Is placebo analgesia for heat pain a sensory effect? An exploratory study on minimizing the influence of response bias.
Is placebo analgesia for heat pain a sensory effect? An exploratory study on minimizing the influence of response bias.
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热痛的安慰剂镇痛是感觉效应吗？
DOI：
10.1016/j.ynpai.2018.09.001
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Bushnell,MCatherine
中科院分区：
文献类型：
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作者：
Case,LauraK;Laubacher,ClaireM;Richards,EmilyA;Grossman,Matthew;Atlas,LaurenY;Parker,Scott;Bushnell,MCatherine
我们探讨了一个持续存在的问题，即安慰剂镇痛是否会在一种新颖的范式中改变传入的伤害性处理，该范式旨在最大限度地减少安慰剂测量中反应偏差的作用。首先，健康的成年参与者接受标准的热安慰剂诱导和调节程序，使用局部“镇痛”霜涂抹在一只手臂上。在随后的安慰剂测试过程中，参与者对接受安慰剂治疗的手臂和未经治疗的手臂上的刺激进行评分，使用的任务最大限度地减少了受试者猜测预期反应的能力，从而减少了实验者的需求。回顾性参与者报告了中等镇痛效果（平均值 = 5.3/10），但对于个人温度评级，只有 2 名受试者表现出感知安慰剂反应 > 5 分。接下来，这些受试者完成了一项新颖的探索性任务，旨在测量臂间辨别准确性的变化，这可以通过传入伤害感受的变化来预测。当安慰剂臂上发生较热的刺激时，两名安慰剂应答者（但没有非应答者）表现出辨别能力降低，这种效应与伤害性传入流的变化一致，并且不太可能是由应答偏差引起的。
We explored the ongoing question of whether placebo analgesia alters afferent nociceptive processing in a novel paradigm designed to minimize the role of response bias in placebo measurement. First, healthy adult participants received a standard heat placebo induction and conditioning procedure using a topical “analgesic” cream applied to one arm. During a subsequent placebo testing procedure, participants rated stimuli on the placebo-treated arm and untreated arm, using a task that minimized subjects’ ability to guess the expected response, thus reducing experimenter demand. Retrospectively participants reported moderate analgesia effectiveness (mean=5.3/10), but for individual temperature ratings, only 2 subjects exhibited a perceptual placebo response >5 points. Next, these subjects completed a novel, exploratory task designed to measure changes in inter-arm in discriminative accuracy that would be expected from changes in afferent nociception. Both placebo responders (but no non-responders) showed reduced discriminative ability when the hotter stimulus occurred on the placebo arm, an effect consistent with alterations in nociceptive afferent flow and unlikely to be caused by response bias.