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Lauren C Howe, Kari A Leibowitz, Margaret A Perry, Julie M Bitler, Whitney Block, Ted J Kaptchuk, Kari C Nadeau, Alia J Crum
BACKGROUND: Oral immunotherapy (OIT) can lead to desensitization to food allergens, but patients can experience treatment-related symptoms of allergic reactions that cause anxiety and treatment dropout. Interventions to improve OIT for patients are needed. OBJECTIVE: To determine whether fostering the mindset that non-life-threatening symptoms during OIT can signal desensitization improves treatment experience and outcomes. METHODS: In a randomized, blinded, controlled phase II study, 50 children/adolescents (28% girls, aged 7-17, M=10...
January 22, 2019: Journal of Allergy and Clinical Immunology in Practice
Kathryn T Hall, Julie E Buring, Kenneth J Mukamal, M Vinayaga Moorthy, Peter M Wayne, Ted J Kaptchuk, Elisabeth M Battinelli, Paul M Ridker, Howard D Sesso, Stephanie J Weinstein, Demetrius Albanes, Nancy R Cook, Daniel I Chasman
Background: Vitamins are among the most frequently used supplements (48% of US adults). However, little is known about contributions of genetic variation to their efficacy and safety. Multiple pathways link catechol-O-methyltransferase (COMT) to the vitamin E supplement, alpha-tocopherol, and cancer. Methods: Here we determined if COMT exerted pharmacogenetic effects on cancer prevention in two randomized trials of alpha-tocopherol supplementation. Pharmacogenetic effects of common COMT rs4680 (val158met), which encodes a nonsynonymous valine-to-methionine substitution, were examined in the trial plus a 10-year post-trial follow-up (overall) period of The Women's Genome Health Study (WGHS, N = 23 294), a 10-year alpha-tocopherol and aspirin trial with 10 years post-trial follow-up...
January 8, 2019: Journal of the National Cancer Institute
Aurore Fernandez, Irving Kirsch, Louis Noël, Pierre Yves Rodondi, Ted J Kaptchuk, Marc R Suter, Isabelle Décosterd, Chantal Berna
Side effects are frequent in pharmacological pain management, potentially preceding analgesia and limiting drug tolerability. Discussing side effects is part of informed consent, yet can favor nocebo effects. This study aimed to test whether a positive suggestion regarding side effects, which could act as reminders of the medication having been absorbed, might favor analgesia in a clinical interaction model. Sixty-six healthy males participated in a study "to validate pupillometry as an objective measure of analgesia"...
2019: PloS One
Charlotte Blease, Michael H Bernstein, Jens Gaab, Ted J Kaptchuk, Joe Kossowsky, Kenneth D Mandl, Roger B Davis, Catherine M DesRoches
OBJECTIVE: To describe the opinions of British general practitioners regarding the potential of future technology to replace key tasks carried out in primary care. DESIGN: Cross sectional online survey. PARTICIPANTS: 1,474 registered GPs in the United Kingdom. MAIN OUTCOME MEASURES: Investigators measured GPs' opinions about the likelihood that future technology will be able to fully replace-not merely aid-the average GP in performing six primary care tasks; in addition, if GPs considered replacement for a particular task likely, the survey measured opinions about how many years from now this technological capacity might emerge...
2018: PloS One
Jeungchan Lee, Ishtiaq Mawla, Jieun Kim, Marco L Loggia, Ana Ortiz, Changjin Jung, Suk-Tak Chan, Jessica Gerber, Vincent J Schmithorst, Robert R Edwards, Ajay D Wasan, Chantal Berna, Jian Kong, Ted J Kaptchuk, Randy L Gollub, Bruce R Rosen, Vitaly Napadow
Although self-report pain ratings are the gold standard in clinical pain assessment, they are inherently subjective in nature and significantly influenced by multidimensional contextual variables. Although objective biomarkers for pain could substantially aid pain diagnosis and development of novel therapies, reliable markers for clinical pain have been elusive. In this study, individualized physical maneuvers were used to exacerbate clinical pain in patients with chronic low back pain (N = 53), thereby experimentally producing lower and higher pain states...
October 17, 2018: Pain
Samantha M Meints, Ishtiaq Mawla, Vitaly Napadow, Jian Kong, Jessica Gerber, Suk-Tak Chan, Ajay D Wasan, Ted J Kaptchuk, Christina McDonnell, Junie Carriere, Bruce Rosen, Randy L Gollub, Robert R Edwards
Changes in central pain processing have been shown in patients with chronic low back pain (cLBP). We used quantitative sensory testing (QST) methods to identify differences in pain sensitization between patients with cLBP (N=167) and healthy controls (N=33). Results indicated that, compared to healthy pain-free controls, cLBP patients showed increased sensitivity and greater painful aftersensations for mechanical pressure and pin prick stimuli and lower tactile spatial acuity in the two-point discrimination task (ps<...
