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Peripheral neuropathies.

Elisa Frisaldi1

  • 1Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, University of Duisburg-Essen, Essen, Germany.

Handbook of Clinical Neurology
|October 29, 2025
PubMed
Summary
This summary is machine-generated.

This review explores placebo and nocebo effects in peripheral neuropathies. Significant effects were found in specific conditions like neuropathic thoracotomy complications and chronic inflammatory demyelinating polyneuropathy (CIPD).

Keywords:
Carpal tunnel syndromeChronic inflammatory demyelinating polyneuropathyGuillain–Barré syndromeNeuropathic complications of thoracotomyNocebo effectsNocebo responsesPainful diabetic neuropathyPeripheral neuropathyPlacebo effectsPlacebo responsesPostherpetic neuralgia

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Area of Science:

  • Neurology
  • Clinical Trials
  • Psychosomatic Medicine

Background:

  • Peripheral neuropathies encompass diverse conditions affecting nerve function.
  • Placebo and nocebo effects, influenced by patient expectations and context, are increasingly studied in pain and neurological disorders.
  • Research on these effects in peripheral neuropathies is expanding, particularly in the last seven years.

Purpose of the Study:

  • To provide an overview of peripheral neuropathies where placebo and nocebo responses/effects have been investigated.
  • To highlight emerging research on these effects in specific neuropathic conditions.
  • To identify areas needing further research to improve clinical trials.

Main Methods:

  • Literature review of studies investigating placebo and nocebo effects in peripheral neuropathies.
  • Focus on original research published over the past seven years.
  • Analysis of specific conditions including painful diabetic neuropathy, postherpetic neuralgia, neuropathic complications of thoracotomy, carpal tunnel syndrome, Guillain-Barré syndrome, and chronic inflammatory demyelinating polyneuropathy (CIPD).

Main Results:

  • Significant placebo effects were reported for neuropathic complications of thoracotomy and chronic inflammatory demyelinating polyneuropathy (CIPD).
  • Treatment expectations were identified as predictors of treatment outcomes in neuropathic complications of thoracotomy.
  • Limited data exists for most other peripheral neuropathies regarding placebo and nocebo effects.

Conclusions:

  • Placebo and nocebo effects play a role in certain peripheral neuropathies, notably neuropathic complications of thoracotomy and CIPD.
  • Future research should prioritize contextual factors, include no-treatment arms, and control for baseline covariates in clinical trials for peripheral neuropathy.
  • Further investigation is needed to fully understand and leverage placebo/nocebo phenomena across the spectrum of peripheral neuropathies.