Effects of sex on placebo effects in chronic pain participants: a cross-sectional study.
Journal
Pain
ISSN: 1872-6623
Titre abrégé: Pain
Pays: United States
ID NLM: 7508686
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
received:
19
04
2020
accepted:
03
08
2020
pubmed:
23
8
2020
medline:
20
5
2021
entrez:
23
8
2020
Statut:
ppublish
Résumé
Sex-related differences can influence outcomes of randomized clinical trials and may jeopardize the effectiveness of pain management and other therapeutics. Thus, it is essential to understand the mechanistic and translational aspects of sex differences in placebo outcomes. Recently, studies in healthy participants have shed light on how sex-related placebo effects might influence outcomes, yet no research has been conducted in a patient population. Herein, we used a tripartite approach to evaluate the interaction of prior therapeutic experience (eg, conditioning), expectations, and placebo effects in 280 chronic (orofacial) pain patients (215 women). In this cross-sectional study, we assessed sex differences in placebo effects, conditioning as a proxy of prior therapeutic effects, and expectations evaluated before and after the exposure to positive outcomes, taking into account participant-experimenter sex concordance and hormonal levels (estradiol and progesterone assessed in premenopausal women). We used mediation analysis to determine how conditioning strength and expectations impacted sex differences in placebo outcomes. Independent of gonadal hormone levels, women showed stronger placebo effects than men. We also found significant statistical sex differences in the conditioning strength and reinforced expectations whereby reinforced expectations mediated the sex-related placebo effects. In addition, the participant-experimenter sex concordance influenced conditioning strength, reinforced expectations, and placebo effects in women but not in men. Our findings suggest that women experience larger conditioning effects, expectations, and placebo effects emphasizing the need to consider sex as a biological variable when placebo components of any outcomes are part of drug development trials and in pain management.
Identifiants
pubmed: 32826757
pii: 00006396-202102000-00018
doi: 10.1097/j.pain.0000000000002038
pmc: PMC7854995
mid: NIHMS1618293
doi:
Substances chimiques
Estradiol
4TI98Z838E
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
531-542Subventions
Organisme : NCCIH NIH HHS
ID : R01 AT010333
Pays : United States
Organisme : NCCIH NIH HHS
ID : R01 AT011347
Pays : United States
Organisme : NIDCR NIH HHS
ID : R01 DE025946
Pays : United States
Informations de copyright
Copyright © 2020 International Association for the Study of Pain.
Références
J Neurol Neurosurg Psychiatry. 1976 Nov;39(11):1071-5
pubmed: 188989
Psychopharmacology (Berl). 2011 Jun;215(3):537-48
pubmed: 21384106
Physiol Behav. 2009 May 25;97(2):229-38
pubmed: 19272397
Psychosom Med. 2008 Sep;70(7):811-8
pubmed: 18725424
Neuropsychopharmacology. 2019 Jan;44(1):1-3
pubmed: 30361539
Biol Psychiatry. 2016 May 15;79(10):794-802
pubmed: 26321018
Brain. 2002 Mar;125(Pt 3):501-10
pubmed: 11872608
J Pain. 2010 May;11(5):408-19
pubmed: 20075013
Psychoneuroendocrinology. 2014 Nov;49:106-18
pubmed: 25080403
J Pain. 2009 May;10(5):447-85
pubmed: 19411059
Eur J Pain. 2004 Oct;8(5):397-411
pubmed: 15324772
Neurosci Lett. 2012 Jun 29;520(2):140-8
pubmed: 22465136
Am J Psychiatry. 2017 Feb 1;174(2):135-142
pubmed: 27609242
Clin Psychol Rev. 2018 Dec;66:80-96
pubmed: 29945741
Neuroscience. 2011 Sep 8;190:379-85
pubmed: 21664434
Synapse. 2008 Sep;62(9):682-8
pubmed: 18566972
