Training Videos > The effectiveness of acupuncture in the absence of placebo

The biggest criticism of complementary therapies is that they only work through placebo mechanisms, so demonstration of effects in the absence of a placebo response would make a strong argument for real effects of treatment, especially in the current climate of evidence-based medicine where proof of a clinically relevant specific effect is becoming more important in order to commission new treatments. In recent years, several studies have shown that the impairment of prefrontal lobe functioning is associated with a reduction in placebo responsiveness in pain, both in patients with dementia with impaired prefrontal connectivity and in normal subjects with reduced integrity of prefrontal white matter. This indicates a key role of prefrontal areas and cognition in placebo analgesia. A review paper by Benedetti et al concluded that ‘if prefrontal functioning is impaired, placebo responses are reduced or totally lacking, as occurs in dementia’. Therefore, it could be argued that the case reports included within this presentation provide evidence of a ‘real’ effect of acupuncture and raise the possibility of including patients with dementia in formal studies from which they might routinely be excluded.