Home About us Contact
|
Home About us Contact | ||
|
|
||
Placebo Condition (placebo + condition)
Selected AbstractsAn evaluation of a visual biofeedback intervention in dyslexic adultsDYSLEXIA, Issue 1 2005Elizabeth Liddle Abstract A prototype of a biofeedback system designed to treat dyslexia by improving heart-rate variability was evaluated in a single blind study of dyslexic adults. Treatment consisted of four 15 minute exposures to a visual display synchronized with either the participant's own cardiac cycle (intervention condition), or of a synthesized cardiac cycle (placebo condition). Repeated measures were made of picture naming speed, single word reading speed and accuracy, copying speed, heart-rate variability and performance on a lateralized visual temporal order judgement task. Small but significant improvements were found in reading and naming speed in the treatment group relative to the placebo group. No significant improvements were found in unspeeded reading measures. Results from heart-rate measures indicated that treatment had effected a shift in the ratio between parameters reflecting the influence of the sympathetic and parasympathetic autonomic nervous systems (ANS), respectively, in favour of the parasympathetic. In the temporal order judgement task, participants who received treatment showed a reduced level of overall improvement relative to that seen in those who received placebo, coupled with evidence of a shift in visual attention from left to right hemifield in their pattern of performance. The results are interpreted as indicating that the treatment induces a shift in autonomic balance in favour of the parasympathetic ANS, and that this shift is also reflected in increased efficiency of left cerebral hemisphere circuits implicated in the perceptual-motor processes required for naming and reading fluency. Conversely, it is also reflected in lower spatial awareness of peripheral visual stimuli, particularly those presented to left hemifield. Copyright © 2004 John Wiley & Sons, Ltd. [source] Dynamic Assessment of Abnormalities in Central Pain Transmission and Modulation in Tension-type Headache SufferersHEADACHE, Issue 2 2000Jonathan D. Neufeld PhD Objective.,To examine and compare central pain processing and modulation in young tension-type headache sufferers with that of matched healthy controls using an induced headache "challenge" paradigm. Background.,Recent research has suggested that abnormalities in central pain processing and descending pain modulation may contribute to chronic tension-type headache. These abnormalities, if they contribute to headache pathogenesis, should be present in young adult tension-type headache sufferers. Recent research using static measures of physiological variables, such as muscle tenderness and exteroceptive suppression, has identified chronic muscle tenderness as a characteristic of young tension-type headache sufferers, but other central nervous system functional abnormalities may require a dynamic "challenge" to be observed. Methods.,Twenty-four young women meeting the International Headache Society diagnostic criteria for tension-type headache (headache-prone) and a matched group of 24 healthy women who reported fewer than 10 problem headaches per year (control) participated in a double-blind, placebo-controlled, crossover study. Subjects completed jaw clenching and a placebo condition on different days in counterbalanced order. Pericranial muscle tenderness, pressure-pain thresholds on the temporalis, and exteroceptive suppression periods were assessed before and after each procedure. Head pain was recorded for 12 to16 hours following each condition. Results.,Headache-prone subjects were more likely than controls to experience headaches after both the jaw clenching and placebo procedures, but neither group was significantly more likely to experience headaches following jaw clenching than placebo. In pretreatment measurements, headache-prone subjects exhibited greater muscle tenderness than controls, but pressure-pain detection thresholds and exteroceptive suppression periods did not differ in the two groups. Control subjects showed increases in muscle tenderness and exteroceptive suppression periods following both the clenching and placebo procedures, whereas headache-prone subjects exhibited no significant changes in any of the physiological measures following either experimental manipulation. Conclusions.,These results confirm previous findings indicating abnormally high pericranial muscle tenderness in young tension headache sufferers even in the headache-free state. In addition, the results suggest that the development of headaches following noxious stimulation is more strongly related to headache proneness and associated abnormalities in central pain transmission or modulation (indexed by pericranial muscle tenderness and exteroceptive suppression responses) than muscle strain induced by jaw clenching. [source] The effect of daily caffeine use on cerebral blood flow: How much caffeine can we tolerate?HUMAN BRAIN MAPPING, Issue 10 2009Merideth A. Addicott Abstract Caffeine is a commonly used neurostimulant that also produces cerebral vasoconstriction by antagonizing adenosine receptors. Chronic caffeine use results in an adaptation of the vascular adenosine receptor system presumably to compensate for the vasoconstrictive effects of caffeine. We investigated the effects of caffeine on cerebral blood flow (CBF) in increasing levels of chronic caffeine use. Low (mean = 45 mg/day), moderate (mean = 405 mg/day), and high (mean = 950 mg/day) caffeine users underwent quantitative perfusion magnetic resonance imaging on four separate occasions: twice in a caffeine abstinent state (abstained state) and twice in a caffeinated state following their normal caffeine use (native state). In each state, there were two drug conditions: participants received either caffeine (250 mg) or placebo. Gray matter CBF was tested with repeated-measures analysis of variance using caffeine use as a between-subjects factor, and correlational analyses were conducted between CBF and caffeine use. Caffeine reduced CBF by an average of 27% across both caffeine states. In the abstained placebo condition, moderate and high users had similarly greater CBF than low users; but in the native placebo condition, the high users had a trend towards less CBF than the low and moderate users. Our results suggest a limited ability of the cerebrovascular adenosine system to compensate for high amounts of daily caffeine use. Hum Brain Mapp 2009. © 2009 Wiley-Liss, Inc. [source] Patients with problematic opioid use can be weaned from codeine without pain escalationACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2010H. K. NILSEN Background: Brief treatments for chronic non-malignant pain