A pain therapy is significantly better when patients are thousands of promise of treatment. Do they have no or even a poor expectation of the therapy, the pain is alleviated only slightly if at all. This phenomenon has Priv.-Doz. Dr. Ulrike Bingel, neurologist at the University Hospital Hamburg-Eppendorf (UKE), now described in an article for the journal Science * Translational Medicine. Especially for chronic pain patients, said Dr. Bingham may be the findings of great importance.
20 and 40 UKE-scientist has repeated for a few seconds exposed to a controlled heat stimulus, which at a moderate to severe pain led (an average of 70 on a scale of 0 to 100). During the experiment, the subjects received an infusion a potent opioid-containing analgesics (remifentanil) in three different conditions: In the first, subjects were given the painkiller in a "covert" Infusion settled, not with pain relief. The pain intensity decreased to about 60 out of 100 "If we are the subjects in the second condition then announced that they have now doubled the drug is administered, the analgesic effect of the identical drug dosing," said UKE-scientist. The pain intensity decreased in the expectation of a treatment under 50
was completely abolished, however, the analgesic effect of potent analgesic when the subjects were told in the third condition that they received no therapy and more like it could hurt more. Although they are without their knowledge, the analgesic was administered, pain intensity shot up again to the baseline. Dr. Bingham: ".. The negative expectation and the fear of pain have destroyed the effect of the drug completely, the pain was in the subjects as much as they would have got absolutely no drug"
was underlined this by simultaneously carried out investigations with functional magnetic resonance imaging (fMRI), with pain processing can be done in the brain. "Relevant Switching points of the pain-processing system (thalamus, Island and somatosensory cortex) that show how a water level indicator, whether the subject have to endure just a lot or a little pain must be shown that the personal expectations influence the effect of the drug "is more:. Did the subject the effect of treatment, was the body's pain inhibitory system is activated, thereby amplifying the analgesic effect of externally supplied painkiller Dr. Bingham, the new findings hold especially for the treatment of chronic pain patients to be relevant. "Many of them failed for years to help they are desperate and afraid, do not trust more in the medicine. Now we can know that the negative expectations affect their success in the therapy and influence the effect of unfavorable really potent painkillers. This should be considered in the selection of therapy more intensively.
this help it can get, patients, intensive and focused on their disease and treatments educate, to raise positive expectations and avoid a negative. "Future clinical studies should try to optimize the interaction of drugs and the body's own regulatory mechanisms for patients to achieve the maximum success of therapy, UKE-scientist Bingel.
* The impact of treatment expectation on drug efficacy: Imaging the Analgesic Benefit of the opioid Reminfentanil
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