Who will a placebo help?
Researchers at Northwestern University, working under the guidance of Professor Vania Apkarian, have developed a method for identifying patients with chronic pain syndrome who respond well to placebo. The method is based on the determination of the characteristics of the psyche and the anatomy of the brain.
As part of their study, they randomly divided 60 patients with chronic back pain into 2 groups. Participants in one group did not know what they were getting: an analgesic drug or a sugar pill as a placebo. The authors did not examine patients receiving a pharmacological drug. Patients of the second group – the control group – visited the clinic, but did not receive either the drug or a placebo.
Patients whose pain subsided in response to the placebo had similar psychological traits and anatomical structure of the brain. The right half of their limbic system, or the so-called "emotional brain", the main components of which are the hypothalamus, amygdala and hippocampus, was larger than the left half. They also had a larger area of the sensory cortex compared to people who did not respond to placebo. In addition, patients with chronic pain responding to placebo were distinguished by emotional self-awareness, sensitivity to difficult situations and attentiveness to their surroundings.
The most interesting thing is that such patients do not even need to be deceived, they respond to a placebo, even if they know that the drug they are taking does not have a physiological effect and only their brain reacts to it (this has been shown in previous studies).
The results obtained by the authors can have three positive effects.
Firstly, doctors will be able to prescribe drugs to such patients that do not have a physiological effect on the body. This will completely eliminate the possibility for them to develop undesirable side effects and addiction associated with most pharmacological therapies.
Secondly, the organizers of clinical trials of pharmaceuticals will be able to filter out participants reacting to placebo and exclude the influence of the placebo effect on the results. As a result, this will reduce the number of participants and eliminate a significant part of the "noise" that interferes with data processing.
Thirdly, replacing drugs with sugar pills will save a significant amount of money for both patients and the healthcare system.
Article by Etienne Vachon-Presseau et al. Brain and psychological determinants of placebo pill response in chronic pain patients published in the journal Nature Communications.
Evgenia Ryabtseva, portal "Eternal Youth" http://vechnayamolodost.ru based on materials from Northwestern University: Sugar pills relieve pain for chronic pain patients.