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Placebo and Pain
Donald D. PriceLene Vase
其他書名
Chapter 21. The Contribution of Desire, Expectation, and Reduced Negative Emotions to Placebo Anti-Hyperalgesia in Irritable Bowel Syndrome
出版Elsevier Inc. Chapters, 2013-08-28
主題Medical / NeurologyMedical / NeuroscienceScience / Life Sciences / NeuroscienceMedical / Pain Management
ISBN01280642859780128064283
URLhttp://books.google.com.hk/books?id=9GxzDAAAQBAJ&hl=&source=gbs_api
EBookSAMPLE
註釋Persistent pain conditions, such as irritable bowel syndrome (IBS), are often accompanied by primary and widespread secondary hyperalgesia, as evidenced by higher pain ratings in response to induced heat stimuli. These forms of hyperalgesia are not static but are dynamically maintained by impulse input from colorectal tissues as well as descending inhibition and facilitation. Two phenomena that closely relate to descending control are nocebo and placebo effects. The latter occur in relation to treatments and are partly mediated by desire for relief, expected pain intensity, and reduced negative emotions. These factors can predict clinical outcomes and could be very useful in managing placebo responses in clinical trials. Evidence also exists that tonic peripheral input and descending inhibition/facilitation interact synergistically such that removing either component alone has potent anti-hyperalgesic effects in the case of IBS. This principle may apply to other persistent pain conditions, including neuropathic pain.