Placebo's Power Goes Beyond The Mind
- NHNE News List
Current Members: 1488
Subscribe/unsubscribe/archive info at the bottom of this message.
PLACEBO'S POWER GOES BEYOND THE MIND
SCIENTISTS TAP INTO FAKE PILL'S EFFECTS TO HELP REAL PAINS
By Linda Carroll
August 21, 2006
Even though medical researchers told Chuck Park that he might be getting a
sugar pill, the 30-year-old software producer was pretty sure he was getting
the real thing. Just a few weeks into the clinical trial, Park¹s depression
started to lift. He began to feel less anxious and sad.
So when Park learned he¹d been taking a placebo all along, it was a
³I was fully expecting to receive the real drug even though I knew that the
placebo was a possibility,² remembers Park of Culver City, Calif. ³I guess I
wanted it to work -- and in a way, it did.
For years, scientists have looked at the placebo effect as just a figment of
overactive patient imaginations. Sure, dummy medications seemed to curb
epileptic seizures, lower blood pressure, soothe migraines and smooth out
jerky movements in Parkinson's -- but these people weren't really better. Or
so scientists thought.
Now, using PET scanners and MRIs to peer into the heads of patients who
respond to sugar pills, researchers have discovered that the placebo effect
is not "all in patients' heads" but rather, in their brains. New research
shows that belief in a dummy treatment leads to changes in brain chemistry.
"There have always been people who have said that we could make ourselves
better by positive thinking,² says Dr. Michael Selzer, professor of
neurology at the University of Pennsylvania School of Medicine. ³After
pooh-poohing this for years, here are studies that show that our thoughts
may actually interact with the brain in a physical way."
New insights into how placebos work may even help scientists figure out how
to harness the effect and teach people to train their own brains to help
Mind over brain matter
Recent reports show that anticipation of relief from a placebo can lead to
an actual easing of aches, when the brain makes more of its own pain-dousing
opiates. Brain scans of Parkinson¹s patients show increases in a chemical
messenger called dopamine, which leads to an improvement in symptoms when
patients think -- mistakenly -- that they are receiving real therapy.
And studies in depressed patients like Park have found that almost as many
are helped by placebo treatments as by actual medications. In fact, as it
turns out, a person¹s response to placebo treatment may offer clues as to
whether ³real² treatments with antidepressants are likely to work.
Researchers are just starting to appreciate the power that the mind can have
over the body, says Tor Wager, an assistant professor of psychology at
³An emerging idea right now is that belief in a placebo taps into processes
in your brain that produce physical results that really shape how your body
responds to things,² he says. ³The brain has much more control over the body
than we can voluntarily exert.²
As an example of this, Wager points to the body¹s response to perceived
³Say it¹s late at night and everything is quiet and then suddenly you see
someone outside, near a window,² he explains. ³Your body starts to respond.
Your pupils dilate. Your heart rate goes up. You start to sweat.²
The belief that something threatening is out there produces a host of
physical responses that you have little control over. If you were told to
calm down and turn off these sensations, you couldn¹t, Wager says. ³But if
the belief changes -- say, it turns out that it¹s just your husband coming
home -- the physical response changes.²
The question, now, is how to tap into these powerful, unconscious responses,
Brain waves may hold key
At the University of California at Los Angeles, placebo-treated volunteers
were hooked up to an electroencephalograph (EEG), a device that records the
brain¹s electrical activity. After a week of sugar pills, the volunteers
were then given either more placebos or an actual antidepressant. They
weren¹t told which type of pill they received.
Eight weeks later, researchers scrutinized the brain waves recorded by the
EEG back when all the volunteers were taking placebos. The UCLA scientists
discovered something intriguing: The people who got the most benefit from
the actual medication had a specific pattern of brain waves when they were
being treated with placebos.
Those results were described in a study published this month in the American
Journal of Psychiatry. Researchers haven¹t figured out yet what the specific
pattern of brain waves mean, but the study does show how patients might be
inexpensively screened with an EEG to show doctors who is most likely to
respond to antidepressant medications, says the report¹s lead author Aimee
M. Hunter, a research associate at the Semel Institute for Neuroscience and
Human Behavior at UCLA.
Teaching patients to soothe themselves
Meanwhile, at Stanford University, scientists figured there must be a way to
harness the placebo response to help patients soothe their own pain.
The researchers rigged up an MRI so that people could watch real-time images
of their brains, while lying in the scanner. The idea was to use the images
to teach study volunteers to consciously pump up activity in parts of the
brain activated by the placebo effect, says Dr. Sean Mackey, associate
director of Stanford¹s pain management division and director of its
neuroimaging and pain lab.
One of those volunteers, Laura Tibbitts, signed up for the study in hopes
that she might be able to find a way to quiet the constant, permanent pain
that descended after her right shoulder and arm were smashed in a riding
accident eight years earlier.
³Pain is not in the muscles or the arm that may be injured,² Mackey says.
³The pain is in our brains.²
A signal starts out at an injured site and travels up to the brain, Mackey
explains. But, until the brain interprets that electrical signal, you don¹t
actually ³feel² pain.
Part of what goes into the brain¹s interpretation is expectation, Mackey
says. ³I think of the placebo response, at least in part, as a manipulation
of expectancy. And perhaps by changing the expectancy and bumping up the
placebo response we might be able to ultimately find a way to provide
sustained therapy for chronic pain.²
Lying back in the scanner watching images of her brain, Tibbitts was told to
conjure up memories of her pain on the day of the accident. Later, she was
instructed to think soothing thoughts. ³I imagined little people scooping
away the pain, trying to rescue me,² the 32-year-old San Francisco resident
says. ³Or I thought about water or snowflakes putting the fire out.²
Through trial and error, Tibbitts determined which kinds of thoughts fired
up and turned down the brain regions that Mackey said were linked to her
pain. The mental pictures had an impact.
And the newfound control over pain levels was empowering, Tibbitts says.
³I think the most incredible thing was to see that scan of my brain
constantly producing pain,² she adds. ³And then to actually gain control
over the pain, to see that I had that power -- even when I was making myself
feel worse -- was amazing to me.²
RELATED NHNE NEWS LIST ARTICLES:
THIS IS YOUR BRAIN UNDER HYPNOSIS (11/23/2005):
PLACEBO SPARKS BRAIN PAINKILLERS (8/24/2005):
ACUPUNCTURE, REAL OR FAKE, MAY HELP MIGRAINES (5/3/2005):
FIRST GLIMPSE OF MECHANISTIC EXPLANATION FOR PLACEBO EFFECT (5/19/2004):
COUGH MEDICINES 'NO MORE EFFECTIVE THAN PLACEBOS' (6/24/2002):
PLACEBOS FIGHT DEPRESSION AS WELL AS DRUGS (5/8/2002):
THE NOCEBO EFFECT: PLACEBO'S EVIL TWIN (5/2/2002):
THE PLACEBO EFFECT: THE POWER OF NOTHING (5/26/2001):
NHNE News List:
To subscribe, send a message to:
To unsubscribe, send a message to:
To review current posts:
Published by David Sunfellow
NHNE Website: http://www.nhne.org/
Phone: (928) 225-2366
Fax: (815) 642-0117
Appreciate what we are doing?
You can say so with a tax-deductible donation:
P.O. Box 2242
Sedona, AZ 86339