Placebo analgesia effects across central nervous system diseases: what do we know and where do we need to go?

Susan Tomczak Matthiesen; Sigrid Juhl Lunde; Sophie Wohlert Kjær; Elisa Carlino; Lene Vase

doi:10.1097/PR9.0000000000000717

Placebo analgesia effects across central nervous system diseases: what do we know and where do we need to go?

Pain Rep. 2019 Jun 7;4(3):e717. doi: 10.1097/PR9.0000000000000717. eCollection 2019 May-Jun.

Authors

Susan Tomczak Matthiesen¹, Sigrid Juhl Lunde¹, Sophie Wohlert Kjær¹, Elisa Carlino², Lene Vase¹

Affiliations

¹ Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark.
² Department of Neuroscience, University of Turin Medical School, Turin, Italy.

Abstract

Placebo effects are well established in healthy participants experiencing experimental or acute pain. Yet, little is known about the mechanisms of placebo analgesia effects in patients with chronic pain and even less is known in patients suffering from central nervous system (CNS) diseases where pain is prevalent, difficult to manage, and often undertreated. This article briefly reviews the current knowledge of placebo analgesia effects in healthy participants with the aim of discussing how the mechanisms in placebo analgesia differ between healthy participants and patients. The focus will be on placebo analgesia effects in chronic pain conditions as well as in 2 CNS diseases: Alzheimer disease and Parkinson disease. Finally, strengths and weaknesses of the current knowledge will be discussed and it will be demonstrated how insights from the placebo literature may point to new ways of improving treatments among patients experiencing pain in relation to CNS diseases.

Keywords: Central nervous system diseases; Chronic pain; Open/hidden design; Placebo analgesia effects.