Placebo and Pain: From Bench to Bedside by Luana Colloca, Magne Arve Flaten, Karin Meissner

By Luana Colloca, Magne Arve Flaten, Karin Meissner

The placebo impact maintains to fascinate scientists, students, and clinicians, leading to a powerful quantity of analysis, ordinarily within the box of soreness. whereas contemporary experimental and scientific reviews have unraveled salient elements of the neurobiological substrates and scientific relevance of ache and placebo analgesia, an authoritative resource remained missing beforehand. through featuring and integrating a large diversity of study, Placebo and Pain complements readers’ wisdom approximately placebo and nocebo results, reexamines the method of scientific trials, and improves the healing ways for sufferers struggling with pain.

Review for Placebo and Pain: “This formidable booklet is the 1st accomplished and unified presentation of the placebo and nocebo phenomena within the quarter of soreness. Written via the overseas major specialists within the box, the e-book presents a correct updated [work] on placebo and soreness facing present views and destiny not easy issues.”--Ted Kaptchuk, affiliate Professor of drugs, Harvard scientific School

  • Contains historic elements of the placebo effect 
  • Discusses organic and mental mechanisms of placebo analgesic responses
  • Reviews implications of the placebo impact for scientific learn and ache management
  • Includes methodological and moral elements of the placebo effect

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Placebo and Pain: From Bench to Bedside

The placebo influence keeps to fascinate scientists, students, and clinicians, leading to a magnificent quantity of study, often within the box of discomfort. whereas fresh experimental and medical experiences have unraveled salient features of the neurobiological substrates and scientific relevance of discomfort and placebo analgesia, an authoritative resource remained missing before.

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In what has become a classic study of components related to the development of placebo analgesic effects, Historically, placebo effects have been reported consistently since the emergence of placebo-controlled trials in the 18th century, when putatively active treatments were for the first time compared against ‘sham’ controls. ’1 In the widely quoted Beecher report of clinical trials of analgesic drugs,2 it was noted that placebos exerted significant clinical responses in approximately 30% of patients enrolled in inactive treatment groups (Ch 1).

J Neurosci. 2001;21(2):732-740. Uslaner J, Badiani A, Day HE, et al. Environmental context modulates the ability of cocaine and amphetamine to induce c-fos mRNA expression in the neocortex, caudate nucleus, and nucleus accumbens. Brain Res. 2001;920(1–2):106-116. de la Fuente-Fernandez R, Phillips AG, Zamburlini M, et al. Dopamine release in human ventral striatum and expectation of reward. Behav Brain Res. 2002;136(2):359-363. Mayberg HS, Silva JA, Brannan SK, et al. The functional neuroanatomy of the placebo effect.

After the experiments were conducted, the perceived effectiveness of the placebo was rated at 42 ± 29. Significant endogenous opioid activation was observed in the pre- and subgenual rACC, orbitofrontal cortex (OFC), anterior insula (aINS) and pINS, medial thalamus (mTHA), NAC, amygdala (AMY) and periaqueductal gray (PAG). There was a notable lack of involvement of the DLPFC in these results, while activation in the OFC was observed instead. Regional magnitudes of activation correlated with the subjects’ expected analgesia (NAC, PAG), the update of these verbally-induced expectations by the subjectively perceived efficacy of the placebo (the ratio between observed and expected efficacy) (NAC, AMY), as well as with placebo-induced changes in pain intensity (rACC, NAC, OFC).

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