Expectancy effects on pain perception and treatment response
The broad role of psychological factors in shaping treatment responses is increasingly acknowledged in many clinical conditions, including chronic visceral and urogenital pain. To understand effects of expectancies and their underlying psychological and neurobiological mechanisms, preclinical studies are urgently needed. Therefore, in this line of work we address how expectations are formed and how they impact on the response to pain. To do so, we combine mechanistic research using brain imaging techniques with preclinical research approaches in healthy volunteers and different patient populations suffering from pain. One of our ongoing projects is devoted to optimizing the treatment of postoperative pain and to unraveling the importance of preoperative anxiety. Herein, we study if improved doctor-patient communication and supportive postoperative acupuncture therapy can reduce postoperative pain as well as postoperative pain medication use. Together, this work complements and extends our lines of research into pain-related learning, fear and stress in the pathophysiology and treatment of visceral pain.
Prof. Dr. U. Bingel, Neurology, Esen University Hospital
Prof. Dr. M. Forsting, Diagnostic and Interventional Radiology and Neuroradiology, Essen University Hospital
Prof. Dr. U. Frey, Susanne Hagen, Anesthesiology and Intensive Care Medicine, Essen University Hospital
Priv.-Doz. Dr. O. Hoffmann, Obstetrics and Gynecology, Essen University Hospital
Prof. Dr. J. Langhorst,Integrative Gastroenterology, Kliniken Essen-Mitte
Prof. P. Enck, Psychosomatic Medicine, University of Tübingen
German Research Foundation (DFG); Project 5 (EL 236/8-2) of the Research Unit FOR 1328 „Expectation and conditioning as basic processes of the placebo and nocebo response.”
IFORES-Program of the Medical Faculty (clinician research stipend awarded to Dr. N. Theysohn).
Foundation „Stiftung Universitätsmedizin Essen“
(www.universitaetsmedizin.de): Research Award 2013 for study on expectancy in postoperative pain
Schmid J, Bingel U, Ritter C, Benson S, Schedlowski M, Gramsch C, Forsting M, Elsenbruch S.
Neural underpinning of nocebo hyperalgesia in visceral pain: A fMRI study in healthy volunteers.
Elsenbruch S, Enck P.
Placebo effects and their determinants in gastrointestinal disorders.
Nat Rev Gastroenterol Hepatol 2015;12(8):472-85.
Schmid J, Langhorst J, Gaß F, Theysohn N, Benson S, Engler H, Gizewski ER, Forsting M, Elsenbruch S.
Placebo analgesia in patients with functional and organic abdominal pain: A fMRI study in irritable bowel syndrome, ulcerative colitis and healthy volunteers.
How positive and negative expectations shape the experience of visceral pain.
Handb Exp Pharmacol 2014;225:97-119.
Schmid J, Theysohn N, Gaß F, Benson S, Gramsch C, Forsting M, Gizewski ER, Elsenbruch S.
Neural mechanisms mediating positive and negative treatment expectations in visceral pain: a functional magnetic resonance imaging study on placebo and nocebo effects in healthy volunteers.