What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation.
What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation.
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DOI：
10.3389/fneur.2018.00310
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发表时间：
2018
影响因子：
3.4
通讯作者：
Benedetti F
中科院分区：
文献类型：
--
作者：
Castelnuovo G;Giusti EM;Manzoni GM;Saviola D;Gabrielli S;Lacerenza M;Pietrabissa G;Cattivelli R;Spatola CAM;Rossi A;Varallo G;Novelli M;Villa V;Luzzati F;Cottini A;Lai C;Volpato E;Cavalera C;Pagnini F;Tesio V;Castelli L;Tavola M;Torta R;Arreghini M;Zanini L;Brunani A;Seitanidis I;Ventura G;Capodaglio P;D'Aniello GE;Scarpina F;Brioschi A;Bigoni M;Priano L;Mauro A;Riva G;Di Lernia D;Repetto C;Regalia C;Molinari E;Notaro P;Paolucci S;Sandrini G;Simpson S;Wiederhold BK;Gaudio S;Jackson JB;Tamburin S;Benedetti F
人们越来越认识到，通过安慰剂效应的机制，医学治疗的结果受到临床遭遇背景的影响。安慰剂镇痛的现象可能被利用，以最大限度地提高神经康复治疗的疗效。由于其强度因神经系统疾病而异，意大利神经康复疼痛共识会议（ICCP）总结了该领域的研究，以提供其使用指南。对现有的综述和荟萃分析进行了综述，以评估可能接受神经康复治疗的疾病中安慰剂效应的程度。使用安慰剂、疼痛和神经系统疾病名称作为关键词在Pubmed上进行检索。使用预先存在的检查表评估方法质量。关于安慰剂效应大小的数据从纳入的综述中提取，并以叙述形式进行评论。11篇文章被纳入本综述。安慰剂治疗对中枢神经性疼痛的影响较弱（疼痛从0-10量表的0.44降至0.66），对带状疱疹后神经痛（1.16）、糖尿病周围神经病变（1.45）和HIV相关疼痛（1.82）的影响中等。对纤维肌痛和偏头痛引起的疼痛也有中度影响;在复杂的区域疼痛综合征中只发现了微弱的短期影响。混杂变量可能会影响这些结果。这些估计值应该谨慎解释，但强调安慰剂效应可以在神经康复计划中利用。没有必要向患者隐瞒其用途。安慰剂机制的知识可用于塑造医患关系，减少镇痛药物的使用，并训练患者成为治疗的积极参与者。
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. 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. 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. 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.
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影响因子：
7.4
作者：
De Pascalis, V;Chiaradia, C;Carotenuto, E
通讯作者：
Carotenuto, E
影响因子：
3.8
作者：
Darragh, Margot;Booth, Roger J.;Consedine, Nathan S.
通讯作者：
Consedine, Nathan S.
影响因子：
82.9
作者：
Benedetti, Fabrizio;Amanzio, Martina;Blanchard, Catherine
通讯作者：
Blanchard, Catherine
影响因子：
3.8
作者：
Castelnuovo G;Giusti EM;Manzoni GM;Saviola D;Gatti A;Gabrielli S;Lacerenza M;Pietrabissa G;Cattivelli R;Spatola CA;Corti S;Novelli M;Villa V;Cottini A;Lai C;Pagnini F;Castelli L;Tavola M;Torta R;Arreghini M;Zanini L;Brunani A;Capodaglio P;D'Aniello GE;Scarpina F;Brioschi A;Priano L;Mauro A;Riva G;Repetto C;Regalia C;Molinari E;Notaro P;Paolucci S;Sandrini G;Simpson SG;Wiederhold B;Tamburin S
通讯作者：
Tamburin S
影响因子：
39.2
作者：
BRODY, H
通讯作者：
BRODY, H