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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dc.contributor.authorCastelnuovo, Gianlucaen
dc.contributor.authorGiusti, Emanuele Mariaen
dc.contributor.authorManzoni, Gian Mauroen
dc.contributor.authorSaviola, Donatellaen
dc.contributor.authorGabrielli, Samanthaen
dc.contributor.authorLacerenza, Marcoen
dc.contributor.authorPietrabissa, Giadaen
dc.contributor.authorCattivelli, Robertoen
dc.contributor.authorSpatola, Chiara Anna Mariaen
dc.contributor.authorRossi, Alessandroen
dc.contributor.authorVarallo, Giorgiaen
dc.contributor.authorNovelli, Margheritaen
dc.contributor.authorVilla, Valentinaen
dc.contributor.authorLuzzati, Francescaen
dc.contributor.authorCottini, Andreaen
dc.contributor.authorLai, Carloen
dc.contributor.authorVolpato, Eleonoraen
dc.contributor.authorCavalera, Cesareen
dc.contributor.authorPagnini, Francescoen
dc.contributor.authorTesio, Valentinaen
dc.contributor.authorCastelli, Lorysen
dc.contributor.authorTavola, Marioen
dc.contributor.authorTorta, Riccardoen
dc.contributor.authorArreghini, Marcoen
dc.contributor.authorZanini, Loredanaen
dc.contributor.authorBrunani, Ameliaen
dc.contributor.authorSeitanidis, Ionathanen
dc.contributor.authorVentura, Giuseppeen
dc.contributor.authorCapodaglio, Paoloen
dc.contributor.authorD'Aniello, Guido Edoardoen
dc.contributor.authorScarpina, Federicaen
dc.contributor.authorBrioschi, Andreaen
dc.contributor.authorBigoni, Matteoen
dc.contributor.authorPriano, Lorenzoen
dc.contributor.authorMauro, Alessandroen
dc.contributor.authorRiva, Giuseppeen
dc.contributor.authorDi Lernia, Danieleen
dc.contributor.authorRepetto, Claudiaen
dc.contributor.authorRegalia, Camilloen
dc.contributor.authorMolinari, Enricoen
dc.contributor.authorNotaro, Paoloen
dc.contributor.authorPaolucci, Stefanoen
dc.contributor.authorSandrini, Giorgioen
dc.contributor.authorSimpson, Susanen
dc.contributor.authorWiederhold, Brenda Kayen
dc.contributor.authorGaudio, Santinoen
dc.contributor.authorJackson, Jeffrey B.en
dc.contributor.authorTamburin, Stefanoen
dc.contributor.authorBenedetti, Fabrizioen
dc.date.accessioned2019-10-29T17:26:57Zen
dc.date.available2019-10-29T17:26:57Zen
dc.date.issued2018-05-18en
dc.description.abstractBackground: 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.en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.3389/fneur.2018.00310en
dc.identifier.issn1664-2295en
dc.identifier.other310en
dc.identifier.pmid29867723en
dc.identifier.urihttp://hdl.handle.net/10919/95197en
dc.identifier.volume9en
dc.language.isoenen
dc.publisherFrontiersen
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectneurorehabilitationen
dc.subjectplaceboen
dc.subjectpainen
dc.subjectclinical psychologyen
dc.subjecthealth psychologyen
dc.subjectplacebo effecten
dc.subjectconsensus conferenceen
dc.titleWhat Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitationen
dc.title.serialFrontiers in Neurologyen
dc.typeReviewen
dc.type.dcmitypeTexten
dc.type.dcmitypeStillImageen

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Destination Area: Adaptive Brain and Behavior (ABB)