MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom.
Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
Elife. 2024 Mar 28;12:RP88889. doi: 10.7554/eLife.88889.
In recent years, there has been debate about the effectiveness of treatments from different fields, such as neurostimulation, neurofeedback, brain training, and pharmacotherapy. This debate has been fuelled by contradictory and nuanced experimental findings. Notably, the effectiveness of a given treatment is commonly evaluated by comparing the effect of the active treatment versus the placebo on human health and/or behaviour. However, this approach neglects the individual's subjective experience of the type of treatment she or he received in establishing treatment efficacy. Here, we show that individual differences in the thought of receiving the active or placebo condition during an experiment - can explain variability in outcomes better than the actual treatment. We analysed four independent datasets (N = 387 participants), including clinical patients and healthy adults from different age groups who were exposed to different neurostimulation treatments (transcranial magnetic stimulation: Studies 1 and 2; transcranial direct current stimulation: Studies 3 and 4). Our findings show that the inclusion of can provide a better model fit either alone or in interaction with (defined as the condition to which participants are assigned in the experiment). These results demonstrate the significant contribution of subjective experience in explaining the variability of clinical, cognitive, and behavioural outcomes. We advocate for existing and future studies in clinical and non-clinical research to start accounting for participants' subjective beliefs and their interplay with objective treatment when assessing the efficacy of treatments. This approach will be crucial in providing a more accurate estimation of the treatment effect and its source, allowing the development of effective and reproducible interventions.
近年来，关于神经刺激、神经反馈、大脑训练和药物治疗等不同领域治疗方法的有效性一直存在争议。这种争议是由相互矛盾且细微的实验结果所推动的。值得注意的是，通常通过比较活性治疗与安慰剂对人类健康和/或行为的影响来评估特定治疗的有效性。然而，这种方法忽略了个体对所接受治疗类型的主观体验在确立治疗效果中的作用。在这里，我们表明，在实验过程中个体对接受活性或安慰剂条件的想法的差异——可以比实际治疗更好地解释结果的可变性。我们分析了四个独立的数据集（N = 387 名参与者），包括来自不同年龄组的临床患者和健康成年人，他们接受了不同的神经刺激治疗（经颅磁刺激：研究 1 和 2；经颅直流电刺激：研究 3 和 4）。我们的研究结果表明，纳入可以单独或与（定义为参与者在实验中被分配到的条件）相互作用提供更好的模型拟合。这些结果表明，主观体验在解释临床、认知和行为结果的可变性方面具有重要贡献。我们主张在临床和非临床研究中，现有的和未来的研究开始考虑参与者的主观信念及其与客观治疗的相互作用，以评估治疗的效果。这种方法对于提供治疗效果及其来源的更准确估计将至关重要，从而能够开发出有效且可重复的干预措施。
