available technical standards. Further work is needed to determine the influence of patient expectation across a range of pain intervention modalities.
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Affiliation(s)
- G C Speldewinde
- Capital Pain & Rehabilitation Clinic, Deakin, ACT, Australia
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12
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Okusogu C, Wang Y, Akintola T, Haycock NR, Raghuraman N, Greenspan JD, Phillips J, Dorsey SG, Campbell CM, Colloca L. Placebo hypoalgesia: racial differences. Pain 2020; 161:1872-1883. [PMID: 32701846 PMCID: PMC7502457 DOI: 10.1097/j.pain.0000000000001876] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
No large-cohort studies that examine potential racial effects on placebo hypoalgesic effects exist. To fill this void, we studied placebo effects in healthy and chronic pain participants self-identified as either African American/black (AA/black) or white. We enrolled 372 study participants, 186 with a diagnosis of temporomandibular disorder (TMD) and 186 race-, sex-, and age-matched healthy participants to participate in a placebo experiment. Using a well-established paradigm of classical conditioning with verbal suggestions, each individual pain sensitivity was measured to calibrate the temperatures for high- and low-pain stimuli in the conditioning protocol. These 2 temperatures were then paired with a red and green screen, respectively, and participants were told that the analgesic intervention would activate during the green screens to reduce pain. Participants then rated the painfulness of each stimulus on a visual analog scale ranging from 0 to 100. Racial influences were tested on conditioning strength, reinforced expectations, and placebo hypoalgesia. We found that white participants reported greater conditioning effects, reinforced relief expectations, and placebo effects when compared with their AA/black counterparts. Racial effects on placebo were observed in TMD, although negligible, short-lasting, and mediated by conditioning strength. Secondary analyses on the effect of experimenter-participant race and sex concordance indicated that same experimenter-participant race induced greater placebo hypoalgesia in TMDs while different sex induced greater placebo hypoalgesia in healthy participants. This is the first and largest study to analyze racial effects on placebo hypoalgesia and has implications for both clinical research and treatment outcomes.
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Affiliation(s)
- Chika Okusogu
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA
| | - Yang Wang
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA
| | - Titilola Akintola
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA
| | - Nathaniel R. Haycock
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA
| | - Nandini Raghuraman
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA
| | - Joel D. Greenspan
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA
- Department of Neural and Pain Sciences and Brotman Facial Pain Clinic, School of Dentistry, Baltimore, USA
| | - Jane Phillips
- Department of Neural and Pain Sciences and Brotman Facial Pain Clinic, School of Dentistry, Baltimore, USA
| | - Susan G. Dorsey
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA
| | - Claudia M. Campbell
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Luana Colloca
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA
- Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, University of Maryland, Baltimore, USA
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13
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Abstract
Placebo effects influence symptom perceptions and treatment outcomes. Placebo effects can be explored in laboratory settings controlling for natural history and expectations. Such a mechanistic approach to neurological disorders has been implemented in the domain of chronic clinical pain and other neurological disorders. This article therefore focuses on definitions and historical notes related to placebo effects and mechanisms of placebo effects in chronic pain. Knowledge on mechanisms of placebo effects could inform current clinical practice for the treatment of neurological disorders by focusing on patients (and providers) expectations for outcome optimization.
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Affiliation(s)
- Luana Colloca
- Department of Pain Translational Symptoms Science, School of Nursing, University of Maryland, Baltimore, MD, United States; Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, United States; Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, MD, United States.
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14
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Abstract
Our research described in this article was motivated by the puzzling finding of the Skylab M131 experiments: head movements made while rotating that are nauseogenic and disorienting on Earth are innocuous in a weightless, 0-g environment. We describe a series of parabolic flight experiments that directly addressed this puzzle and discovered the gravity-dependent responses to semicircular canal stimulation, consistent with the principles of velocity storage. We describe a line of research that started in a different direction, investigating dynamic balancing, but ended up pointing to the gravity dependence of angular velocity-to-position integration of semicircular canal signals. Together, these lines of research and the theoretical framework of velocity storage provide an answer to at least part of the M131 puzzle. We also describe recently discovered neural circuits by which active, dynamic vestibular, multisensory, and motor signals are interpreted as either appropriate for action and orientation or as conflicts evoking motion sickness and disorientation.
