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Challenges of differential placebo effects in contemporary medicine: The example of brain stimulation
Author(s) -
Burke Matthew J.,
Kaptchuk Ted J.,
PascualLeone Alvaro
Publication year - 2019
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.25387
Subject(s) - nothing , functional magnetic resonance imaging , placebo , electroencephalography , magnetic resonance imaging , differential effects , stimulation , brain stimulation , psychology , medicine , neuroscience , physical medicine and rehabilitation , alternative medicine , philosophy , radiology , epistemology , pathology
'Differential placebo effects' is the concept that different types of placebos (e.g. inert pill versus sham device) may yield different magnitudes of placebo effects. This issue has been pushed into the spotlight by recent clinical trials of new technologies reporting unexpectedly large placebo effects from sham devices/procedures needed to maintain blinding integrity. In this Neurology Grand Rounds, we use transcranial magnetic stimulation as a model to explore the principles and implications of differential placebo effects. We highlight emerging research on the neurobiology of placebo effects and analyze fundamental questions of measuring efficacy in contemporary medicine. This article is protected by copyright. All rights reserved.