Treatment history and placebo responses to experimental and clinical pain in chronic pain patients

Müller, Maike; Kamping, Sandra; Benrath, Justus; Skowronek, H; Schmitz, Julia; Klinger, Regine; Flor, Herta

doi:10.1002/ejp.877

Cited by 38 publications

(42 citation statements)

References 26 publications

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“…Several studies demonstrate higher and more enduring placebo effects in patients as compared to healthy participants (Sauro & Greenberg, 2005). Expectancy-induced placebo effects elicited a large placebo analgesic effect to both acute experimental and chronic pain, however, the placebo effects were unrelated to each other (Müller et al, 2016). Charron, Rainville, and Marchand (2006) examined changes in the intensity and unpleasantness of pain in patients with low back pain undergoing a placebo treatment consisting of a saline injection presented as a potent painkiller in one session or as an inactive substance in the control session.…”

Section: Experimental and Clinical Placebo Studiesmentioning

confidence: 99%

“…In healthy individuals, prior positive experiences with effective treatment enhance the placebo effect. In patients with chronic pain, a more negative pain-related treatment history was associated with larger placebo effects for the relief of clinical pain (Müller et al, 2016). Clinically, the efficacy of sham rTMS for neuropathic pain relief could be improved by being administered following a successful active rTMS (André-Obadia, Magnin, & Garcia-Larrea, 2011).…”

Section: Experimental and Clinical Placebo Studiesmentioning

confidence: 99%

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Pain Modulation: From Conditioned Pain Modulation to Placebo and Nocebo Effects in Experimental and Clinical Pain

Damien

Colloca

Belleï-Rodriguez

et al. 2018

International Review of Neurobiology

112

107

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Accumulating evidence reveal important applications of endogenous pain modulation assessment in healthy controls and in patients in clinical settings, as dysregulations in the balance of pain modulatory circuits may facilitate pain and promote chronification of pain. This article reviews data on pain modulation, focusing on the mechanisms and translational aspects of pain modulation from conditioned pain modulation (CPM) to placebo and nocebo effects in experimental and clinical pain. The specific roles of expectations, learning, neural and neurophysiological mechanisms of the central nervous system are briefly reviewed herein. The interaction between CPM and placebo systems in pain inhibitory pathways is highly relevant in the clinic and in randomized controlled trials yet remains to be clarified. Examples of clinical implications of CPM and its relationship to placebo and nocebo effects are provided. A greater understanding of the role of pain modulation in various pain states can help characterize the manifestation and development of chronic pain and assist in predicting the response to pain-relieving treatments. Placebo and nocebo effects, intrinsic to every treatment, can be used to develop personalized therapeutic approaches that improve clinical outcomes while limiting unwanted effects.

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Section: Experimental and Clinical Placebo Studiesmentioning

confidence: 99%

Section: Experimental and Clinical Placebo Studiesmentioning

confidence: 99%

Pain Modulation: From Conditioned Pain Modulation to Placebo and Nocebo Effects in Experimental and Clinical Pain

Damien

Colloca

Belleï-Rodriguez

et al. 2018

International Review of Neurobiology

112

107

View full text Add to dashboard Cite

show abstract

“…First, the significance of these findings, and more generally of those obtained in the context of laboratory experiments on healthy volunteers, should not be generalized to the understanding of placebo responses in pain patients. In fact, a lack of correlation between placebo analgesia in experimental pain and clinical pain has been reported (Muller et al, 2016). Second, the interpretation of placebo effects is context-dependent and importantly relies on individuals’ interpretation of the treatment context (Enck & Klosterhalfen, 2013; Whalley, Hyland, & Kirsch, 2008).…”

Section: Discussionmentioning

confidence: 99%

The true size of placebo analgesia: Concordant neural and behavioural measures of placebo analgesia during experimental acute pain

