Kosek, Eva, Rosen, Annelie, Carville, Serena, Choy, Ernest, Gracely, Richard H., Marcus, Hanke, Petzke, Frank, Ingvar, Martin ORCID: 0000-0002-9041-5714 and Jensen, Karin B. (2017). Lower Placebo Responses After Long-Term Exposure to Fibromyalgia Pain. J. Pain, 18 (7). S. 835 - 844. EDINBURGH: CHURCHILL LIVINGSTONE. ISSN 1526-5900
Full text not available from this repository.Abstract
Knowledge about placebo mechanisms in patients with chronic pain is scarce. Fibromyalgia syndrome (FM) is associated with dysfunctions of central pain inhibition, and because placebo analgesia entails activation of endogenous pain inhibition, we hypothesized that long-term exposure to FM pain would negatively affect placebo responses. In our study we examined the placebo group (n = 37, mean age 45 years) from a 12-week, randomized, double-blind, placebo-controlled trial investigating the effects of milnacipran or placebo. Twenty-two patients were classified as placebo non responders and 15 as responders, according to the Patient Global Impression of Change scale. Primary outcome was the change in pressure pain sensitivity from baseline to post-treatment. Secondary outcomes included ratings of clinical pain (visual analog scale), FM effect (Fibromyalgia Impact Questionnaire), and pain drawing. Among placebo responders, longer FM duration was associated with smaller reductions in pressure pain sensitivity (r=.689, P=.004), but not among nonresponders (r=.348, P=.112). In our study we showed that FM duration influences endogenous pain regulation, because pain levels and placebo-induced analgesia were negatively affected. Our results point to the importance of early FM interventions, because endogenous pain regulation may still be harnessed at that early time. Also, placebo-controlled trials should take FM duration into consideration when interpreting results. Perspective: This study presents a novel perspective on placebo analgesia, because placebo responses among patients with chronic pain were analyzed. Long-term exposure to fibromyalgia pain was associated with lower placebo analgesia, and the results show the importance of taking pain duration into account when interpreting the results from placebo-controlled trials. (C) 2017 The Authors. Published by Elsevier Inc. on behalf of the American Pain Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Item Type: | Journal Article | ||||||||||||||||||||||||||||||||||||||||
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URN: | urn:nbn:de:hbz:38-226693 | ||||||||||||||||||||||||||||||||||||||||
DOI: | 10.1016/j.jpain.2017.02.434 | ||||||||||||||||||||||||||||||||||||||||
Journal or Publication Title: | J. Pain | ||||||||||||||||||||||||||||||||||||||||
Volume: | 18 | ||||||||||||||||||||||||||||||||||||||||
Number: | 7 | ||||||||||||||||||||||||||||||||||||||||
Page Range: | S. 835 - 844 | ||||||||||||||||||||||||||||||||||||||||
Date: | 2017 | ||||||||||||||||||||||||||||||||||||||||
Publisher: | CHURCHILL LIVINGSTONE | ||||||||||||||||||||||||||||||||||||||||
Place of Publication: | EDINBURGH | ||||||||||||||||||||||||||||||||||||||||
ISSN: | 1526-5900 | ||||||||||||||||||||||||||||||||||||||||
Language: | English | ||||||||||||||||||||||||||||||||||||||||
Faculty: | Unspecified | ||||||||||||||||||||||||||||||||||||||||
Divisions: | Unspecified | ||||||||||||||||||||||||||||||||||||||||
Subjects: | no entry | ||||||||||||||||||||||||||||||||||||||||
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Refereed: | Yes | ||||||||||||||||||||||||||||||||||||||||
URI: | http://kups.ub.uni-koeln.de/id/eprint/22669 |
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