December 7, 2018: Pain
Alan E Kazdin, Adam Glick, Jennifer Pope, Ted J Kaptchuk, Bernadette Lecza, Erin Carrubba, Emily McWhinney, Natasha Hamilton
Background/Objective: The study evaluated two variations of Parent Management Training (PMT) for children referred to treatment for oppositional, aggressive, and antisocial behavior. The goal was to evaluate the impact of multiple enhancements to optimize common and placebo factors to augment therapeutic change. Method: The families of all children ( N =138, 39 girls and 99 boys, ages 6-13) received PMT. One half of the families were assigned to receive an enhanced version with multiple additions designed to increase bonding of the parent to the therapist, professionalism of treatment and setting, credibility of the intervention, and expectancies for therapeutic change...
May 2018: International Journal of Clinical and Health Psychology: IJCHP
Ted J Kaptchuk
Open-label placebos (OLP)-placebo pills honestly prescribed-have challenged the notion that placebos require either deception or concealment to evoke salubrious benefits. This essay describes how the author arrived at the counter-intuitive OLP hypothesis, discusses evidence for OLP effectiveness, and examines mechanistic explanations for OLP. Current dominant theories such as expectation and conditioning are found to be insufficient or inaccurate. The author proposes that emerging concepts of prediction and error processing (PEP), Bayesian brain, and embodied cognition are more appropriate models for understanding OLP...
2018: Perspectives in Biology and Medicine
Ted J Kaptchuk, Franklin G Miller
No abstract text is available yet for this article.
October 2, 2018: BMJ: British Medical Journal
Giulio Ongaro, Ted J Kaptchuk
No abstract text is available yet for this article.
August 6, 2018: Pain
Andrea W M Evers, Luana Colloca, Charlotte Blease, Marco Annoni, Lauren Y Atlas, Fabrizio Benedetti, Ulrike Bingel, Christian Büchel, Claudia Carvalho, Ben Colagiuri, Alia J Crum, Paul Enck, Jens Gaab, Andrew L Geers, Jeremy Howick, Karin B Jensen, Irving Kirsch, Karin Meissner, Vitaly Napadow, Kaya J Peerdeman, Amir Raz, Winfried Rief, Lene Vase, Tor D Wager, Bruce E Wampold, Katja Weimer, Katja Wiech, Ted J Kaptchuk, Regine Klinger, John M Kelley
BACKGROUND: Placebo and nocebo effects occur in clinical or laboratory medical contexts after administration of an inert treatment or as part of active treatments and are due to psychobiological mechanisms such as expectancies of the patient. Placebo and nocebo studies have evolved from predominantly methodological research into a far-reaching interdisciplinary field that is unravelling the neurobiological, behavioural and clinical underpinnings of these phenomena in a broad variety of medical conditions...
2018: Psychotherapy and Psychosomatics
Jian Kong, Zengjian Wang, Jaclyn Leiser, Domenic Minicucci, Robert Edwards, Irving Kirsch, Ajay D Wasan, Courtney Lang, Jessica Gerber, Siyi Yu, Vitaly Napadow, Ted J Kaptchuk, Randy L Gollub
Objectives: Expectation can significantly modulate pain and treatment effects. This study aims to investigate if boosting patients' expectancy can enhance the treatment of knee osteoarthritis (KOA), and its underlying brain mechanism. Methods: Seventy-four KOA patients were recruited and randomized to three groups: boosted acupuncture (with a manipulation to enhance expectation), standard acupuncture, or treatment as usual (TAU). Each patient underwent six treatments before being debriefed, and four additional treatments after being debriefed...
2018: NeuroImage: Clinical
Alia J Crum, Modupe Akinola, Bradley P Turnwald, Ted J Kaptchuk, Kathryn T Hall
There is evidence that altering stress mindset-the belief that stress is enhancing vs. debilitating-can change cognitive, affective and physiological responses to stress. However individual differences in responsiveness to stress mindset manipulations have not been explored. Given the previously established role of catecholamines in both placebo effects and stress, we hypothesized that genetic variation in catechol-O-methyltransferase (COMT), an enzyme that metabolizes catecholamines, would moderate responses to an intervention intended to alter participants' mindsets about stress...
2018: PloS One
Julia Kirchhof, Liubov Petrakova, Alexandra Brinkhoff, Sven Benson, Justine Schmidt, Maike Unteroberdörster, Benjamin Wilde, Ted J Kaptchuk, Oliver Witzke, Manfred Schedlowski
Patients after organ transplantation or with chronic, inflammatory autoimmune diseases require lifelong treatment with immunosuppressive drugs, which have toxic adverse effects. Recent insight into the neurobiology of placebo responses shows that associative conditioning procedures can be employed as placebo-induced dose reduction strategies in an immunopharmacological regimen. However, it is unclear whether learned immune responses can be produced in patient populations already receiving an immunosuppressive regimen...
