The neurobiology of placebo effects in sports: EEG frontal alpha asymmetry increases in response to a placebo ergogenic aid

Broelz, Ellen; Enck, Paul; Nieß, Andreas M.; Schneeweiss, Patrick; Wolf, Sebastian; Weimer, Katja

doi:10.1038/s41598-019-38828-9

Cited by 20 publications

(16 citation statements)

References 58 publications

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“…Second, in line with previous findings suggesting that placebo improvement is underpinned by brain circuitry supporting reward and valuation mechanisms (Ashar et al, 2017;De la Fuente-Fernández et al, 2001;Ellingsen et al, 2013;Fields, 2004;Lidstone et al, 2005;Mayberg et al, 2002;Oken et al, 2008;Petrovic et al, 2002;Scott et al, 2007Scott et al, , 2008, another central hypothesis is that traits related to behavioral activation and reward responsiveness may be a positive predictor of placebo responsivity (De Pascalis & Scacchia, 2019;Schweinhardt et al, 2009). Conversely, behavioral inhibition has been linked to anxiety (Carver & White, 1994), and thus may be negatively associated with placebo improvement (Broelz et al, 2019).…”

Section: Introductionsupporting

confidence: 64%

“…Conversely, more pessimistic people may react more saliently to information about adverse outcomes and side effects, which in turn may contribute to nocebo effects. Trait anxiety, which is sometimes negatively associated with optimism (Scheier et al, 1994), and related to negative expectancy bias (Cabeleira et al, 2014) has been suggested as a negative predictor of placebo responsiveness (Broelz et al, 2019;Horing et al, 2014;Morton et al, 2009;. Similarly, neuroticism , pain catastrophizing (Sullivan et al, 2008), fear of pain (Corsi & Colloca, 2017;Lyby et al, 2010) have been linked to placebo effects as a negative predictor.…”

Section: Introductionmentioning

confidence: 99%

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Association between personality traits and placebo effects: a preregistered systematic review and meta-analysis

Kang

Miksche

Ellingsen

2022

Pain

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Placebo effects are ubiquitous yet highly variable between individuals, and therefore strongly impact clinical trial outcomes. It is unclear whether dispositional psychological traits influence responsiveness to placebo. This preregistered meta-analysis and systematic review synthesized the literature investigating the association between personality traits and placebo effects. Based on 19 studies with 712 participants, we performed formal meta-analyses for 10 different personality traits. We did not find evidence of associations between any of these traits and magnitude of placebo effects, which was supported by equivalence tests. Furthermore, we did not find evidence for moderating factors such as placebo manipulation type (Conditioning, non-conditioning) or condition (pain, non-pain). However, the current synthesis was not statistically powered for full inquiry into potential conditional or interactive associations between personality and situational variables. These findings challenge the notion that personality influences responsiveness to placebos and contradict its utility for identifying placebo "responders" and "non-responders".

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Section: Introductionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Association between personality traits and placebo effects: a preregistered systematic review and meta-analysis

Kang

Miksche

Ellingsen

2022

Pain

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“…Participants completed a set of questionnaires (Table 1) to assess psychological traits that have previously been linked to placebo responsiveness (Broelz et al., 2019; Corsi & Colloca, 2017; Lyby et al., 2010; Zhou et al., 2019). Questionnaires were completed between the familiarization with the CPT and the test sessions.…”

Section: Methodsmentioning

confidence: 99%

‘External timing’ of placebo analgesia in an experimental model of sustained pain

