Neurobiology of Placebos with Fabrizio Benedetti (BSP 77)

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Fabrizio Benedetti, MD

 Fabrizio Benedetti is one of the world's leading researchers of the neurobiology of placebos.  In a recent interview (BSP 77) he explained to me that he believes that "today we are in a very good position to describe, from a biological and from an evolutionary approach, the doctor-patient relationship, and the placebo effect, itself."

To appreciate Dr. Benedetti's work, one must first realize that his approach differs from that of the typical clinical trial.  As he observed, "To the clinical trialist, a placebo effect means any improvement which may take place after placebo administration.  To the neurobiologist, a placebo response, or placebo effect means only something active in the brain happening after placebo administration: learning, anxiety reduction, activation of reward mechanisms."

In contrast, he explains, "The real placebo response, the real placebo effect is a psychobiological phenomenon.  It is something active happening in the brain after placebo administration: like learning, like anxiety reduction, and such like." Brain Science Podcast #77 provides an introduction to this complex, but fascinating topic.

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References

  • Benedetti F, Mayberg HS, Wager TD, Stohler CS, Jon-Kar Zubieta J (2005) Neurobiological Mechanisms of the Placebo Effect. The Journal of Neuroscience, 25,10390-10402. (Full article)

  • Benedetti F (2009) Placebo Effects: Understanding the mechanisms in health and disease. Oxford University Press.

  • Benedetti F (2011) The Patient's Brain: The neuroscience behind the doctor-patient relationship. Oxford University Press.

  • Levine JD, Gordon NC and Fields, HL (1978) The mechanisms of placebo analgesia. Lancet, 2, 654-7. (Abstract)

  • Levine JD, Gordon NC and Fields, HL (1978) “The mechanisms of placebo analgesia.” Lancet, 2, 654-7. (Abstract). See also a follow-up paper: Levine JD, Gordon NC, Bornstein JC, and H L Fields HL (1979) “Role of pain in placebo analgesia.” Proc Natl Acad Sci76(7): 3528–3531. (full text)

  • Volkow, ND, Wang JG, Ma Y, Fowler JS, Zhu W, Maynard L et al. (2003) Expectation enhances the regional brain metabolic and the reinforcing effects of stimulants in cocaine abusers. Journal of Neuroscience, 23, 11261–8. (Full text)

  • de la Fuente-Fernández R, et al. (2001) Expectation and Dopamine Release: Mechanism of the Placebo Effect in Parkinson's Disease. Science293, 1164. (Abstract)

  • Benedetti F, Colloca L, Torre E et al. (2004) Placebo-responsive Parkinson patients show decreased activity in single neurons of the subthalamic nucleus. Nature Neuroscience, 7, 587-88. (Abstract)

  • Herrnstein RJ, (1962) Placebo Effect in the Rat. Science138, 677-678.

  • Linde K, Witt CM, Streng A et al. (2007) The impact of patient expectation in four randomized control trials of acupuncture in patients with chronic pain. Pain, 128, 264-71. (Abstract)

Announcements

Corrections

  •  32:48 only NON-members are eligible to get a free audiobook download from our sponsor at http://audiblepodcast.com/brainscience.

  • Dr. Benedetti’s first book is called Placebo Effects, not Placebo “responses”.

  • Special Thanks to Lori Wolfson for finding these mistakes and correcting them in the episode transcript.

Send me feedback at gincampbell at brainsciencepodcast@gmail.com