Citation

Polich G, Iaccarino MA, Kaptchuk TJ, Morales-Quezada L, Zafonte R. Am. J. Phys. Med. Rehabil. 2019; ePub(ePub): ePub.

Affiliation

Instructor in Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; Home Base a Red Sox Foundation and Massachusetts General Hospital Program; Brigham and Women's Hospital, Boston, MA, USA. Telephone: 617-952-5243 | Fax: 617-952-5934. gpolich@partners.org Instructor in Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; MassGeneral Hospital for Children Sport Concussion Program; Home Base a Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts, USA. Telephone: 617-952-5243 | Fax: 617-952-5934. miaccarino@partners.org Professor of Medicine, Program in Placebo Studies & Therapeutic Encounter, Department of General Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. Telephone: 617-945-7827. ted_kaptchuk@hms.harvard.edu Associate Research Director, Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA, Telephone: 617-952-5243 | Fax: 617-952-5934. jmorales-quezada@partners.org Earl P. and Ida S. Charlton Professor, Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; Massachusetts General Hospital; Brigham and Women's Hospital; Home Base a Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts, USA, Telephone: 617-952-5243 | Fax: 617-952-5934. rzafonte@mgh.harvard.edu.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/PHM.0000000000001290

PMID

31393270

Abstract

Nocebo effects refer to new or worsening symptoms that develop in response to negative health-related information, beliefs, and/or experiences. In recent years, research on concussion pathophysiology has significantly advanced. Through health campaigns and media coverage, emerging knowledge on the risks of this injury has been quickly disseminated to the public, and nowadays the public perceives concussions as more hazardous to health than ever before. While advancements in concussion-related research and care are of great importance and value, we ask in this article whether the increasing negative publicity regarding concussion also carries any latent costs. Are additional nocebo effects being fostered? To do so, we will review the literature on the psychological and neurobiological processes underlying nocebo effects, present a series of clinical studies demonstrating the ways in which nocebos may impact concussion outcomes both clinically and societally, then speculate on further potential mechanisms for nocebo effects in concussion. We conclude with an outline of the specific efforts one may take to minimize nocebo effects in concussion-related care.

Language: en