Nocebo Responses in Brain Diseases: A Systematic Review of the Current Literature

International Review of Neurobiology
Panagiotis Zis, Dimos-Dimitrios Mitsikostas

Abstract

Placebo is an intervention with no therapeutic effect that is used as a control in randomized controlled trials (RCTs). Placebo effects and responses can produce a beneficial effect that cannot be attributed to the properties of the intervention itself, since it is usually inactive, and should, therefore, be due to the patient's expectations about treatment (placebo effects), or confounding factors such as natural history, co-interventions, biases, among other co-factors (placebo responses). However, adverse events (AEs) may occur when using a placebo intervention, a phenomenon that is called nocebo. Like placebo, the nocebo effect is a cognitive and idiosyncratic phenomenon with specific biological bases, controlled by distinctive neurotransmitters within mapped brain areas most likely located within the network of the limbic system. Nocebo responses has been found to be very prevalent in various neurological conditions, in particular, in many brain disorders including headache, Parkinson's disease, Alzheimer's disease, depression, epilepsy, multiple sclerosis and motor neuron disease. Pooled AE rates in the placebo groups (nocebo AE rates) vary from 25% in the symptomatic treatment for multiple sclerosis RCTs to almost 80% in...Continue Reading

Citations

Mar 22, 2019·Neuromodulation : Journal of the International Neuromodulation Society·Panagiotis ZisPtolemaios G Sarrigiannis
Aug 10, 2019·Frontiers in Pharmacology·Ioanna SpanouDimos D Mitsikostas
Feb 7, 2019·BMC Medicine·Panagiotis Zis, Panagiota Sykioti
Nov 28, 2020·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Elan A CohenWilliam P Horan

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