Skip to main content

Placeboeffekte in der Schmerzmedizin

  • Living reference work entry
  • Latest version View entry history
  • First Online:
Praktische Schmerzmedizin

Part of the book series: Springer Reference Medizin ((SRM))

  • 308 Accesses

Zusammenfassung

Der Placeboeffekt unterliegt seit einigen Jahren einem starken Paradigmenwechsel: Ursprünglich wurde er als unerklärbares, eher mystisches Phänomen angesehen, heute wird er vor dem Hintergrund einer Vielzahl empirischer Befunde zu seiner Wirksamkeit und seinen Wirkmechanismen zunehmend als nachvollziehbarer Prozess in Forschung und Klinik wahrgenommen. Placeboeffekte werden nicht mehr nur auf „unspezifische Effekte“ reduziert. Neuerdings wird sogar diskutiert, wie der Placeboeffekt im klinischen Bereich nutzbringend eingesetzt werden kann.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Literatur

  • Ader R (1997) Processes underlying placebo effects – the preeminence of conditioning. Pain Forum 6:56–58

    Article  Google Scholar 

  • Amanzio M, Benedetti F (1999) Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specific subsystems. J Neurosci 19:484–494

    CAS  PubMed  Google Scholar 

  • Bandura A, Ross SA, Ross D (1963) A comparative test of status envy, social power, and secondary reinforcement theories of identificatory learning. J Abnorm Psychol 67:527–536

    Article  CAS  PubMed  Google Scholar 

  • Benedetti F (2006) Placebo analgesia. Neurol Sci 27(Suppl 2):100–102

    Article  Google Scholar 

  • Benedetti F, Arduino C, Amanzio M (1999) Somatotopic activation of opioid systems by target-directed expectations of analgesia. J Neurosci 19:3639–3648

    CAS  PubMed  Google Scholar 

  • Benedetti F, Pollo A, Lopiano L, Lanotte M, Vighetti S, Rainero I (2003) Conscious expectation and unconscious conditioning in analgesic, motor, and hormonal placebo/nocebo responses. J Neurosci 23:4315–4323

    CAS  PubMed  Google Scholar 

  • Benedetti F, Arduino C, Costa S, Vighetti S, Tarenzi L, Rainero I et al (2006) Loss of expectation-related mechanisms in Alzheimer’s disease makes analgesic therapies less effective. Pain 121:133–144

    Article  CAS  PubMed  Google Scholar 

  • Benedetti F, Amanzio M, Rosato R, Blanchard C (2011) Nonopioid placebo analgesia is mediated by CB1 cannabinoid receptors. Nat Med 17:1228

    Article  CAS  PubMed  Google Scholar 

  • Bingel U, Lorenz J, Schoell E, Weiller C, Buchel C (2006) Mechanisms of placebo analgesia: rACC recruitment of a subcortical antinociceptive network. Pain 120:8–15

    Article  CAS  PubMed  Google Scholar 

  • Blasini M, Corsi N, Klinger R, Colloca L (2017) Nocebo and pain: an overview of the psychoneurobiological mechanisms. Pain Rep 2(2):e585

    Article  PubMed  PubMed Central  Google Scholar 

  • Brody HBD (2002) Der Placebo-Effekt. Die Selbstheilungskräfte unseres Körpers. DTV, München

    Google Scholar 

  • Colloca L, Benedetti F (2009) Placebo analgesia induced by social observational learning. Pain 144:28–34

    Article  PubMed  Google Scholar 

  • Colloca L, Lopiano L, Lanotte M, Benedetti F (2004) Overt versus covert treatment for pain, anxiety, and Parkinson’s disease. Lancet Neurol 3:679–684

    Article  PubMed  Google Scholar 

  • Colloca L, Sigaudo M, Benedetti F (2008a) The role of learning in nocebo and placebo effects. Pain 136:211–218

    Article  CAS  PubMed  Google Scholar 

  • Colloca L, Tinazzi M, Recchia S, Le Pera D, Fiaschi A, Benedetti F et al (2008b) Learning potentiates neurophysiological and behavioral placebo analgesic responses. Pain 139:306–314

    Article  PubMed  Google Scholar 

  • Colloca L, Klinger R, Flor H, Bingel U (2013) Placebo analgesia: psychological and neurobiological mechanisms. Pain 154(4):511

    Article  PubMed  PubMed Central  Google Scholar 

  • DIVS (2008) S3-Leitlinie Behandlung akuter perioperativer und posttraumatischer Schmerzen (Bd AWMF-Reg.-Nr. 041/001). Deutscher Ärzte-Verlag, Köln

