Nocebo Responses in Brain Diseases: A Systematic Review of the Current Literature

Publication date: Available online 2 August 2018Source: International Review of NeurobiologyAuthor(s): Panagiotis Zis, Dimos-Dimitrios MitsikostasAbstractPlacebo is an intervention with no therapeutic effect that is used as a control in randomized controlled trials (RCTs). Placebo effects and responses can produce a beneficial effect that cannot be attributed to the properties of the intervention itself, since it is usually inactive, and should, therefore, be due to the patient's expectations about treatment (placebo effects), or confounding factors such as natural history, co-interventions, biases, among other co-factors (placebo responses). However, adverse events (AEs) may occur when using a placebo intervention, a phenomenon that is called nocebo. Like placebo, the nocebo effect is a cognitive and idiosyncratic phenomenon with specific biological bases, controlled by distinctive neurotransmitters within mapped brain areas most likely located within the network of the limbic system.Nocebo responses has been found to be very prevalent in various neurological conditions, in particular, in many brain disorders including headache, Parkinson's disease, Alzheimer's disease, depression, epilepsy, multiple sclerosis and motor neuron disease. Pooled AE rates in the placebo groups (nocebo AE rates) vary from 25% in the symptomatic treatment for multiple sclerosis RCTs to almost 80% in motor neuron disease RCTs. Pooled dropout rates because of AEs in the placebo groups (i.e., nocebo ...
Source: International Review of Neurobiology - Category: Neuroscience Source Type: research

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Conclusions:DORAs offer an additional treatment option for insomnia. More clinical trials are needed to robustly evaluate their safety and effectiveness in several subclasses of individuals with insomnia. Given the published literature, head-to-head comparisons to existing treatment for insomnia are warranted.Citation:Janto K, Prichard JR, Pusalavidyasagar S. An update on dual orexin receptor antagonists and their potential role in insomnia therapeutics.J Clin Sleep Med. 2018;14(8):1399–1408.
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
We describe an 8-year-old male with a pathogenicUNC80 mutation, intellectual disability, hypotonia and epilepsy with severe central sleep apnea (213.5 events/h) on polysomnography (PSG). We also describe a 20-month-old female with aKCNJ11 mutation, neonatal diabetes and developmental delay who had severe central sleep apnea (131.1 events/h). Both patients had irregular respiratory patterns during sleep and wakefulness and were placed on empiric bilevel positive airway pressure therapy, which was well tolerated with resolution of abnormal respiratory control and hypercapnia. Patients withUNC80 andKCNJ11 gene mutations may h...
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
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Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research
Dr Ruth Webster, of the George Institute for Global Health in Australia, said: 'Our results could help millions of people globally reduce their blood pressure and their risk of heart attack or stroke.'
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Authors: Choy M Abstract Lofexidine hydrocholoride (Lucemyra) for opioid withdrawal; erenumab-aooe (Aimovig) for migraine; and sodium zirconium cyclosilicate (Lokelma) for hyperkalemia. PMID: 30100686 [PubMed]
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ConclusionThe detailed surgical procedure of slMFB DBS implantation has not been described before. The slMFB emerges as an interesting region for the treatment of major depression (and other psychiatric diseases) with DBS. So far it has only been successfully researched in open label clinical case series and in 15 patients published. Stimulation probably achieves its effect through direct white-matter modulation of slMFB fibers. The surgical implantation comprises a standardized protocol combining tractographic imaging based on DTI, targeting and electrophysiological evaluation of the target region. To this end, slMFB DBS ...
Source: NeuroImage: Clinical - Category: Radiology Source Type: research
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