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PLACEBO'S POWER GOES BEYOND THE MIND
SCIENTISTS TAP INTO FAKE PILL'S EFFECTS TO HELP REAL PAINS
By Linda Carroll
MSNBC
August 21, 2006
http://www.msnbc.msn.com/id/14309026/
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, Parkıs
depression
started to lift. He began to feel less anxious and sad.
So when Park learned heıd been taking a placebo all along, it
was a
surprise.
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
with healing.
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 Parkinsonıs 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 personıs 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
Columbia University.
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 bodyıs response to
perceived
threats.
³Say itıs 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 couldnıt, Wager
says. ³But if
the belief changes -- say, it turns out that itıs just your
husband coming
home -- the physical response changes.²
The question, now, is how to tap into these powerful,
unconscious responses,
Wager says.
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
brainıs electrical activity. After a week of sugar pills, the
volunteers
were then given either more placebos or an actual
antidepressant. They
werenıt 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 havenıt 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 reportıs 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 Stanfordıs 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 donıt
actually ³feel² pain.
Part of what goes into the brainıs 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
Empowering experiment
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
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PLACEBO SPARKS BRAIN PAINKILLERS (8/24/2005):
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ACUPUNCTURE, REAL OR FAKE, MAY HELP MIGRAINES (5/3/2005):
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FIRST GLIMPSE OF MECHANISTIC EXPLANATION FOR PLACEBO EFFECT
(5/19/2004):
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COUGH MEDICINES 'NO MORE EFFECTIVE THAN PLACEBOS' (6/24/2002):
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PLACEBOS FIGHT DEPRESSION AS WELL AS DRUGS (5/8/2002):
http://groups.yahoo.com/group/nhnenews/message/3126
THE NOCEBO EFFECT: PLACEBO'S EVIL TWIN (5/2/2002):
http://groups.yahoo.com/group/nhnenews/message/3100
THE PLACEBO EFFECT: THE POWER OF NOTHING (5/26/2001):
http://groups.yahoo.com/group/nhnenews/message/1513
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Published by David Sunfellow
NewHeavenNewEarth (NHNE)
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