The new study has provided scientists with a better understanding of why taking simple sugar pills can significantly reduce pain in some people.
It turns out that all this is in their heads.
Using functional magnetic resonance imaging of the brain, scientists at the Northwestern Institute of Medicine and Rehabilitation in Chicago have found for the first time an area of the brain that is responsible for the "placebo effect" in pain relief. This area in the front of the brain is called the middle frontal gyrus, and it also plays a key role in emotion and decision-making.
In two clinical trials involving 95 patients with chronic osteoarthritis pain, the researchers found that in about half of the participants, the middle frontal gyrus was more connected to other parts of the brain and responded better to the placebo effect.
“Given the enormous social cost of chronic pain, the ability to single out placebo-treated people with chronic pain could help develop personalized medicines and improve the effectiveness of clinical trials,” said scientist Marwan Baliki.
“This will allow clinical trials to be conducted more effectively, screening out patients who respond to placebo and leaving those who are not. This will make it possible to more accurately measure the effectiveness of certain drugs."
Baliki said the differences in the brain may explain why some prescription drugs are effective in relieving pain in some people without affecting others.
The research results were published in the journal PLOS Biology.
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“New technologies will allow doctors to see which part of the brain is activated when pain occurs in an individual and to choose a specific drug for targeted action,” said co-author of the study, professor of physiology Vanya Apkaryan. “It will also provide more reliable results. Doctors will be able to assess how pain-related areas respond to the drug.”
Currently, most clinical studies of pain syndromes are conducted in healthy subjects under controlled experimental conditions. In these experiments, acute pain is usually caused by exposure to cold water, pressure, or otherwise. There is a significant difference between acute and chronic pain, Baliki said, and this is often overlooked in clinical trials, where pain tends to be chronic.
Sergey Lukavsky