Tag Archives: medication

Study finds how to predict which brains respond to placebo treatments

A new study offers insight into why a simple sugar pill can work to significantly reduce pain for some patients while having no effect on others.

Image credits Patrik Nygren / Flickr.

A team from the Northwestern Medicine and the Rehabilitation Institute of Chicago (RIC) used fMRI to identify the brain area responsible for the placebo effect in pain relief. This region, known as the mid-frontal gyrus (MFG), is located at the front of the brain and also plays a key role in our decision making and emotional state. The data was recorded in two clinical trials involving 95 patients with chronic pain from osteoarthritis. The team found that participants who had better connectivity between the MFG and other brain areas were more likely to respond to the placebo effect.

The findings could be used to better tailor pain medication to each patient’s brain structure, offering a safer and more efficient alternative to the current trial-and-error approach. In Germany, half of all doctors prescribe placebos for non-chronic illnesses — they might be on to something.

“Given the enormous societal toll of chronic pain, being able to predict placebo responders in a chronic pain population could both help the design of personalized medicine and enhance the success of clinical trials,” said Marwan Baliki, PhD, a research scientist at RIC and assistant professor of physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine.

Also, these differences in brain structure could be the reason why some drugs — such as pregabalin, commercially known as Lyrica — provide pain relief in some patients, but not others. By understanding how each patient responds to pain medication, those predisposed to the placebo effect can be eliminated from clinical trials, making future research far more reliable.

“This can help us better conduct clinical studies by screening out patients that respond to placebo and we can just include patients that do not respond. And we can measure the efficacy of a certain drug in a much more effective manner,” he added.

“If we do the same with Lyrica, maybe we can find another area of the brain that can predict the response to that drug.”

Professor of physiology at Feinberg and study co-author Vania Apkarian said that the findings will allow physicians to see what brain regions become active while a patient feels pain, then decide on a drug that specifically targets that area.

“It also will provide more evidence-based measurements. Physicians will be able to measure how the patient’s pain region is affected by the drug,” she added.

The full paper “Brain Connectivity Predicts Placebo Response across Chronic Pain Clinical Trials” has been published in the journal PLOS Biology.

Of pain and marijuana

The sun begins to ooze off outside of Birmingham, England. It’s tea time. A woman stands alone in her house, making herself a nice warm cup. After the tea is done, she stirs a half spoon cannabis in her tea, in an attempt to seek relief from pain and spasms caused by her multiple sclerosis. This desperate attempt to get rid of the chronic pain for just a few hours is, in the eyes of British justice, a crime.

She realizes what she’s doing; doesn’t take the drug lightly, or for recreational purposes. She’s also aware that it could get her prosecuted, and yet she still refuses to take the daily 13 pills she’s been prescribed, and instead chooses to use cannabis, which gives her 3 hours of relief. In case you don’t know, multiple sclerosis is one of the worst diseases you can have. It’s basically a degenerative disease of the central nervous system, with symptoms including pain, paralysis, loss of balance, etc.

“When I wake up in the morning my knees, my ankles, I have all these muscles pull my leg to the left so I find it hard to walk straight,” she said. “With cannabis these symptoms recede to a point where I can walk OK-ish. I want politicians to be nice to me… I’m sick.”[..] “I just don’t want to take the route of taking 13 pills a day when I can just use one medicine – cannabis – and I feel fantastic using it,” she said.
“I’d rather take the risk of breaking the law than go through that.”

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So why doesn’t she just take the pills ? Well, first of all they have a sum of negative side effects that include high blood pressure, ulcers and even the risk of heart failure and psychosis. They also just don’t work sometimes, or require an increase of dosage at regular intervals. I don’t know, but I’m guessing they’re also very expensive. As for cannabis, well, the risk of negative side effects is almost neglectable. You can literally grow it yourself, and it’s accepted (even recommended) by more and more countries in medical situations. The medical uses of marijuana are numerous, including multiple sclerosis, glaucoma, HIV/AIDS, arthritis, and cancer. It greatly reduces pain and nausea, spasms, depression and sleeping disorders, and patients who used it reported a significant increase in the general quality of life.

To my knowledge, this is the only natural plant that’s illegal. The real irony here is that just by watching TV for a couple of hours you’re bombarded with commercials for powerful medications with numerous possible side effects, but they’re perfectly legal; even more than that – they’re recommended.

Via BBC, who I’d like to thank