April 17, 2018: Proceedings of the National Academy of Sciences of the United States of America
Kathryn T Hall, Joseph Loscalzo, Ted Kaptchuk
There is perhaps no more important time in the history of placebos to consider their role in clinical trials and in medicine. Increasingly well-designed pharmaceutical and academic clinical trials testing promising and established drug and surgical interventions have failed to "beat" the placebo response. The collateral damage resulting from these failures is staggering; novel treatments, many with compelling mechanisms of action and promising Phase 2 trial results, never reach the patient, adversely affecting small and large pharma alike...
April 18, 2018: ACS Chemical Neuroscience
Teri W Hoenemeyer, Ted J Kaptchuk, Tapan S Mehta, Kevin R Fontaine
The purpose of this 21-day assessor blinded, randomized-controlled trial was to compare an open-label placebo (OLP) to treatment as usual (TAU) for cancer survivors with fatigue. This was followed by an exploratory 21-day study in which TAU participants received OLPs while OLP participants in the main study were followed after discontinuing placebos. Cancer survivors (N = 74) who completed cancer treatment 6 months to 10 years prior to enrollment reporting at least moderate fatigue (i.e., ≥4 on a 0-10 scale) were randomized to OLP or TAU...
February 9, 2018: Scientific Reports
Ginger Polich, Mary Alexis Iaccarino, Ted J Kaptchuk, Leon Morales-Quezada, Ross Zafonte
In recent years, several randomized controlled trials evaluating pharmaceutical treatments for traumatic brain injury (TBI) have failed to demonstrate efficacy over placebo, with both active and placebo arms improving at comparable rates. These findings could be viewed in opposing ways, suggesting on the one hand failure of the tested outcome, but on the other, representing evidence of robust placebo effects in TBI. In this article, we examine several of the primary psychological processes driving placebo effects (verbal suggestion, cognitive re-framing, interpersonal interactions, conditioning, therapeutic alliance, anxiety reduction) as well as placebo neurobiology (top-down cortical regulation, reward system activation, dopaminergic and serotonergic neurotransmission)...
June 1, 2018: Journal of Neurotrauma
Randy L Gollub, Irving Kirsch, Nasim Maleki, Ajay D Wasan, Robert R Edwards, Yiheng Tu, Ted J Kaptchuk, Jian Kong
Placebo treatments and healing rituals share much in common, such as the effects of expectancy, and have been used since the beginning of human history to treat pain. Previous mechanistic neuroimaging studies investigating the effects of expectancy on placebo analgesia have used young, healthy volunteers. Using functional magnetic resonance imaging (fMRI), we aimed to investigate the neural mechanisms by which expectancy evokes analgesia in older adults living with a chronic pain disorder and determine whether there are interactions with active treatment...
May 2018: Journal of Pain: Official Journal of the American Pain Society
Farah Z Zia, Oluwadamilola Olaku, Ting Bao, Ann Berger, Gary Deng, Arthur Yin Fan, Mary K Garcia, Patricia M Herman, Ted J Kaptchuk, Elena J Ladas, Helene M Langevin, Lixing Lao, Weidong Lu, Vitaly Napadow, Richard C Niemtzow, Andrew J Vickers, Xin Shelley Wang, Claudia M Witt, Jun J Mao
The Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, at the National Cancer Institute (NCI) held a symposium on "Acupuncture for Cancer Symptom Management" on June 16 and 17, 2016. Invited speakers included 19 scientists and scholars with expertise in acupuncture and cancer research from the United States, Europe, and China. The conference reviewed the NCI's grant funding on acupuncture, analyzed the needs of cancer patients, reviewed safety issues, and assessed both the current scientific evidence and research gaps of acupuncture in oncology care...
November 1, 2017: Journal of the National Cancer Institute. Monographs
Ina Skyt, Kurosh Moslemi, Cathrine Baastrup, Kasper Grosen, Fabrizio Benedetti, Gitte L Petersen, Donald D Price, Kathryn T Hall, Ted J Kaptchuk, Peter Svensson, Troels S Jensen, Lene Vase
Placebo effects have been reported in patients with chronic neuropathic pain. Expected pain levels and positive emotions are involved in the observed pain relief, but the underlying neurobiology is largely unknown. Patients with neuropathic pain are highly motivated for pain relief, and as motivational factors such as expectations of reward, as well as pain processing in itself, are related to the dopaminergic system, it can be speculated that dopamine release contributes to placebo effects in neuropathic pain...
February 2018: Pain
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