Are Children the Better Placebo Analgesia Responders? An Experimental Approach

JOURNAL OF PAIN

卷:16

Article

Wrobel, Nathalie^1,2  Fadai, Tahmine³  Sprenger, Christian^2,3  Hebebrand, Johannes⁴  Wiech, Katja^5,6  Bingel, Ulrike¹ 

[1] Univ Hosp Essen, Dept Neurol, Essen, Germany

[2] Univ Med Ctr Hamburg Eppendorf, Dept Neurol, Hamburg, Germany

[3] Univ Med Ctr Hamburg Eppendorf, Dept Syst Neurosci, Hamburg, Germany

[4] Univ Duisburg Essen, Dept Child & Adolescent Psychiat & Psychothe, Essen, Germany

[5] Univ Oxford, Oxford Ctr Funct Magnet Resonance Imaging Brain, Oxford, England

[6] Univ Oxford, John Radcliffe Hosp, Nuffield Dept Clin Neurosci, Oxford OX3 9DU, England

关键词: Placebo analgesia;    placebo effect;    experimental pain;    children;    adolescent;    adults;    learning;   

DOI  :  10.1016/j.jpain.2015.06.013

来源: Elsevier

【 摘 要 】

There is little information regarding changes in placebo responsiveness with age, although first predictors of placebo responders such as psychological and physiological processes have been identified. Reviews and meta-analyses indicate that placebo response rates in randomized controlled trials (RCTs) are higher in children and adolescents compared with adults. As these studies cannot control for age-dependent differences in the natural course of the disease, biases might contribute to different placebo rates in RCTs. To avoid these biases, this study investigated age-related differences in placebo responsiveness between children and adults in a well-established experimental model of placebo analgesia combining classic conditioning and expectation. Our data confirm placebo analgesic responses in children, which did not differ in magnitude from those of adults. The influence of previous experience on subsequent treatment outcome was stronger in children than in adults, indicating an increased relevance of learning processes for treatment outcomes in children. Further studies are needed to understand the influence of treatment-related learning processes in children and adolescents, which might critically determine treatment responsiveness during adulthood. Perspective: This study is the first to experimentally explore placebo analgesia and influences of previous experience on placebo responses in children compared with adults. We found comparable placebo responses in both groups and an increased relevance of learning processes for treatment outcomes in children. (C) 2015 by the American Pain Society

【 授权许可】

Free