patients with problematic opioid use are warranted. The aims of the present study were to investigate (1) whether it is possible to withdraw codeine use in such patients with a brief cognitive-behavioural therapy (CBT), (2) whether this could be done without pain escalation and reduction in quality of life and (3) to explore the effects of codeine reduction on neurocognitive functioning. Methods: Eleven patients using codeine daily corresponding to 40,100 mg morphine were included. Two specifically trained physicians treated the patients with six CBT sessions, tapering codeine gradually within 8 weeks. Codeine use, pain intensity, quality of life and neuropsychological functioning were assessed at pre-treatment to the 3-month follow-up. Results: Codeine use was significantly reduced from mean 237 mg [standard deviation (SD) 65] pre-treatment to 45 mg (SD 66) post-treatment and to 48 mg (SD 65) at follow-up without significant pain escalation or reductions in quality of life. Moreover, neuropsychological functioning improved significantly on some tests, while others remained unchanged. Conclusion: The promising findings of codeine reduction in this weaning therapy programme for pain patients with problematic opioid use should be further evaluated in a larger randomized control trial comparing this brief CBT with both another brief treatment and attention placebo condition. [source] Subjective Response to Alcohol: A Critical Review of the LiteratureALCOHOLISM, Issue 3 2010Meghan E. Morean Background:, Subjective response to alcohol (SR), which reflects individual differences in sensitivity to the pharmacological effects of alcohol, may be an important endophenotype in understanding genetic influences on drinking behavior and alcohol use disorders (AUDs). SR predicts alcohol use and problems and has been found to differ by a range of established risk factors for the development of AUDs (e.g., family history of alcoholism). The exact pattern of SR associated with increased risk for alcohol problems, however, remains unclear. The Low Level of Response Model (LLR) suggests that high-risk individuals experience decreased sensitivity to the full range of alcohol effects, while the Differentiator Model (DM) asserts that high risks status is associated with increased sensitivity to alcohol's positive effects but decreased sensitivity to negative effects. Aims:, The current paper (1) reviews two prominent models of subjective response, (2) reviews extant laboratory-based research on subjective response, (3) highlights remaining gaps in our understanding and assessment of subjective response, and (4) encourages collaborative efforts to address these methodological and conceptual concerns. Methods:, This paper reviews studies which employed placebo-controlled and non-placebo-controlled alcohol challenge paradigms to assess a range of alcohol effects including impairment, stimulation, and sedation. Results:, The research literature provides at least partial support for both the LLR and DM models. High-risk individuals have been shown to have a reduced response to alcohol with respect to sedative or impairing effects, particularly on the descending limb of the blood alcohol curve (BAC). There is also evidence that ascending limb stimulant effects are more pronounced or operate differently for high-risk individuals. Discussion:, Despite commendable advances in SR research, important questions remain unanswered. Inconsistent results across studies may be attributable to a combination of an inadequate understanding of the underlying construct and methodological differences across studies (e.g., number and timing of assessments across the BAC, inclusion of a placebo condition). With respect to the underlying construct, existing measures fail to adequately distinguish between cognitive/behavioral impairment and sedation, aspects of which may be perceived positively (e.g., anxiolysis) due to their ability to act as negative reinforcers. Conclusions:, Addressing the concerns raised by the current review will be integral to making meaningful scientific progress in the field of subjective response. [source] Problems with the use of placebo conditions in psychotherapy research, suggested alternatives, and some strategies for the pursuit of the placebo phenomenonJOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2005T. D. Borkovec Due to the numerous conceptual, methodological, and ethical problems that are associated with placebo conditions in psychotherapy research, their use should be abandoned, and more powerful therapy outcome designs (dismantling, additive, parametric, and catalytic) that can contribute to basic knowledge through their ability to isolate specific cause-and-effect relationships are recommended. On the other hand, if indeed the placebo effect is a reliable phenomenon, it would be wise to pursue its causal mechanisms, and some research strategies for initiating such pursuit are briefly described. © 2005 Wiley Periodicals, Inc. J Clin Psychol 61: 805,818, 2005. [source] Naltrexone Selectively Elevates GABAergic Neuroactive Steroid Levels in Heavy Drinkers With the ASP40 Allele of the OPRM1 Gene: A Pilot InvestigationALCOHOLISM, Issue 8 2010Lara A. Ray Background:, Preclinical studies have implicated GABAergic neurosteroids in behavioral responses to alcohol. Naltrexone is thought to blunt the reinforcing effects of alcohol, and a few studies have found that the effects of naltrexone are moderated by the Asn40Asp polymorphisms of the OPRM1 gene. The present study seeks to integrate these lines of research by testing (i) the moderating role of the functional Asn40Asp polymorphism of the OPRM1 gene on naltrexone-induced alternations in GABAergic neurosteroid levels, namely (3,,5,)-3-hydroxypregnan-20-one (allopregnanolone, ALLO); and (ii) the combined effects of naltrexone or genotype with alcohol administration on neurosteroid levels in a sample of at-risk drinkers. Methods:, Participants were 32 (9 females) nontreatment-seeking heavy drinkers who completed a placebo-controlled laboratory study of naltrexone (50 mg/d for 3 days) and provided complete sets of serum samples for ALLO assays before and after alcohol administration under both naltrexone and placebo conditions. Results:, Naltrexone treatment raised ALLO levels among carriers of the Asp40 allele, but not homozygotes for the Asn40 allele. The Asn40Asp polymorphism did not moderate effects of naltrexone on cortisol levels. Ethanol infusion modestly reduced ALLO levels in all subjects, independent of genotype or naltrexone exposure. Conclusions:, Naltrexone increased ALLO levels among individuals with the Asn40Asp allele suggesting a potential neurosteroid contribution to the neuropharmacological effects of naltrexone among Asp40 carriers. [source] | |||||||||||||