- The Washington Times - Monday, November 28, 2005

ASSOCIATED PRESS

Medical research is showing that the power of expectations has physical — not just psychological — effects on your health. Scientists can now measure the resulting changes in the brain, from the release of natural painkilling chemicals to alterations in how neurons fire.

Among the most provocative findings: New research suggests that once Alzheimer’s disease robs someone of the ability to expect that a proven painkiller will help them, it doesn’t work as well.

It’s a new spin on the so-called placebo effect — and it raises the question of how to harness this power and thus enhance treatment benefits for patients.

“Your expectations can have profound impacts on your brain and your health,” said Columbia University neuroscientist Tor Wager.



“There is not a single placebo effect, but many placebo effects,” that differ by illness, said Dr. Fabrizio Benedetti of Italy’s University of Turin Medical School, who is studying those effects in patients with Alzheimer’s, Parkinson’s disease and pain.

The placebo effect is infamous from studies of medications: Scientists often give either an experimental drug or a dummy pill to patients and see how they fare. Frequently, those taking the fake feel better, too, for a while, making it more difficult to determine the medication’s true effects.

Doctors have long thought the placebo effect was psychological.

Now scientists are amassing the first direct evidence that the placebo effect actually is physical, and that expecting benefit can trigger the same neurological pathways of healing as real medication does. Among them:

• University of Michigan scientists injected the jaws of healthy young men with saltwater to cause painful pressure, while PET scans measured the affect in their brains. During one scan, the men were told they were getting a pain reliever, actually a placebo.

Their brains immediately released more endorphins — chemicals that act as natural painkillers by blocking the transmission of pain signals between nerve cells — and the men felt better. To return to pre-placebo pain levels, scientists had to increase the saltwater pressure.

• Dr. Benedetti gave Parkinson’s patients a placebo and measured the electrical activity of individual nerve cells in a movement-controlling part of the brain. Those neurons quieted down, a decrease in firing of about 40 percent.

To further prove the power of belief, Dr. Benedetti hooked pain patients to a morphine injection system. Sometimes the computer administered a dose without them knowing it; sometimes a nurse pretended to give it. The morphine was up to 50 percent more effective when patients knew it was coming.

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