Sep 032016

From Senior Wire News Service, September 2016

By Amy Abbott
“Expectation (from the patient) plays a potent role in the placebo effect. The more a person believes they are going to benefit from treatment, the more likely it is they will experience a benefit.”

Avid watchers of “The Andy Griffith Show” recall when pharmacist Ellie Walker came to Mayberry. The 1960 episode put the new pharmacist in a pickle. Resident Emma Brand demanded her standard ten-cent nerve pills from the new pharmacist.

Ellie refused to give Emma her usual dose. As happens in all sitcoms, the problem was solved in 23 minutes when Sheriff Andy Taylor stepped in. The lawman suggested Ellie bend the rules for the quirky Mayberry resident.

The fictional Emma experienced the placebo effect.

Intriguing, new research suggests placebos can cause positive benefits for patients. The human brain may receive clinical benefit from positive expectations via the “placebo effect,” noted an animal study published in the journal Nature Medicine in July 2016.

The placebo effect or “response” is a bogus treatment. According to “Expectation (from the patient) plays a potent role in the placebo effect. The more a person believes they are going to benefit from treatment, the more likely it is they will experience a benefit.”

In plain speak, Emma Brand thought her sugar pills would cure what ailed her, and they did.

Science long studied this effect and wants proof of what Dr. Norman Vincent Peale called “the power of positive thinking” in a clinical improvement.

Researchers in the Nature Medicine study found activation of the ventral tegmental area – a part of the brain – strengthened immune response in mice. We are not Mickey or Minnie, but most medical research starts with animals and progresses to human subjects when appropriate.

The researchers used “designer receptors activated by designer drugs” to activate dopaminergic neurons in the VTA of mice. The $50-dollar word “dopaminergic” relates to dopamine, from the pleasure or rewards center of the brain.

Researchers then applied a virus and studied the immune response. Presto! They noted an immune response against the bacteria. Researchers at the Israel Institute of Technology, Haifa, Israel, concluded their findings established a relationship between the brain activity and the immune response to the bacteria.

What is the significance of this mouse study on mere mortals? For us seniors, who take the lion’s share of prescription medication, this research is significant, or at the very least, compelling.

Ted J. Kaptchuk, Harvard, is likely the guru of studying the placebo effect in this country and offers some answers.

A 2013 Harvard Magazine article recalls a clinical drug trial Kaptchuk directed early in his career for patients experiencing pain. The study compared medication with acupuncture treatments. Researchers warned patients treatments might cause significant side effects. According to the Harvard Magazine, many patients reported real relief as well as significant side effects from treatment. Acupuncture patients reported even better results. However, it was a sham; pills consisted of cornstarch, fake needles didn’t penetrate skin.

Kaptchuk spent his career since this early trial studying the placebo response in the human brain. The challenge, he told Harvard Magazine, is uncovering the mechanisms behind the physical response.

“The experiment, among the first to tease apart the components of placebo response, showed that the method of placebo administration as important as the administration itself,” said Kaptchuk. Is the doctor kind or friendly during the appointment? Did the office have a warm atmosphere?

What a revelation for caregivers! Kaptchuk believes data shows the patient’s perceptions also matter.

Western medicine does not always recognize his work. Kaptchuk’s degree is not an MD or a Ph.D., rather a degree in Traditional Chinese Medicine from a Chinese school. While traditional Western medicine does recognize the power of the mind in healing, it often questions the accuracy of studies.

Kaptchuk told the New Yorker, “Placebos do not shrink tumors. They do not make blind people see. If you are paralyzed, they will not help you walk.” Even after all his research, he says he is not a “zealot or a true believer. I am sure that I do not understand the placebo effect. I ask questions, hopefully, valuable questions, and we will see where the research lands.”

So, is the body pre-conditioned to expect a response? Research continues on this interesting question. Stay tuned.




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