    Google Scholar 

  • Eippert F, Finsterbusch J, Bingel U, Buchel C (2009a) Direct evidence for spinal cord involvement in placebo analgesia. Science 326:404

    Article  CAS  PubMed  Google Scholar 

  • Eippert F, Bingel U, Schoell ED, Yacubian J, Klinger R, Lorenz J et al (2009b) Activation of the opioidergic descending pain control system underlies placebo analgesia. Neuron 63:533–543

    Article  CAS  PubMed  Google Scholar 

  • Enck P, Benedetti F, Schedlowski M (2008) New insights into the placebo and nocebo responses. Neuron 59:195–206

    Article  CAS  PubMed  Google Scholar 

  • Finniss DG, Kaptchuk TJ, Miller F, Benedetti F (2010) Biological, clinical, and ethical advances of placebo effects. Lancet 375:686–695

    Article  PubMed  PubMed Central  Google Scholar 

  • Hrobjartsson A, Gotzsche PC (2003) Unreliable analysis of placebo analgesia in trials of placebo pain mechanisms. Pain 104:714–715. author reply 715–716

    Article  PubMed  Google Scholar 

  • Hrobjartsson A, Gotzsche PC (2004) Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no treatment. J Intern Med 256:91–100

    Article  CAS  PubMed  Google Scholar 

  • Kaptchuk TJ, Friedlander E, Kelley JM, Sanchez MN, Kokkotou E, Singer JP, Kowalczykowski M, Miller FG, Kirsch I, Lembo AJ (2010) Placebos without deception: a randomized controlled trial in irritable bowel syndrome. PLoS One 5:e15591

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kelley JM, Lembo AJ, Ablon JS, Villanueva JJ, Conboy LA, Levy R, Marci CD, Kerr CE, Kirsch I, Jacobson EE, Riess H, Kaptchuk TJ (2009) Patient and practitioner influences on the placebo effect in irritable bowel syndrome. Psychosom Med 71:789–797

    Article  PubMed  PubMed Central  Google Scholar 

  • Kelley JM, Kaptchuk TJ, Cusin C, Lipkin S, Fava M (2012) Open-label placebo for major depressive disorder: a pilot randomized controlled trial. Psychother Psychosom 81:312–314. https://doi.org/10.1159/000337053

    Article  PubMed  Google Scholar 

  • Kirsch I (1978) Placebo effect and cognitive-behavioral revolution. Cogn Ther Res 2:255–264

    Article  Google Scholar 

  • Kirsch I (1997) Expectancy and conditioning in placebo analgesia – related or independent mechanisms? Pain Forum 6:59–61

    Article  Google Scholar 

  • Kirsch I, Lynn SJ, Vigorito M, Miller RR (2004) The role of cognition in classical and operant conditioning. J Clin Psychol 60:369–392

    Article  PubMed  Google Scholar 

  • Klinger R (2010) Das Potenzial des analgetischen Plazeboeffektes: S3-Leitlinien-Empfehlung zur Behandlung akuter und perioperativer Schmerzen. Anästhesiol Intensivmed Notfallmed Schmerzther 45:22–29

    Article  PubMed  Google Scholar 

  • Klinger R, Soost S, Flor H, Worm M (2007) Classical conditioning and expectancy in placebo hypoalgesia: a randomized controlled study in patients with atopic dermatitis and persons with healthy skin. Pain 128:31–39

    Article  PubMed  Google Scholar 

  • Klinger R, Becker M, Bryant M, Thomm M (2008) Allgemeine Patienteninformation und -schulung. In: D. D. i. V. f. Schmerztherapie (Hrsg) S3-Leitlinie Behandlung akuter und perioperativer posttraumatischer Schmerzen. Deutscher Ärzte-Verlag, Köln, S 19–22

    Google Scholar 

  • Klinger R, Colloca L, Bingel U, Flor H (2014) Placebo analgesia: clinical applications. Pain 155(6):1055

    Article  PubMed  Google Scholar 

  • Klinger R, Blasini M, Schmitz J, Colloca L (2017a) Nocebo effects in clinical studies: hints for pain therapy. Pain Rep 2(2):e586

    Article  PubMed  PubMed Central  Google Scholar 

  • Klinger R, Kothe R, Schmitz J, Kamping S, Flor H (2017b) Placebo effects of a sham opioid solution: a randomized controlled study in patients with chronic low back pain. Pain 158(10):1893–1902. https://doi.org/10.1097/j.pain.0000000000000977

    Article  PubMed  Google Scholar 

  • Kong J, Gollub RL, Rosman IS, Webb JM, Vangel MG, Kirsch I et al (2006) Brain activity associated with expectancy-enhanced placebo analgesia as measured by functional magnetic resonance imaging. J Neurosci 26:381–388

