Placebo and nocebo effects on itch: effects, mechanisms, and predictors

Bartels, D.J.P.; Laarhoven, Antoinette I. M. van; Kerkhof, Peter C M van de; Evers, Andrea W M

doi:10.1002/ejp.750

Cited by 46 publications

(39 citation statements)

References 30 publications

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“…The ACC has been consistently reported to be activated in functional imaging studies of itch in both healthy subjects and patients with atopic dermatitis (AD) . Moreover, the dlPFC is activated by various pruritogens and has been implicated in both nocebo and placebo itch relief in patients with AD . Histamine exhibited distinct patterns in AD patients, and correlations were observed between disease severity and dlPFC activity, an area involved in affect/emotion and control of the scratch response .…”

Section: Clinical and Neurobiological Similarities Between Addiction mentioning

confidence: 76%

Addiction and the itch‐scratch cycle. What do they have in common?

Ishiuji

2019

Experimental Dermatology

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Itch is a multidimensional experience involving various brain regions associated with sensory perception and emotion, as well as an urge to scratch employing the motor system. Scratch temporarily relieves itch sensation in healthy subjects. However, in patients with chronic itch, rather than inhibit, scratch may aggravate itch. Patients with chronic itch, such as those with atopic dermatitis, experience severe itch and a strong desire to scratch. This urge to scratch is the driving force underlying the formation of the itch‐scratch‐cycle, an addictive and vicious cycle in chronic itch patients. This vicious itch‐scratch behaviour and various types of addiction (henceforth, including recreational drug use) were shown to share common sensory mechanisms. Abnormalities have been observed in central neural circuits, including the reward, motivation/drive, control and learning/memory circuits, as well as other brain systems. Reward systems, including the ventral tegmental area (VTA), nucleus accumbens (NAc) and striatum, are important for brain processing of both addiction and itch. In addition to reward, addicted individuals can experience severe disruptions in motor control, cognitive awareness, executive function, learning/memory and even emotional functions. Findings showing that addiction and itch share a common neurobiological foundation could have important mechanistic and therapeutic implications. Here we propose that similar neuroadaptations exist in addiction and chronic itch patients.

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Section: Clinical and Neurobiological Similarities Between Addiction mentioning

confidence: 76%

Addiction and the itch‐scratch cycle. What do they have in common?

Ishiuji

2019

Experimental Dermatology

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“…Paradigmatically, the placebo and nocebo phenomena have been most extensively studied in analgesia 7-10 and irritable bowel syndrome (IBS). 11 These phenomena have been studied more recently in the field of dermatology [12][13][14] and in psychiatry, particularly in depression. 15 The underpinnings of placebo and nocebo are psychological and neurobiological.…”

Section: Introductionmentioning

confidence: 99%

The Placebo and Nocebo Phenomena: Their Clinical Management and Impact on Treatment Outcomes

Chavarría

Vian

Pereira

et al. 2017

Clinical Therapeutics

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“…There are, however, indications that the placebo and nocebo effects induced by verbal suggestion also apply to patients with itch,[20] fatigue, nausea and hypokinesia in patients with Parkinson’s disease. [8]…”

Section: Being Positivementioning

confidence: 99%

Context as a drug: some consequences of placebo research for primary care

Olesen

2016

Scandinavian Journal of Primary Health Care

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ObjectiveOn the basis of emerging research evidence, this review aims to discuss the importance of the context surrounding the doctor–patient encounter for the success of treatment.Design and settingDiscussion paper based on placebo–nocebo and pain studies conducted in the western world.Main outcome measuresLiterature-based theory about impact of communication elements on seriousness of symptoms in clinical practice.ResultsThe therapeutic outcome seems to be impacted by rituals around a clinical encounter and by the doctor patient communication and relation. A warm, friendly and empathic attitude is crucial in the first contact with the practice and during the consultation as it influences the patient’s perceived outcome. It is important to raise positive expectations when discussing the prognosis, conducting treatment and prescribing medications as the effect may be reduced if the physician expresses doubt about the effectiveness of the medication. Additionally, overly focus on side effects in the doctor–patient conversation about proposed treatments seems to influence the magnitude of perceived side effects in the patient. Thus, shared decision-making might be a desirable tool for ensuring better expectations in the patient and successful symptom relief.ConclusionsThe context of the doctor–patient interplay matters. Placebo–nocebo research provides strong evidence for this link. The therapeutic context induces biomedical processes in the patient’s brain that may enhance or reduce the effects of chosen interventions. The context thus works as a drug, with real effects and side effects. KEY POINTSIncreased awareness of the context drug may help GPs alleviate symptoms and better motivate patients for treatment.Treatment is affected by multiple types of context, as also confirmed by placebo–nocebo research.The therapeutic context influences the biomedical processes, which may enhance or reduce intervention effects on symptoms.The impact of context should be considered in daily general practice as it may serve as a drug, with real effects and side effects.

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Placebo and nocebo effects on itch: effects, mechanisms, and predictors

Cited by 46 publications

References 30 publications

Addiction and the itch‐scratch cycle. What do they have in common?

Addiction and the itch‐scratch cycle. What do they have in common?

The Placebo and Nocebo Phenomena: Their Clinical Management and Impact on Treatment Outcomes

Context as a drug: some consequences of placebo research for primary care

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