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What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation
BACKGROUND: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments....
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968866/ https://www.ncbi.nlm.nih.gov/pubmed/29867723 http://dx.doi.org/10.3389/fneur.2018.00310 |
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author | Castelnuovo, Gianluca Giusti, Emanuele Maria Manzoni, Gian Mauro Saviola, Donatella Gabrielli, Samantha Lacerenza, Marco Pietrabissa, Giada Cattivelli, Roberto Spatola, Chiara Anna Maria Rossi, Alessandro Varallo, Giorgia Novelli, Margherita Villa, Valentina Luzzati, Francesca Cottini, Andrea Lai, Carlo Volpato, Eleonora Cavalera, Cesare Pagnini, Francesco Tesio, Valentina Castelli, Lorys Tavola, Mario Torta, Riccardo Arreghini, Marco Zanini, Loredana Brunani, Amelia Seitanidis, Ionathan Ventura, Giuseppe Capodaglio, Paolo D’Aniello, Guido Edoardo Scarpina, Federica Brioschi, Andrea Bigoni, Matteo Priano, Lorenzo Mauro, Alessandro Riva, Giuseppe Di Lernia, Daniele Repetto, Claudia Regalia, Camillo Molinari, Enrico Notaro, Paolo Paolucci, Stefano Sandrini, Giorgio Simpson, Susan Wiederhold, Brenda Kay Gaudio, Santino Jackson, Jeffrey B. Tamburin, Stefano Benedetti, Fabrizio |
author_facet | Castelnuovo, Gianluca Giusti, Emanuele Maria Manzoni, Gian Mauro Saviola, Donatella Gabrielli, Samantha Lacerenza, Marco Pietrabissa, Giada Cattivelli, Roberto Spatola, Chiara Anna Maria Rossi, Alessandro Varallo, Giorgia Novelli, Margherita Villa, Valentina Luzzati, Francesca Cottini, Andrea Lai, Carlo Volpato, Eleonora Cavalera, Cesare Pagnini, Francesco Tesio, Valentina Castelli, Lorys Tavola, Mario Torta, Riccardo Arreghini, Marco Zanini, Loredana Brunani, Amelia Seitanidis, Ionathan Ventura, Giuseppe Capodaglio, Paolo D’Aniello, Guido Edoardo Scarpina, Federica Brioschi, Andrea Bigoni, Matteo Priano, Lorenzo Mauro, Alessandro Riva, Giuseppe Di Lernia, Daniele Repetto, Claudia Regalia, Camillo Molinari, Enrico Notaro, Paolo Paolucci, Stefano Sandrini, Giorgio Simpson, Susan Wiederhold, Brenda Kay Gaudio, Santino Jackson, Jeffrey B. Tamburin, Stefano Benedetti, Fabrizio |
author_sort | Castelnuovo, Gianluca |
collection | PubMed |
description | BACKGROUND: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. METHODS: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. RESULTS: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0–10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. CLINICAL IMPLICATIONS: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor–patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy. |
format | Online Article Text |
id | pubmed-5968866 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-59688662018-06-04 What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation Castelnuovo, Gianluca Giusti, Emanuele Maria Manzoni, Gian Mauro Saviola, Donatella Gabrielli, Samantha Lacerenza, Marco Pietrabissa, Giada Cattivelli, Roberto Spatola, Chiara Anna Maria Rossi, Alessandro Varallo, Giorgia Novelli, Margherita Villa, Valentina Luzzati, Francesca Cottini, Andrea Lai, Carlo Volpato, Eleonora Cavalera, Cesare Pagnini, Francesco Tesio, Valentina Castelli, Lorys Tavola, Mario Torta, Riccardo Arreghini, Marco Zanini, Loredana Brunani, Amelia Seitanidis, Ionathan Ventura, Giuseppe Capodaglio, Paolo D’Aniello, Guido Edoardo Scarpina, Federica Brioschi, Andrea Bigoni, Matteo Priano, Lorenzo Mauro, Alessandro Riva, Giuseppe Di Lernia, Daniele Repetto, Claudia Regalia, Camillo Molinari, Enrico Notaro, Paolo Paolucci, Stefano Sandrini, Giorgio Simpson, Susan Wiederhold, Brenda Kay Gaudio, Santino Jackson, Jeffrey B. Tamburin, Stefano Benedetti, Fabrizio Front Neurol Neuroscience BACKGROUND: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. METHODS: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. RESULTS: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0–10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. CLINICAL IMPLICATIONS: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor–patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy. Frontiers Media S.A. 2018-05-18 /pmc/articles/PMC5968866/ /pubmed/29867723 http://dx.doi.org/10.3389/fneur.2018.00310 Text en Copyright © 2018 Castelnuovo, Giusti, Manzoni, Saviola, Gabrielli, Lacerenza, Pietrabissa, Cattivelli, Spatola, Rossi, Varallo, Novelli, Villa, Luzzati, Cottini, Lai, Volpato, Cavalera, Pagnini, Tesio, Castelli, Tavola, Torta, Arreghini, Zanini, Brunani, Seitanidis, Ventura, Capodaglio, D’Aniello, Scarpina, Brioschi, Bigoni, Priano, Mauro, Riva, Di Lernia, Repetto, Regalia, Molinari, Notaro, Paolucci, Sandrini, Simpson, Wiederhold, Gaudio, Jackson, Tamburin, Benedetti. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Castelnuovo, Gianluca Giusti, Emanuele Maria Manzoni, Gian Mauro Saviola, Donatella Gabrielli, Samantha Lacerenza, Marco Pietrabissa, Giada Cattivelli, Roberto Spatola, Chiara Anna Maria Rossi, Alessandro Varallo, Giorgia Novelli, Margherita Villa, Valentina Luzzati, Francesca Cottini, Andrea Lai, Carlo Volpato, Eleonora Cavalera, Cesare Pagnini, Francesco Tesio, Valentina Castelli, Lorys Tavola, Mario Torta, Riccardo Arreghini, Marco Zanini, Loredana Brunani, Amelia Seitanidis, Ionathan Ventura, Giuseppe Capodaglio, Paolo D’Aniello, Guido Edoardo Scarpina, Federica Brioschi, Andrea Bigoni, Matteo Priano, Lorenzo Mauro, Alessandro Riva, Giuseppe Di Lernia, Daniele Repetto, Claudia Regalia, Camillo Molinari, Enrico Notaro, Paolo Paolucci, Stefano Sandrini, Giorgio Simpson, Susan Wiederhold, Brenda Kay Gaudio, Santino Jackson, Jeffrey B. Tamburin, Stefano Benedetti, Fabrizio What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation |
title | What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation |
title_full | What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation |
title_fullStr | What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation |
title_full_unstemmed | What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation |
title_short | What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation |
title_sort | what is the role of the placebo effect for pain relief in neurorehabilitation? clinical implications from the italian consensus conference on pain in neurorehabilitation |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968866/ https://www.ncbi.nlm.nih.gov/pubmed/29867723 http://dx.doi.org/10.3389/fneur.2018.00310 |
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