Показаны записи 181 - 190 из 567
Participants in the NT group did not receive any treatment and were told that they are in the “no treatment group”.
All participants in the three other groups (OPR-, OPR+, and DP)
received an inert white placebo cream. However, the provided rationale in the three groups differed.
In the OPR- group, participants were told: “You are receiving a placebo cream. This means that your cream does not contain any pharmacological ingredient, hence it is an inert substance”. No additional information regarding placebo mechanisms was provided to this group.
In the OPR+ group, participants were informed that they are receiving an inert placebo cream. In accordance with Kaptchuk et al. [32], the investigator explained that (a) the placebo effect is powerful, explaining that “it is well known that placebos are very effective, particularly in the area of pain, Parkinson’s disease, depression, migraine, and asthma” and described findings of placebo analgesia and open-label placebo studies. Further, the investigator mentioned that (b) the “body can automatically respond to placebos like Pavlov’s
dogs who salivated when they heard a bell” after explaining the classical conditioning theory.
In addition, “researchers assume that this culturally anchored ritual activates automatic selfhealing processes, which in turn may lead to an effective analgesia”. Finally, the investigator stated that (c) “an advantage of placebos is that a positive attitude can be helpful but is not necessary”. We did not mention the importance of compliance (i.e., taking the placebo faithfully is critical) as in Kaptchuk et al. [32], since our treatment consisted of a single
application of the placebo cream.
In the DP group, participants were told: “You are receiving a generic analgesic cream, which contains lidocaine, the main ingredient used in Stilex [a local anaesthetic commonly used in Switzerland]. The “Antidolor” cream prevents and treats pain or itching related to dermatological diseases such as small burns (…). The effectiveness of lidocaine was proven in several high quality studies.”– while in fact they received an inert placebo cream.
All participants in the three other groups (OPR-, OPR+, and DP)
received an inert white placebo cream. However, the provided rationale in the three groups differed.
In the OPR- group, participants were told: “You are receiving a placebo cream. This means that your cream does not contain any pharmacological ingredient, hence it is an inert substance”. No additional information regarding placebo mechanisms was provided to this group.
In the OPR+ group, participants were informed that they are receiving an inert placebo cream. In accordance with Kaptchuk et al. [32], the investigator explained that (a) the placebo effect is powerful, explaining that “it is well known that placebos are very effective, particularly in the area of pain, Parkinson’s disease, depression, migraine, and asthma” and described findings of placebo analgesia and open-label placebo studies. Further, the investigator mentioned that (b) the “body can automatically respond to placebos like Pavlov’s
dogs who salivated when they heard a bell” after explaining the classical conditioning theory.
In addition, “researchers assume that this culturally anchored ritual activates automatic selfhealing processes, which in turn may lead to an effective analgesia”. Finally, the investigator stated that (c) “an advantage of placebos is that a positive attitude can be helpful but is not necessary”. We did not mention the importance of compliance (i.e., taking the placebo faithfully is critical) as in Kaptchuk et al. [32], since our treatment consisted of a single
application of the placebo cream.
In the DP group, participants were told: “You are receiving a generic analgesic cream, which contains lidocaine, the main ingredient used in Stilex [a local anaesthetic commonly used in Switzerland]. The “Antidolor” cream prevents and treats pain or itching related to dermatological diseases such as small burns (…). The effectiveness of lidocaine was proven in several high quality studies.”– while in fact they received an inert placebo cream.
На предшествующей картинке - интенсивность боли после "лечения".
В этой таблице показатели до лечения, после, а в последних 2-х столбиках ожидаемые значения.
В группе OPR- интенсивность боли увеличилась (но не факт, что статистически значимо), а субъективная неприятность боли осталась прежней.
Группы довольно маленькие, по 37-40 человек. Статистическая достоверность различий выявлена только при сравнении группы открытого плацебо без объяснения с объединенной группой открытого плацебо с объяснением + закрытого плацебо.
Вот только это различие и следует обсуждать. Но стоит ли? Гора родила мышь.
NT - без лечения, OPR- открытое плацебо без объяснения, OPR+ открытое плацебо с объяснением, DP тайное (закрытое) плацебо
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Открытое плацебо БЕЗ объяснения уменьшило боль, но не
elgru в посте Metapractice (оригинал в ЖЖ)
При открытом плацебо, которое давалось без объяснения, почему оно должно действовать, боль была больше, чем при использовании открытого плацебо с объяснением.
Для полноты картины могли бы еще дать мазь с действующим веществом кому-то с объяснением/внушением, а кому-то - без. И сравнить эффект объяснения/внушения при использовании плацебо и при использовании конвенциональной аналгезии.
