Citation

Polich G, Iaccarino MA, Kaptchuk TJ, Morales-Quezada L, Zafonte R. J. Neurotrauma 2018; 35(11): 1205-1212.

Affiliation

Harvard Medical School, 1811, Boston, Massachusetts, United States ; rzafonte@partners.org.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5506

PMID

29343158

Abstract

In recent years, several randomized controlled trials evaluating pharmaceutical treatments for traumatic brain injury (TBI) have failed to demonstrate efficacy over placebo, with both active and placebo arms improving at comparable rates. These findings could be viewed in opposing ways, suggesting on the one hand failure of the tested outcome, but representing on the other, evidence of robust placebo effects in TBI. In this article, we examine several of the primary psychological processes driving placebo effects (verbal suggestion, cognitive re-framing, interpersonal interactions, conditioning, therapeutic alliance, anxiety reduction) as well as placebo neurobiology (top-down cortical regulation, reward system activation, dopaminergic and serotonergic neurotransmission). We then extrapolate from the literature to explore whether something inherent to TBI makes it particularly responsive to placebos. Viewed as such here, placebos may indeed be a powerful and effective treatment for a variety of post-TBI complaints.

Language: en

Keywords

Behavior; REHABILITATION; TRAUMATIC BRAIN INJURY