NEUROBIOLOGICAL MECHANISMS

Neurobiological Mechanisms of the Placebo Effect and How It Could Lead To Improvement In Patients With Diseases of the CNS



Neurobiological Mechanisms of the Placebo Effect and How It Could Lead To Improvement In Patients With Diseases of the CNS

Introduction

Affective disorders are frequent and disabling conditions in multiple sclerosis; however, the underlying neurobiological mechanisms are still poorly understood and investigated. Previous structural imaging studies have suggested that damage of frontal and temporal cortices plays an important role in the genesis of emotional disorders in multiple sclerosis, although psychosocial factors have been also implicated. However, this initial research may not have fully characterized the brain's functional dynamics of emotional processes in multiple sclerosis. Functional magnetic resonance imaging (fMRI) appears, therefore, to be a sensible tool to explore neurobiological mechanisms of emotions in multiple sclerosis since it also allows investigation of the functional connectivity or 'communication' between critical regions in affective behaviour

All medical procedures are associated with a complex psychosocial context that might affect the therapeutic outcome. To analyse the effects of the psychosocial context on the patient, we need to eliminate the specific action of a therapy (for example, a drug) and to reproduce a context that is similar in all respects to that of real drug administration, without the specific action of the drug itself. To do this, a dummy treatment (the placebo) is given, which the patient believes is an effective therapy, and so expects a reduction in symptoms. The placebo effect, or response, is the outcome that follows the dummy treatment (Benedetti & Amanzio, 1999). Therefore, the study of the placebo effect is essentially the study of the psychosocial context that surrounds the patient. This paper discusses neurobiological mechanisms of the placebo effect and how it could lead to improvement in patients with diseases of the CNS in a concise and comprehensive way.

Define & Describe Neurobiological Mechanisms of the Placebo Effect & How It Could Lead

Neurobiological mechanisms are an effort that psychologists and neurologists invest considerable effort in the study of working memory. In terms of information retention, there is a difference between long-term memory, which is affected in diseases such as Alzheimer, and short-term or working memory, which allows us to make immediate decisions or structure a discourse. This more ephemeral memory is affected in diseases such as schizophrenia and depression, although a cause-effect relationship has not been established.

There is no standard definition of the "placebo effect." As a clinical phenomenon, the "placebo effect" is a generic name for beneficial effects that derive from the context of the clinical encounter, including the ritual of treatment and the clinician-patient relationship, as distinct from therapeutic benefits produced by the specific or characteristic pharmacological or physiological effects of medical interventions. Although the "inert" placebo (such as a sugar pill or saline injection) is a tool for scientific understanding of the placebo effect, a placebo intervention is not necessary to elicit it. The placebo effect may accompany and enhance the effectiveness of medical interventions with demonstrated specific treatment ...