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Affiliation(s)
- James R Lackner
- Ashton Graybiel Spatial Orientation Laboratory, Brandeis University, Waltham, Massachusetts
| | - Paul DiZio
- Ashton Graybiel Spatial Orientation Laboratory, Brandeis University, Waltham, Massachusetts
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15
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Wang Y, Tricou C, Raghuraman N, Akintola T, Haycock NR, Blasini M, Phillips J, Zhu S, Colloca L. Modeling Learning Patterns to Predict Placebo Analgesic Effects in Healthy and Chronic Orofacial Pain Participants. Front Psychiatry 2020; 11:39. [PMID: 32116854 PMCID: PMC7029355 DOI: 10.3389/fpsyt.2020.00039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 01/13/2020] [Indexed: 02/01/2023] Open
Abstract
Successfully predicting the susceptibility of individuals to placebo analgesics will aid in developing more effective pain medication and therapies, as well as aiding potential future clinical use of placebos. In pursuit of this goal, we analyzed healthy and chronic pain patients' patterns of responsiveness during conditioning rounds and their links to conditioned placebo analgesia and the mediating effect of expectation on those responses. We recruited 579 participants (380 healthy, 199 with temporomandibular disorder [TMD]) to participate in a laboratory placebo experiment. Individual pain sensitivity dictated the temperatures used for high- and low-pain stimuli, paired with red or green screens, respectively, and participants were told there would be an analgesic intervention paired with the green screens. Over two conditioning sessions and one testing session, participants rated the painfulness of each stimulus on a visual analogue scale from 0 to 100. During the testing phase, the same temperature was used for both red and green screens to assess responses to the placebo effect, which was defined as the difference between the average of the high-pain-cue stimuli and low-pain-cue stimuli. Delta scores, defined as each low-pain rating subtracted from its corresponding high-pain rating, served as a means of modeling patterns of conditioning strength and placebo responsiveness. Latent class analysis (LCA) was then conducted to classify the participants based on the trajectories of the delta values during the conditioning rounds. Classes characterized by persistently greater or increasing delta scores during conditioning displayed greater placebo analgesia during testing than those with persistently lower or decreasing delta scores. Furthermore, the identified groups' expectation of pain relief acted as a mediator for individual placebo analgesic effects. This study is the first to use LCA to discern the relationship between patterns of learning and the resultant placebo analgesia in chronic pain patients. In clinical settings, this knowledge can be used to enhance clinical pain outcomes, as chronic pain patients with greater prior experiences of pain reduction may benefit more from placebo analgesia.
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Affiliation(s)
- Yang Wang
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States.,Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, United States
| | - Christina Tricou
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, United States
| | - Nandini Raghuraman
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States
| | - Titilola Akintola
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States
| | - Nathaniel R Haycock
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States
| | - Maxie Blasini
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States
| | - Jane Phillips
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, United States
| | - Shijun Zhu
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, MD, United States
| | - Luana Colloca
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States.,Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, United States.,Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, MD, United States
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16
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Krimmel SR, Zanos P, Georgiou P, Colloca L, Gould TD. Classical conditioning of antidepressant placebo effects in mice. Psychopharmacology (Berl) 2020; 237:93-102. [PMID: 31422429 PMCID: PMC6954278 DOI: 10.1007/s00213-019-05347-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/09/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Placebo effects in human clinical trials for depression treatment are robust and often comparable to drug effects. Placebo effects are traditionally difficult to study in rodents due to the slow-onset action of classical antidepressant drugs. We hypothesized that the rapid antidepressant actions of ketamine would allow modeling antidepressant placebo effects in rodents. METHODS Male and female CD-1 mice received either ketamine or saline injections with concomitant exposure to specific environmental conditioning stimuli, for a total of three drug/conditioning sessions each 2 weeks apart. Two weeks later, during an evocation phase, mice were exposed to the drug-paired conditioning stimuli or no conditioned stimuli followed by testing for motor stimulatory actions and antidepressant-like effects using the forced swim test. Negative (no ketamine administration at any time) and positive (acute ketamine administration prior to evocation testing) control groups were included as comparators. RESULTS Both male and female mice exhibited increased locomotor activity following ketamine administration during the conditioning phase, which was not observed following exposure to the conditioning stimuli. Exposure to the conditioning stimuli previously paired with ketamine, similar to an acute ketamine administration, reduced immobility time in the forced swim test both 1 and 24 h after administration in male, but not female, mice. CONCLUSIONS These results represent the first evidence of antidepressant-like placebo-conditioned effects in an animal model. The developed approach can be used as a model to explore the neurobiological mechanisms of placebo effects, their possible sexually dimorphic effects, and relevance to mechanisms underlying antidepressant action.