Most intriguingly, that the placebo group without any theoretical embedding displayed significantly higher subjective pain ratings than the placebo groups with a theoretical embedding indicates the special significance of the rationale itself. Clinicians should be aware that a convincing story behind an intervention leads to better outcomes - at least concerning
openly prescribed placebos.
The importance of a certain rationale, i.e. a verbal suggestion, is
also of relevance regarding the augmentation of nocebo effects [57] and in other domains such as in psychotherapy [8,22]. Therefore, our findings emphasise that the power of verbal suggestions deserves further scrutiny in relation to future placebo research. This is in line with the recommendation that physicians may best benefit from placebo effects by enhancing patients’ expectations through communication.
openly prescribed placebos.
The importance of a certain rationale, i.e. a verbal suggestion, is
also of relevance regarding the augmentation of nocebo effects [57] and in other domains such as in psychotherapy [8,22]. Therefore, our findings emphasise that the power of verbal suggestions deserves further scrutiny in relation to future placebo research. This is in line with the recommendation that physicians may best benefit from placebo effects by enhancing patients’ expectations through communication.
The research team used data from 1,079 participants from the MAPP study that included questionnaires capturing their pain severity and function. They were also asked to draw on a body map where they were experiencing pain.
Researchers then had a subset of the participants undergo functional and structural MRIs.
“Surprisingly, many of the individuals, in addition to having pain located in the pelvic region, had pain also widely distributed throughout their body,” Harris says. “Interestingly, when we put these individuals into the brain imaging scanner, we found that those who had widespread pain had increased gray matter and brain connectivity within sensory and motor cortical areas, when compared to pain-free controls.”
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Urological chronic pelvic pain syndrome patients with widespread pain showed increased brain gray matter volume and functional connectivity involving the sensorimotor and insular cortices.
“What was surprising was these individuals with widespread pain, although they had the diagnosis of urological chronic pelvic pain, were actually identical to another chronic pain disorder: fibromyalgia,” Harris says.
The team notes the changes in brain gray matter volume and functional connectivity were identical to outcomes present in fibromyalgia patients but were not seen in the pain-free control group.
“This study represents the fact that pelvic pain patients, a subset of them, have characteristics of fibromyalgia,” Harris says. “Not only do they have widespread pain, but also they have brain markers indistinguishable from fibromyalgia patients.”
Harris and colleagues hope this study provides physicians with the opportunity to look at new ways of treating chronic pain patients — as there might be similarities across pain conditions if both show widespread pain.
“We think that this type of study will help treat these patients because if they have a central nerve biological component to their disorder, they’re much more likely to benefit from targets that affect the central nervous system rather than from treatments that are aimed at the pelvic region,” Harris says.
Source:
http://labblog.uofmhealth.org/lab-report/does-widespread-pain-stem-from-brain-mri-study-investigates
Researchers then had a subset of the participants undergo functional and structural MRIs.
“Surprisingly, many of the individuals, in addition to having pain located in the pelvic region, had pain also widely distributed throughout their body,” Harris says. “Interestingly, when we put these individuals into the brain imaging scanner, we found that those who had widespread pain had increased gray matter and brain connectivity within sensory and motor cortical areas, when compared to pain-free controls.”
Related Stories
Researchers get closer to creating new blood test that can identify breast cancer brain metastasis
Researchers discover way to stop deadly fungus from spreading to the brain
Scientists use magnetic nanoparticles to trigger activity deep inside the brain
Urological chronic pelvic pain syndrome patients with widespread pain showed increased brain gray matter volume and functional connectivity involving the sensorimotor and insular cortices.
“What was surprising was these individuals with widespread pain, although they had the diagnosis of urological chronic pelvic pain, were actually identical to another chronic pain disorder: fibromyalgia,” Harris says.
The team notes the changes in brain gray matter volume and functional connectivity were identical to outcomes present in fibromyalgia patients but were not seen in the pain-free control group.
“This study represents the fact that pelvic pain patients, a subset of them, have characteristics of fibromyalgia,” Harris says. “Not only do they have widespread pain, but also they have brain markers indistinguishable from fibromyalgia patients.”
Harris and colleagues hope this study provides physicians with the opportunity to look at new ways of treating chronic pain patients — as there might be similarities across pain conditions if both show widespread pain.
“We think that this type of study will help treat these patients because if they have a central nerve biological component to their disorder, they’re much more likely to benefit from targets that affect the central nervous system rather than from treatments that are aimed at the pelvic region,” Harris says.
Source:
http://labblog.uofmhealth.org/lab-report/does-widespread-pain-stem-from-brain-mri-study-investigates
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Дочитали до конца.