Gender Differences in Placebo Analgesia: Event-Related Potentials and Emotional Modulation

Aslaksen, Per M.; Bystad, Martin; Vambheim, Sara Magelssen; Flaten, Magne Arve

doi:10.1097/psy.0b013e3182080d73

Cited by 102 publications

(91 citation statements)

References 43 publications

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“…4). Electroencephalography (EEG) studies have further confirmed that placebo analgesia is associated with reduced amplitudes of event-related potentials to experimental pain stimuli (Wager et al, 2006;Watson et al, 2007;Aslaksen et al, 2011). Evidence from spinal cord forced magnetic resonance imaging (fMRI), which only recently became technically feasible in both humans and animals, has revealed that pain-related activity in the ipsilateral dorsal horn, corresponding to painful stimulation, is substantially reduced under placebo (Eippert et al, 2009b) and rises under expectations of increased pain (nocebo) .…”

Section: A Painmentioning

confidence: 92%

“…This notion is supported by observations where placebo analgesia was associated with a reduction in subjective stress levels, heart rate, and heart rate variability. The reduction in sympathetic activity appeared to be a factor involved in anticipatory placebo analgesia rather than simply a direct consequence of pain reduction (Aslaksen and Flaten, 2008;Aslaksen et al, 2011). These placebo responses reflected in the heart rate appear to be mediated via the prefrontal cortex, because the impaired connectivity of the prefrontal lobes in Alzheimer patients has been associated with both absent placebo analgesia and a heart rate reduction (Benedetti et al, 2006).…”

Section: F Autonomic Organ Functioningmentioning

confidence: 99%

See 1 more Smart Citation

Neuro-Bio-Behavioral Mechanisms of Placebo and Nocebo Responses: Implications for Clinical Trials and Clinical Practice

Schedlowski¹,

Enck²,

Rief³

et al. 2015

Pharmacol Rev

266

257

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Section: A Painmentioning

confidence: 92%

Section: F Autonomic Organ Functioningmentioning

confidence: 99%

Neuro-Bio-Behavioral Mechanisms of Placebo and Nocebo Responses: Implications for Clinical Trials and Clinical Practice

Schedlowski¹,

Enck²,

Rief³

et al. 2015

Pharmacol Rev

266

257

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“…However, experimental studies on placebo analgesia usually reveal higher placebo response rates in male adults (52). To our knowledge, there are only two articles that report analyses of gender differences in the placebo response in children: the review by Evers et al (34) found no gender differences, whereas the other review (53), also focusing on migraine headache, found higher placebo response rates in girls (66.7%) as compared with boys (43.3%).…”

Section: Are the Mediators And Moderators Of The Placebo Effect Similmentioning

confidence: 91%

Placebo effects in children: a review

Weimer¹,

et al. 2013

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Of more than 155,000 PubMed citations found with the search term "placebo, " only ~9,000 (5.8%) included the terms "children" or "adolescents. " When all these papers were screened, only ~2,000 of them investigated the placebo effect per se, and of those, only ~50 (2.5%) discussed the placebo effect in children and adolescents. In this narrative review, we explore four aspects of the placebo response in children and adolescents: (i) the legal and ethical limitations and restrictions for the inclusion of children in clinical trials as well as in experimental (placebo) research that may explain the poor knowledge base; (ii) the question of whether or not the placebo effect is larger in children and adolescents as compared with adults; (iii) whether the mechanisms underlying the placebo effect are similar between children and adults; and (iv) whether mediators and moderators of the placebo effect are comparable between children and adults. We finally discuss some of the consequences from the current placebo research in adults that may affect both experimental and clinical research in children and adolescents.

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“…Aslaksen et al [11] recorded stress and arousal in the absence of pain to observe whether stress was reduced by information that a painkiller was administered. Experimental heat pain was induced before, and at 10-15 and at 25-30 min after administration of a painkiller with information that it was a potent painkiller.…”

Section: Do Emotions Modulate the Placebo Response Or Does The Placementioning

confidence: 99%

“…This response bias is a serious problem for the reliability of subjective report, and needs to be considered when recording pain. Especially in the field of placebo analgesia, where response bias has been put forth as an explanation for the reduced pain report after administration of a placebo [9,10], the use of objective methods is especially important, and such methods are being increasingly used [11][12][13].…”

Section: Painmentioning

confidence: 99%

The relation of emotions to placebo responses

Flaten

Aslaksen

Lyby

et al. 2011

Phil. Trans. R. Soc. B

Self Cite

123

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The hypothesis put forth is that expectations of treatment effects reduce negative emotions and thereby reduce symptoms, e.g. pain. Negative emotions increase pain, and it is hypothesized that placebos reduce pain by reducing negative emotions, i.e. feelings of nervousness, fear and anxiety. Placebo analgesia has been shown to be mediated via opioid activity, and relaxation increases opioid activity. The placebo acquires its relaxing effect due to verbal information that pain will be reduced, or due to associations between the placebo and the reduction in pain after effective treatment. Thus, the placebo signals that unpleasantness will be less after administration of the placebo. This involves negative reinforcement which is due to activation of a dopaminergic system that has been found to be activated during placebo analgesia and is involved in positive emotions. The nocebo effect of increased pain is, consistent with this model, because of increased fear and anxiety. The new aspect of the presented model is the hypothesis that expectations reduce negative emotions, and that negative reinforcement that involves the dopaminergic reinforcement system should be a contributor to placebo responses.

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Gender Differences in Placebo Analgesia: Event-Related Potentials and Emotional Modulation

Abstract: A placebo response on pain unpleasantness was observed in men only, and reduced stress after placebo administration was observed in males only. Thus, reduced stress may be a mechanism for placebo responses in pain.

Cited by 102 publications

References 43 publications

Neuro-Bio-Behavioral Mechanisms of Placebo and Nocebo Responses: Implications for Clinical Trials and Clinical Practice

Neuro-Bio-Behavioral Mechanisms of Placebo and Nocebo Responses: Implications for Clinical Trials and Clinical Practice

Placebo effects in children: a review

The relation of emotions to placebo responses

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