    Article  CAS  PubMed  Google Scholar 

  • Levine JD, Gordon NC, Fields HL (1978) The mechanism of placebo analgesia. Lancet 2:654–657

    Article  CAS  PubMed  Google Scholar 

  • Millan MJ (2002) Descending control of pain. Prog Neurobiol 66:355–474

    Article  CAS  PubMed  Google Scholar 

  • Petrovic P, Kalso E, Petersson KM, Ingvar M (2002) Placebo and opioid analgesia – imaging a shared neuronal network. Science 295:1737–1740

    Article  CAS  PubMed  Google Scholar 

  • Pollo A, Amanzio M, Arslanian A, Casadio C, Maggi G, Benedetti F (2001) Response expectancies in placebo analgesia and their clinical relevance. Pain 93:77–84

    Article  CAS  PubMed  Google Scholar 

  • Price DD, Craggs J, Verne GN, Perlstein WM, Robinson ME (2007) Placebo analgesia is accompanied by large reductions in pain-related brain activity in irritable bowel syndrome patients. Pain 127:63–72

    Article  PubMed  Google Scholar 

  • Price DD, Finniss DG, Benedetti F (2008) A comprehensive review of the placebo effect: recent advances and current thought. Annu Rev Psychol 59:565–590

    Article  PubMed  Google Scholar 

  • Stein N, Sprenger C, Scholz J, Wiech K, Bingel U (2012) White matter integrity of the descending pain modulatory system is associated with interindividual differences in placebo analgesia. Pain 153:2210–2217

    Article  PubMed  Google Scholar 

  • Stewart-Williams S, Podd J (2004) The placebo effect: dissolving the expectancy versus conditioning debate. Psychol Bull 130:324–340

    Article  PubMed  Google Scholar 

  • Turner JA, Deyo RA, Loeser JD, Vonkorff M, Fordyce WE (1994) The importance of placebo-effects in pain treatment and research. JAMA 271:1609–1614

    Article  CAS  PubMed  Google Scholar 

  • Vase L, Riley JL 3rd, Price DD (2002) A comparison of placebo effects in clinical analgesic trials versus studies of placebo analgesia. Pain 99:443–452

    Article  PubMed  Google Scholar 

  • Vase L, Petersen GL, Riley JL 3rd, Price DD (2009) Factors contributing to large analgesic effects in placebo mechanism studies conducted between 2002 and 2007. Pain 145:36–44

    Article  PubMed  Google Scholar 

  • Wager TD, Rilling JK, Smith EE, Sokolik A, Casey KL, Davidson RJ et al (2004) Placebo-induced changes in FMRI in the anticipation and experience of pain. Science 303:1162–1167

    Article  CAS  PubMed  Google Scholar 

  • Wager TD, Scott DJ, Zubieta JK (2007) Placebo effects on human mu-opioid activity during pain. Proc Natl Acad Sci USA 104:11056–11061

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wall P (1999) Textbook of pain. Livingstone, Philadelphia

    Google Scholar 

  • Watson A, El-Deredy W, Iannetti GD, Lloyd D, Tracey I, Vogt BA et al (2009) Placebo conditioning and placebo analgesia modulate a common brain network during pain anticipation and perception. Pain 145:24–30

    Article  PubMed  PubMed Central  Google Scholar 

  • Wickramasekera I (1980) A conditioned response model of the placebo effect predictions from the model. Biofeedback Self Regul 5:5–18

    Article  CAS  PubMed  Google Scholar 

  • Zubieta JK, Bueller JA, Jackson LR, Scott DJ, Xu Y, Koeppe RA et al (2005) Placebo effects mediated by endogenous opioid activity on mu-opioid receptors. J Neurosci 25:7754–7762

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Regine Klinger .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag GmbH Deutschland

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Klinger, R., Bingel, U. (2018). Placeboeffekte in der Schmerzmedizin. In: Baron, R., Koppert, W., Strumpf, M., Willweber-Strumpf, A. (eds) Praktische Schmerzmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54670-9_3-2

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-54670-9_3-2

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-54670-9

  • Online ISBN: 978-3-642-54670-9

  • eBook Packages: Springer Referenz Medizin

Publish with us

Policies and ethics

Chapter history

  1. Latest

    Placeboeffekte in der Schmerzmedizin
    Published:
    13 December 2017

    DOI: https://doi.org/10.1007/978-3-642-54670-9_3-2

  2. Original

    Placeboeffekte in der Schmerzmedizin
    Published:
    06 November 2014

    DOI: https://doi.org/10.1007/978-3-642-54670-9_3-1