Camerone

Wiech

Carlino

et al. 2021

European Journal of Pain

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Background Research on placebo analgesia commonly focuses on the impact of information about direction (i.e., increase or decrease of pain) and magnitude of the expected analgesic effect, whereas temporal aspects of expectations have received little attention so far. In a recent study, using short‐lasting, low‐intensity stimuli, we demonstrated that placebo analgesia onset is influenced by temporal information. Here, we investigate whether the same effect of temporal suggestions can be found in longer lasting, high‐intensity pain in a Cold Pressor Test (CPT). Methods Fifty‐three healthy volunteers were allocated to one of three groups. Participants were informed that the application of an (inert‐)cream would reduce pain after 5 min (P5) or 30 min (P30). The third group was informed that the cream only had hydrating properties (NE). All participants completed the CPT at baseline and 10 (Test 10) and 35 min (Test 35) following cream application. Percentage change in exposure time (pain tolerance) from baseline to Test 10 (Δ10) and to Test 35 (Δ35) and changes in heart rate (HR) during CPT were compared between the three groups. Results Δ10 was greater in P5 than in NE and P30, indicating that analgesia was only present in the group that was expecting an early onset of analgesia. Δ35 was greater in P5 and P30 compared to NE, reflecting a delayed onset of analgesia in P30 and maintained analgesia in P5. HR differences between groups were not significant. Conclusions Our data suggest that ‘externally timing’ of placebo analgesia may be possible for prolonged types of pain. Significance Research on placebo effects mainly focuses on the influence of information about direction (i.e., increase or decrease of pain) and magnitude (i.e., strong or weak) of the expected effect but ignores temporal aspects of expectations. In our study in healthy volunteers, the reported onset of placebo analgesia followed the temporal information provided. Such ‘external timing’ effects could not only aid the clinical use of placebo treatment (e.g., in open‐label placebos) but also support the efficacy of active drugs.

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“…Furthermore, the psychobiological model of endurance performance posits that interventions designed to reduce perceptual exertion and/or enhance motivation may improve exercise tolerance [70,71]. Indeed, placebos have been observed to increase frontal alpha asymmetry and associated positive affect appraisal of effort perception, when described as ergogenic aids [72]. It is also plausible that perceptual exertion and/or motivation may share an inverse relationship [73], though subjective motivation was not directly assessed here.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Caffeine Expectancies on Simulated Soccer Performance in Recreational Individuals

et al. 2019

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Caffeine (CAF) has been reported to improve various facets associated with successful soccer play, including gross motor skill performance, endurance capacity and cognition. These benefits are primarily attributed to pharmacological mechanisms. However, evidence assessing CAF’s overall effects on soccer performance are sparse with no studies accounting for CAF’s potential psychological impact. Therefore, the aim of this study was to assess CAF’s psychological vs. pharmacological influence on various facets of simulated soccer performance. Utilising a double-dissociation design, eight male recreational soccer players (age: 22 ± 5 years, body mass: 78 ± 16 kg, height: 178 ± 6 cm) consumed CAF (3 mg/kg/body mass) or placebo (PLA) capsules, 60 min prior to performing the Loughborough Intermittent Shuttle Test (LIST) interspersed with a collection of ratings of perceived exertion (RPE), blood glucose and lactate, heart rate and performing the Loughborough Soccer Passing Test (LSPT). Whole-body dynamic reaction time (DRT) was assessed pre- and post- LIST, and endurance capacity (TLIM) post, time-matched LIST. Statistical analysis was performed using IBM SPSS (v24) whilst subjective perceptions were explored using template analysis. Mean TLIM was greatest (p < 0.001) for synergism (given CAF/told CAF) (672 ± 132 s) vs. placebo (given PLA/told PLA) (533 ± 79 s). However, when isolated, TLIM was greater (p = 0.012) for CAF psychology (given PLA/told CAF) (623 ± 117 s) vs. pharmacology (given CAF/told PLA) (578 ± 99 s), potentially, via reduced RPE. Although DRT performance was greater (p = 0.024) post-ingestion (+5 hits) and post-exercise (+7 hits) for pharmacology vs. placebo, psychology and synergism appeared to improve LSPT performance vs. pharmacology. Interestingly, positive perceptions during psychology inhibited LSPT and DRT performance via potential CAF over-reliance, with the opposite occurring following negative perceptions. The benefits associated with CAF expectancies may better suit tasks that entail lesser cognitive-/skill-specific attributes but greater gross motor function and this is likely due to reduced RPE. In isolation, these effects appear greater vs. CAF pharmacology. However, an additive benefit may be observed after combining expectancy with CAF pharmacology (i.e., synergism).

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The neurobiology of placebo effects in sports: EEG frontal alpha asymmetry increases in response to a placebo ergogenic aid

Cited by 20 publications

References 58 publications

Association between personality traits and placebo effects: a preregistered systematic review and meta-analysis

Association between personality traits and placebo effects: a preregistered systematic review and meta-analysis

‘External timing’ of placebo analgesia in an experimental model of sustained pain

The Influence of Caffeine Expectancies on Simulated Soccer Performance in Recreational Individuals

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