To the Editor Linnman and Morales-Quezada recently questioned why the neurologic pain signature (NPS)1 is largely unresponsive to placebo treatment.2 They suggest it may be because the NPS was trained on pain ratings elicited by heat applied to the left forearm,1 but tested on studies involving various body sites and stimulation types.2 Predictive models like the NPS can be expected to be more sensitive in settings similar to the training situation, although the degree to which they generalize is an empirical question.
Zunhammer M, Bingel U, Wager TD. Laterality and Stimulation Bias in Meta-analysis of Placebo Responses—Reply. JAMA Neurol. Published online May 20, 201976(7):870. doi:10.1001/jamaneurol.2019.1232
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