Manipulating the Placebo Effect?

` *Newsflash!* I have just read a Nature News article that there is some headway in understanding the placebo effect! (As published in Neuron.) This may one day lead to doctors actually using it to help patients, which I've always thought they ought to!

` The presence of the placebo effect - which is basically a benefit that is perceived apart from (or in absence of) medical treatment - has long been known to complicate medical trials (as I have mentioned in my first/last post).
` It explains why an ailing patient can feel as if they are improving, even dramatically, though they have received no real treatment at all. As it turns out, the presence and even the strength of the placebo effect has been linked to activity in a part of the brain called the nucleus accumbens.

` This brain structure is known to activate when we anticipate a future reward. Not only that, but when it is overactive we can develop addictions to things like drugs and gambling.
` According to the head of the study, Jon-Kar Zubieta of the University of Michigan, "This is driving the idea that you can manipulate the placebo effect, to increase it for therapeutic treatment."
` One way it could be done is to urge doctors to be more optimistic about their patients' treatment options and, says I, to give them more undivided attention. Seeing as how much of 'alternative' medicine seems to rely on this principle, that seems reasonable to me!

` On the other hand, methods to reduce or otherwise control the placebo effect might actually improve the accuracy of telling the effects of placebo apart from those of the actual treatment during medical trials.

` Zubieta and team have tested it out this way: They injected salt solution into the cheek of each of their thirty volunteers. Then, the subjects were given a mystery injection that was either a painkiller or a placebo.
` What they didn't know was that they had all gotten placebos!
` Some of the volunteers were also re-injected with the salt solution, but not offered anything else. That time, most of them reported that the mystery injection had been more effective than nothing. And yet, it was - technically - nothing!

` Interestingly, there was a lot of variation in the level of each person's placebo effect, and the team figured it might have something to do with the nucleus accumbens. So, they scanned the brains of fourteen of the volunteers, and sure enough, they measured more dopamine being produced in that area - a sign that indicates a reward being anticipated.
` They also found that the more dopamine that was being produced in the nucleus accumbens, the stronger the placebo effect was.
` The people with the highest dopamine output (and placebo effect) also had the most optimism concerning future rewards, which was revealed later when their brains were scanned while they played a gambling game.

` As neuropsychologist Chris Frith at University College London notes; "The doctors who do best are the ones who are most deluded that their treatments do work."
` Incidentally, this is exactly what science writer Toby Murcott says keeps alternative medicine practitioners in business. But that's a Whole 'nother Story.

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