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SPNer
February 16, 2011
Attitude can influence effectiveness of medical treatment, study shows
Joseph Hall
Health Reporter
When it comes to medical therapies, disposition is as potent as drugs, a new study shows.
In first-of-its-kind research, German scientists have used brain imaging scans to show that a patient’s positive outlooks towards treatments can actually double their effectiveness. A gloomy attitude can nearly negate any benefits.
“It’s been a very long-standing clinical observation that patients’ beliefs and expectations affect how any treatment works,” says Dr. Ulrike Bingel, the lead study author.
“What we’ve shown is that this is a real physical effect,” says Bingel, a pain specialist and neurologist at the University of Hamburg.
The work shows that instilling a positive attitude in patients can vastly increase the effectiveness of medical treatments, she says.
The study was released Wednesday by the journal Science Translational Medicine.
Past work on this outlook effect in medicine has relied on patients’ self reported assessment of a treatment’s benefits, Bingel says.
But these subjective reports could often mask the true effects of outlook because patients might often tell their physicians what they think they’d like to hear, she says.
“You can think a patient wants to report an increased benefit to please the physician,” Bingel says.
To get around these subjective reporting doubts, Bingel’s team turned to functional magnetic resonance imaging, or fMRI, to peer into the brain areas that regulate pain while a drug was active.
The researchers took 22 healthy students and used heat to apply pain to their forearms. The students were then administered an opioid-based pain medication under three different conditions.
One set of students were not told they would receive the drug, another group was told the pain would be reduced and a third that the pain might become worse.
“Then we used fMRI to have some objective proof of the (painkiller’s) benefit,” Bingel says.
Training their scans on the area of the brain that processes pain intensity, the researchers could judge the effectiveness of the drug on each different group.
“We found that with the positive treatment expectancy that the effect of the (pain killer) was enhanced,” Bingel says.
“It was in fact doubled, which was quite surprising. Doubled just by positive expectancy. . . as if you have two drugs”
For the students who believed that there would be increased suffering — something many real patients fear ahead of treatment — scans showed the drug had no effect.
“It was completely abolished, as if they were not given any drug at all,” Bingel says.
Bingel says that the attitudinal effect shown with pain killer should apply to many different types of drugs.
Indeed, earlier experiments using self reporting techniques have shown similar outlook effects with drugs for depression and anxiety.
Because the brain is so involved in regulation of the immune system, the same effect might also be expected for cancer chemotherapies as well, Bingel says.
“I’m convinced a very similar mechanism could be applied to these situations,” she says.
“The next step is to look at different systems and look at how different drugs combine with expectation and experience.”
Just what how attitude plays a physiological role in enhancing drugs and other therapies has yet to be determined, Bingel says.
But, she says, the study opens up the possibility that drugs could be tailor made to work with the specific brain areas that positive attitudes spark up to enhance relief or healing.
The challenge, she says, is to now find ways to instill optimism in patients ahead of treatments.
source: http://www.healthzone.ca/health/newsfeatures/article/940027--attitude-can-influence-effectiveness-of-medical-treatment-study-shows?bn=1
Attitude can influence effectiveness of medical treatment, study shows
Joseph Hall
Health Reporter
When it comes to medical therapies, disposition is as potent as drugs, a new study shows.
In first-of-its-kind research, German scientists have used brain imaging scans to show that a patient’s positive outlooks towards treatments can actually double their effectiveness. A gloomy attitude can nearly negate any benefits.
“It’s been a very long-standing clinical observation that patients’ beliefs and expectations affect how any treatment works,” says Dr. Ulrike Bingel, the lead study author.
“What we’ve shown is that this is a real physical effect,” says Bingel, a pain specialist and neurologist at the University of Hamburg.
The work shows that instilling a positive attitude in patients can vastly increase the effectiveness of medical treatments, she says.
The study was released Wednesday by the journal Science Translational Medicine.
Past work on this outlook effect in medicine has relied on patients’ self reported assessment of a treatment’s benefits, Bingel says.
But these subjective reports could often mask the true effects of outlook because patients might often tell their physicians what they think they’d like to hear, she says.
“You can think a patient wants to report an increased benefit to please the physician,” Bingel says.
To get around these subjective reporting doubts, Bingel’s team turned to functional magnetic resonance imaging, or fMRI, to peer into the brain areas that regulate pain while a drug was active.
The researchers took 22 healthy students and used heat to apply pain to their forearms. The students were then administered an opioid-based pain medication under three different conditions.
One set of students were not told they would receive the drug, another group was told the pain would be reduced and a third that the pain might become worse.
“Then we used fMRI to have some objective proof of the (painkiller’s) benefit,” Bingel says.
Training their scans on the area of the brain that processes pain intensity, the researchers could judge the effectiveness of the drug on each different group.
“We found that with the positive treatment expectancy that the effect of the (pain killer) was enhanced,” Bingel says.
“It was in fact doubled, which was quite surprising. Doubled just by positive expectancy. . . as if you have two drugs”
For the students who believed that there would be increased suffering — something many real patients fear ahead of treatment — scans showed the drug had no effect.
“It was completely abolished, as if they were not given any drug at all,” Bingel says.
Bingel says that the attitudinal effect shown with pain killer should apply to many different types of drugs.
Indeed, earlier experiments using self reporting techniques have shown similar outlook effects with drugs for depression and anxiety.
Because the brain is so involved in regulation of the immune system, the same effect might also be expected for cancer chemotherapies as well, Bingel says.
“I’m convinced a very similar mechanism could be applied to these situations,” she says.
“The next step is to look at different systems and look at how different drugs combine with expectation and experience.”
Just what how attitude plays a physiological role in enhancing drugs and other therapies has yet to be determined, Bingel says.
But, she says, the study opens up the possibility that drugs could be tailor made to work with the specific brain areas that positive attitudes spark up to enhance relief or healing.
The challenge, she says, is to now find ways to instill optimism in patients ahead of treatments.
source: http://www.healthzone.ca/health/newsfeatures/article/940027--attitude-can-influence-effectiveness-of-medical-treatment-study-shows?bn=1