Curr Opin Neurol. 2013 Apr;26(2):146-53
pubmed: 23406909
J Pain. 2017 Mar;18(3):295-307
pubmed: 27884689
J Pain. 2016 Sep;17(9 Suppl):T93-T107
pubmed: 27586833
Psychosom Med. 2011 Feb-Mar;73(2):193-9
pubmed: 21217098
Psychother Psychosom. 2020;89(6):371-378
pubmed: 32492688
Neurosci Lett. 2004 Dec 6;372(3):250-5
pubmed: 15542250
Nat Rev Neurosci. 2012 Dec;13(12):859-66
pubmed: 23165262
Int Rev Neurobiol. 2018;138:1-15
pubmed: 29681320
Nat Methods. 2014 Jun;11(6):629-32
pubmed: 24776635
Physiol Behav. 2016 Feb 1;154:40-8
pubmed: 26556539
Braz Dent J. 2014 Jan-Feb;25(1):54-8
pubmed: 24789293
Ann Behav Med. 2007 Feb;33(1):112-6
pubmed: 17291177
Dent Clin North Am. 2018 Oct;62(4):665-682
pubmed: 30189989
PLoS One. 2011 Apr 27;6(4):e19070
pubmed: 21556361
N Engl J Med. 2008 Dec 18;359(25):2693-705
pubmed: 19092154
Int Rev Neurobiol. 2018;138:61-80
pubmed: 29681335
Nat Neurosci. 2011 Oct 23;14(12):1569-73
pubmed: 22019732
Prog Brain Res. 2010;186:141-57
pubmed: 21094890
Pain. 2016 Apr;157(4):858-867
pubmed: 26675825
Pain. 2005 Mar;114(1-2):37-46
pubmed: 15733629
J Pain. 2011 Nov;12(11 Suppl):T102-7
pubmed: 22074748
Sci Rep. 2015 Dec 14;5:18114
pubmed: 26655917
Handb Exp Pharmacol. 2012;(214):107-26
pubmed: 23027448
Exp Clin Psychopharmacol. 2016 Feb;24(1):1-11
pubmed: 26570992
Addict Behav. 2004 Aug;29(6):1221-4
pubmed: 15236826
Eur J Pain. 2012 Aug;16(7):1005-13
pubmed: 22337582
Pain Res Manag. 2006 Spring;11(1):11-38
pubmed: 16511612
J Oral Facial Pain Headache. 2018 Mar 21;32(2):151–158
pubmed: 29561915
Arch Gen Psychiatry. 2003 Jun;60(6):565-71
pubmed: 12796219
Pain. 2007 Nov;132 Suppl 1:S26-S45
pubmed: 17964077
Pain. 2008 Oct 15;139(2):306-314
pubmed: 18538928
Science. 2001 Aug 10;293(5532):1164-6
pubmed: 11498597
J Pain. 2014 Dec;15(12):1282-93
pubmed: 25261340
Pain. 2014 Jun;155(6):1110-1117
pubmed: 24602997
Gynecol Endocrinol. 2005 Feb;20(2):99-103
pubmed: 15823829
Nat Neurosci. 2014 Dec;17(12):1793-7
pubmed: 25326691
Int Rev Neurobiol. 2018;138:39-59
pubmed: 29681334
Proc Natl Acad Sci U S A. 2010 Nov 16;107(46):20115-9
pubmed: 21041644
Int Rev Neurobiol. 2018;139:255-296
pubmed: 30146050
Pain. 2012 Jan;153(1):197-202
pubmed: 22100358
Pain. 2013 Aug;154(8):1368-76
pubmed: 23701723
JAMA Intern Med. 2013 Aug 12;173(15):1468-9
pubmed: 23780284
Biol Psychiatry. 2011 Nov 15;70(10):920-7
pubmed: 21762880
Gerontology. 2015;61(2):97-108
pubmed: 25427869
N Engl J Med. 2020 Feb 6;382(6):554-561
pubmed: 32023375
Nat Neurosci. 2004 Jun;7(6):587-8
pubmed: 15146189
Pain. 2020 Aug;161(8):1872-1883
pubmed: 32701846
J Pain Res. 2017 Jul 31;10:1831-1839
pubmed: 28831271
Pain. 2006 Sep;124(1-2):126-33
pubmed: 16701952
Front Neurosci. 2019 Mar 04;13:160
pubmed: 30886569
Lancet Psychiatry. 2015 Mar;2(3):246-57
pubmed: 25815249
Pain. 2005 Dec 15;119(1-3):65-74
pubmed: 16298065
Psychopharmacology (Berl). 2020 Jan;237(1):93-102
pubmed: 31422429
Clin Pharmacol Ther. 2001 Sep;70(3):287-91
pubmed: 11557917
J Pain Res. 2012;5:289-300
pubmed: 23049277
J Neurosci. 2003 May 15;23(10):4315-23
pubmed: 12764120
Neuroscience. 2015 Oct 29;307:231-41
pubmed: 26335379
J Pain. 2001 Oct;2(5):251-7
pubmed: 14622803
J Consult Clin Psychol. 1975 Apr;43(2):278
pubmed: 1120844
Front Psychol. 2018 May 25;9:788
pubmed: 29887820
Proc Natl Acad Sci U S A. 2007 Feb 13;104(7):2465-70
pubmed: 17267613
Pain. 1990 Jan;40(1):85-91
pubmed: 2339021
J Neurosci. 2006 May 24;26(21):5777-85
pubmed: 16723535
Clin Pharmacol Ther. 2019 Dec;106(6):1246-1252
pubmed: 31350784
J Oral Facial Pain Headache. 2014 Winter;28(1):6-27
pubmed: 24482784
J Psychosom Res. 2009 Apr;66(4):323-8
pubmed: 19302890
Nat Rev Neurosci. 2015 Jul;16(7):403-18
pubmed: 26087681