Valentini

Aglioti

Chakrabarti

2018

Preprint

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Abstract‘Placebo analgesia’ refers to the reduction of pain following the administration of an inactive treatment. While most clinical trials compare a drug treatment against a placebo to determine the efficacy of the analgesic, most experimental studies of placebo analgesia do not include a real analgesic condition. A direct comparison of placebo against a real analgesic can inform us about the true size of the placebo effect. To this end, we aimed to provide a robust estimate of placebo analgesia by contrasting the effect of pain relief expectation from an inert cream (vaseline) against a real topical analgesic agent (lidocaine) applied on two different limbs and their respective control conditions. Pain reports and electroencephalography (EEG) responses triggered by laser nociceptive stimulation were collected. Forty typical healthy adults were enrolled in a double-blind randomized within-subject study where a standard placebo induction script of verbal suggestions in a sham medical setting was used to enhance the expectation on treatment outcome. In line with the earliest studies of placebo analgesia, majority (30 of 40) of participants was placebo responders, i.e. they reported lower pain to the placebo treatment. Placebo responders reported low pain and displayed low laser evoked potentials (LEPs) amplitude for both the analgesic and placebo treatment limbs compared to the respective control limbs. Placebo analgesia correlated positively with the amplitude of the LEPs, thus establishing convergent validity of the findings. This study provides a robust estimate of the neural and behavioural measures of placebo analgesia, in comparison to a real analgesic. These estimates can help inform the quantitative criteria for similar neural and behavioural measures in assessing the effectiveness of a real drug in placebo controlled trials.

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“…However, negative treatment expectancies trigger fear of treatment and reduce the treatment effects (Bingel, Wanigasekera, et al, 2011; Sonthalia et al, 2015). Moreover, there is evidence that the expectancy is influenced by previous experiences (Muller et al, 2016). Though, little research has examined the mechanisms of the expectancy effect yet.…”

Section: Underlying Psychological Mechanisms Of Analgesic Placebo Effmentioning

confidence: 99%

“…There are many differences due to patient’s characteristics (e.g., treatment history and illness beliefs). However, very important distinguishing features are the different expectancies resulting from the different previous experiences with treatment, medication, and the healing context (Muller et al, 2016). Studies which compare the placebo effect in healthy people and patients are required to determine whether the placebo response is the same in both samples.…”

Section: Requirements For a Clinical Application Of Placebo Effectsmentioning

confidence: 99%

Clinical Use of Placebo Effects in Patients With Pain Disorders

Klinger

Stuhlreyer

Schwartz

et al. 2018

International Review of Neurobiology

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The analgesic placebo effect is well documented by numerous studies. Many important influencing factors, however, are yet to be discovered. In the arena of placebo effects and clinical implications, expectancies play a central role. Expectancies are shaped by processes of classical and social learning as well as verbal instructions and are strongly related to emotional factors. Expectancies trigger a cascade of endogenous opioids and nonopioids, which alter the experience of pain. For clinical application it is important to know, that placebo research yields ethical possibilities to use placebo effects without deception and without using placebos. Since placebo effects contribute to responses to active anal-gesics, it is feasible to enhance patients’ benefits from pain treatments by increasing the additional placebo effect. There are several possibilities to use the placebo effects via shaping and adapting information about analgesic medication and via associating medication intake with a positive context. A positive patient–clinician communication atmosphere is very important to generate clinically meaningful placebo effects in pain medicine.

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Treatment history and placebo responses to experimental and clinical pain in chronic pain patients

Cited by 38 publications

References 26 publications

Pain Modulation: From Conditioned Pain Modulation to Placebo and Nocebo Effects in Experimental and Clinical Pain

Pain Modulation: From Conditioned Pain Modulation to Placebo and Nocebo Effects in Experimental and Clinical Pain

The true size of placebo analgesia: Concordant neural and behavioural measures of placebo analgesia during experimental acute pain

Clinical Use of Placebo Effects in Patients With Pain Disorders

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