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Affiliation(s)
- Samuel R. Krimmel
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA.,Program in Neuroscience, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Panos Zanos
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Polymnia Georgiou
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Luana Colloca
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Pain Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA.,Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA.,Center to Advance Chronic Pain Research, University of Maryland, Baltimore, USA
| | - Todd D. Gould
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA.,Veterans Affairs Maryland Health Care System, Baltimore, MD, 21201, USA.,To whom correspondence should be addressed: Todd D. Gould, MD, Department of Psychiatry, University of Maryland School of Medicine, Rm. 936 MSTF, 685 W. Baltimore St., Baltimore, MD 21201, USA, Phone: (410) 706-5585,
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17
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Spink KS, Federow CW, Lanovaz JL, Oates AR. Haptic input and balance control: An exploratory study examining normative messaging. J Health Psychol 2019; 26:1433-1442. [PMID: 31544519 DOI: 10.1177/1359105319877446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined the effect of descriptive norm messaging information on the relationship between haptic input and balance control. Participants were randomly assigned to either a message group where they balanced with haptic input after receiving a descriptive norm message about the positive effect of haptic input or a control group. Findings from an analysis of covariance revealed a significant difference between the two groups. Those in the descriptive norm message group had better balance control than those in the control group. These findings suggest that efforts designed to improve balance control through haptic input may be enhanced through normative messaging.
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18
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Colloca L, Schenk LA, Nathan DE, Robinson OJ, Grillon C. When Expectancies Are Violated: A Functional Magnetic Resonance Imaging Study. Clin Pharmacol Ther 2019; 106:1246-1252. [PMID: 31350784 DOI: 10.1002/cpt.1587] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/12/2019] [Indexed: 11/07/2022]
Abstract
Positive and negative expectancies drive behavioral and neurobiological placebo and nocebo effects, which in turn can have profound effects on patient improvement or worsening. However, expectations of events and outcomes are often not met in daily life and clinical practice. It is currently unknown how this affects placebo and nocebo effects. We have demonstrated that the violation of expectancies, such as when there is a discrepancy between what is expected and what is actually presented, reduces both placebo and nocebo effects while causing an extinction of placebo effects. The reduction of placebo and nocebo effects was paralleled by an activation of the left inferior parietal cortex, a brain region that redirects attention when discrepancies between sensory and cognitive events occur. Our findings highlight the importance of expectancy violation in shaping placebo and nocebo effects and open up new avenues for managing positive and negative expectations in clinical trials and practices.
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Affiliation(s)
- Luana Colloca
- Department of Pain and Translational Symptom Science, University of Maryland Baltimore School of Nursing, Baltimore, Maryland, USA
| | - Lieven A Schenk
- Department of Pain and Translational Symptom Science, University of Maryland Baltimore School of Nursing, Baltimore, Maryland, USA
| | - Dominic E Nathan
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Oliver J Robinson
- University College London Institute of Cognitive Neuroscience, London, UK
| | - Christian Grillon
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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19
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Palese A, Rossettini G, Colloca L, Testa M. The impact of contextual factors on nursing outcomes and the role of placebo/nocebo effects: a discussion paper. Pain Rep 2019; 4:e716. [PMID: 31583342 PMCID: PMC6749917 DOI: 10.1097/pr9.0000000000000716] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/23/2018] [Accepted: 01/05/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Placebo and nocebo effects represent one of the most fascinating topics in the health care field. OBJECTIVES the aims of this discussion paper were (1) to briefly introduce the placebo and nocebo effects, (2) to elucidate the contextual factors able to trigger placebo and nocebo effects in the nursing field, and (3) to debate the impact of contextual factors on nursing education, practice, organisation, and research. METHODS a narrative review was conducted based on the available evidence. RESULTS Placebo responses (from Latin "I shall please") are a beneficial outcome(s) triggered by a positive context. The opposite are the nocebo effects (from Latin "I shall harm"), which indicates an undesirable outcome(s) caused by a negative context. Both are complex and distinct psychoneurobiological phenomena in which behavioural and neurophysiological changes arise subsequent to an interaction between the patient and the health care context. CONCLUSION Placebo and nocebo concepts have been recently introduced in the nursing discipline, generating a wide debate on ethical issues; however, the impact on nursing education, clinical practice, nursing administration, and research regarding contextual factors triggering nocebo and placebo effects has not been debated to date.
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Affiliation(s)
- Alvisa Palese
- Department Biological and Medical Science, University of Udine, Italy, Udine, Italy
| | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Italy, Savona, Italy
| | - Luana Colloca
- Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA
- Departments of Anesthesiology and Psychiatry, School of Medicine, Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, USA
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Italy, Savona, Italy
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