Project Details
Projekt
Exploiting learning mechanisms to maximize analgesic treatment outcome
Applicant
Professorin Dr. Ulrike Bingel
Subject Area
Human Cognitive and Systems Neuroscience
Personality Psychology, Clinical and Medical Psychology, Methodology
Personality Psychology, Clinical and Medical Psychology, Methodology
Term
from 2010 to 2020
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 138279939
Behavioral conditioning is considered a key mechanism of placebo and nocebo responses and, moreover, it is part of any therapeutic approach, including pharmacotherapy. Here we propose two projects that aim at elucidating mechanisms and modulators of behaviorally conditioned placebo responses in pain therapy to improve the efficacy and tolerability of pharmacological pain treatment as an example for pharmacological interventions. In project 1, we will investigate behaviorally conditioned placebo analgesia following morphine exposure to answer the following questions: (i) How is the conditioned analgesic response related to conditioned adverse effects? (ii) Can the conditioned analgesic response be enhanced by pairing sub-therapeutic doses of morphine with the conditioned stimulus (CS)? (iii) Can interindividual differences in conditioned morphine analgesia be predicted by psychological or physiological trait variables? And (iv) what are the distinct neural mechanisms of conditioned pharmacological analgesia compared to other types of placebo analgesia? These questions are particularly relevant for the exploitation of the conditioning of pharmacological responses in the clinical context to maximize conditioned therapeutic effects, minimize potential adverse effects of the conditioned response and predict the benefit of a treatment strategy in individual patients. In project 2, we will investigate whether the effect of prior treatment experience on a subsequent treatment approach depends on the similarity of both treatments. According to the conditioning literature, ‘carry-over effects’ are more likely the more similar the conditioned stimuli are in appearance. More specifically, we will systematically vary two important variables of the treatment context between two subsequent treatments, namely the application form (e.g., from topical to systemic application) and the study physician. To allow for the assessment of treatment history effects irrespective of pharmacological peculiarities, experimental models of placebo analgesia will be used that allow for the generalization of our findings. We expect that a change in application form and/or a change in study physician will minimize negative carry-over effects after treatment failure. The insights that are expected from the experimental approaches used in these projects could easily be transferred into a clinical context to optimize therapeutic approaches.
DFG Programme
Research Units
