Harnessing Placebo Effects for the Treatment of Functional Cognitive Disorder: A Feasibility Pilot Study.

IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY
Matthew J Burke, Davide Cappon, David L Perez, Alvaro Pascual-Leone, Emiliano Santarnecchi
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引用次数: 0

Abstract

Objective: Limited research has directly investigated whether and how placebo effects can be harnessed for the treatment of functional neurological disorder (FND), despite a long-standing and controversial history of interest in this area.

Methods: A small exploratory study was conducted with adults with a cognitive subtype of FND recruited from a single cognitive neurology center in the United States. Participants were given the expectation of receiving cranial stimulation that could benefit their memory symptoms; however, the intervention was sham transcranial magnetic stimulation (placebo). Outcomes included measures of short-term memory testing, subjective memory rating, and state anxiety before and after stimulation. After the study, the true objective and rationale for investigating placebo effects were explained in a scripted debriefing session. Acceptability of the study design and qualitative feedback were collected. Institutional ethics approval and signed consent were obtained.

Results: Three patients (female, N=2; male, N=1; average age=57 years) were recruited. Outcome data were analyzed descriptively at the patient level. Trends of improvement in subjective memory rating, but not objective cognitive test scores, and decreases in state anxiety were observed. After the debriefing session, all patients found the study design to be acceptable (ratings of 70%, 90%, and 100%), and two of the three patients believed that withholding mechanistic information about the intervention was needed to leverage placebo effects as treatment.

Conclusions: In the first study to prospectively investigate the feasibility of harnessing placebo effects for the treatment of FND, promising preliminary findings were obtained, and methods and resources for use in larger future studies are offered.

利用安慰剂效应治疗功能性认知障碍:可行性试点研究
目的:尽管人们对功能性神经紊乱(FND)的研究兴趣由来已久,但直接研究安慰剂效应是否可用于治疗以及如何利用安慰剂效应的研究却十分有限:尽管人们对功能性神经紊乱(FND)的关注由来已久且存在争议,但直接调查安慰剂效应是否可用于治疗功能性神经紊乱以及如何利用安慰剂效应的研究却十分有限:一项小型探索性研究从美国一家认知神经病学中心招募了患有认知亚型 FND 的成年人。参与者期望接受颅磁刺激,以改善他们的记忆症状;但干预措施是假性经颅磁刺激(安慰剂)。研究结果包括刺激前后的短期记忆测试、主观记忆评分和状态焦虑。研究结束后,研究人员会在脚本汇报环节中解释研究安慰剂效应的真正目的和原理。此外,还收集了研究设计的可接受性和定性反馈。研究获得了机构伦理批准并签署了同意书:共招募了三名患者(女性,N=2;男性,N=1;平均年龄=57 岁)。对患者的结果数据进行了描述性分析。观察到主观记忆评分有改善趋势,但客观认知测试评分没有改善,而且状态焦虑有所减轻。汇报环节结束后,所有患者都认为研究设计可以接受(评分分别为 70%、90% 和 100%),三位患者中有两位认为需要隐瞒有关干预的机制性信息,以利用安慰剂效应作为治疗手段:在第一项对利用安慰剂效应治疗 FND 的可行性进行前瞻性调查的研究中,获得了令人鼓舞的初步结果,并提供了用于未来更大规模研究的方法和资源。
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来源期刊
CiteScore
5.30
自引率
3.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.
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