Abstract
| Original language | Italian |
|---|---|
| Journal | Frontiers in Neurology |
| Volume | 9 |
| DOIs | |
| Publication status | Published - 2018 |
Cite this
What Is the Role of the Placebo Effect for Pain Relief 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.
In: Frontiers in Neurology, Vol. 9, 2018.Research output: Contribution to journal › Article
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TY - JOUR
T1 - What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation?
AU - Castelnuovo, Gianluca
AU - Giusti, Emanuele Maria
AU - Manzoni, Gian Mauro
AU - Saviola, Donatella
AU - Gabrielli, Samantha
AU - Lacerenza, Marco
AU - Pietrabissa, Giada
AU - Cattivelli, Roberto
AU - Spatola, Chiara Anna Maria
AU - Rossi, Alessandro
AU - Varallo, Giorgia
AU - Novelli, Margherita
AU - Villa, Valentina
AU - Luzzati, Francesca
AU - Cottini, Andrea
AU - Lai, Carlo
AU - Volpato, Eleonora
AU - Cavalera, Cesare
AU - Pagnini, Francesco
AU - Tesio, Valentina
AU - Castelli, Lorys
AU - Tavola, Mario
AU - Torta, Riccardo
AU - Arreghini, Marco
AU - Zanini, Loredana
AU - Brunani, Amelia
AU - Seitanidis, Ionathan
AU - Ventura, Giuseppe
AU - Capodaglio, Paolo
AU - D'Aniello, Guido Edoardo
AU - Scarpina, Federica
AU - Brioschi, Andrea
AU - Bigoni, Matteo
AU - Priano, Lorenzo
AU - Mauro, Alessandro
AU - Riva, Giuseppe
AU - Di Lernia, Daniele
AU - Repetto, Claudia
AU - Regalia, Camillo
AU - Molinari, Enrico
AU - Notaro, Paolo
AU - Paolucci, Stefano
AU - Sandrini, Giorgio
AU - Simpson, Susan
AU - Wiederhold, Brenda Kay
AU - Gaudio, Santino
AU - Jackson, Jeffrey B
AU - Tamburin, Stefano
AU - Benedetti, Fabrizio
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
U2 - 10.3389/fneur.2018.00310
DO - 10.3389/fneur.2018.00310
M3 - Articolo
VL - 9
JO - Frontiers in Neurology
JF - Frontiers in Neurology
SN - 1664-2295
ER -