There has been an ongoing debate about placebos on SBM, both in the articles and in the comments. What does it mean that a treatment has been shown to be “no better than placebo?” If our goal is for patients to feel better and they feel better with placebos, why not prescribe them? Do placebos actually do anything useful? What can science tell us about why a patient might report diminished pain after taking an inert sugar pill? The subject is complex and prone to misconceptions. A recent podcast interview offers a breakthrough in understanding.
On her Brain Science Podcast Dr. Ginger Campbell interviewed Dr. Fabrizio Benedetti, a physician and clinical neurophysiologist who is one of the world’s leading researchers on the neurobiology of placebos. A transcript of the interview [PDF] is available on her website for those who prefer reading to listening. The information Dr. Benedetti presents and the expanded remarks by Dr. Campbell after the interview go a long way towards explaining the placebo phenomenon and its consequences for clinical medicine. Dr. Campbell also includes a handy list of references. I’ll try to provide a summary of the main points, but I recommend reading or listening to the original.
According to a new study in Nature Neuroscience, there are songs that can arouse feelings of euphoria and craving by endogenous dopamine release in the striatum:
If music-induced emotional states can lead to dopamine release, as our findings indicate, it may begin to explain why musical experiences are so valued. These results further speak to why music can be effectively used in rituals, marketing or film to manipulate hedonic states. Our findings provide neurochemical evidence that intense emotional responses to music involve ancient reward circuitry and serve as a starting point for more detailed investigations of the biological substrates that underlie abstract forms of pleasure.
According to study author Robert Zatorre, one of those songs is “Adagio For Strings” by DJ Tiesto:
Psychological Science, a journal of the Association for Psychological Science, published a very interesting paper focusing on the genetic background of social drinking. Specific gene variants might increase the risk for extensive alcohol use or abuse when spending time with heavy-drinking peers. An excerpt from Medical News Today:
Drinking alcohol increases levels of dopamine –- a brain chemical that causes pleasure and makes us feel good. The dopamine D4 receptor gene (DRD4) has been shown to be involved in motivation of seeking out rewards. Research has suggested that carrying a specific form (or variant) of this gene –- one that includes seven or more repeats of a certain section of the gene –- may be associated with craving caused by alcohol-related cues. Psychological scientist Helle Larsen from Radboud University in The Netherlands and her colleagues wanted to investigate if this 7-repeat gene variant plays a role in how an individual responds to alcohol-related cues.
The results showed an effect between how much the confederate drank and the gene variant on volunteers’ alcohol consumption: When the confederate was seen consuming three or four drinks, carriers of the 7-repeat form of the gene drank more than twice as many glasses of alcohol than did noncarriers of the gene variant. However, when the confederate consumed only one drink, there was no difference in alcohol consumption between carriers and noncarriers. These findings suggest that individuals carrying this form of the DRD4 gene may be more sensitive than noncarriers to other people’s drinking behavior.
*This blog post was originally published at ScienceRoll*
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