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Certain Brain Region Responsible For Placebo Effect in Pain Relievers

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Researchers from Northwestern Medicine and the Rehabilitation Institute, Chicago (RIC) spotted the region in human brain responsible for causing placebo effect, the relief in pain experienced as a result of fake treatment.

According to the researchers, the discovery could help provide personalized medication to about 100 million people in the United States suffering from chronic pain. Patients could be given individualized treatment using the newly developed fMRI technology by giving specific drugs based on the way the patient’s brain responds to the medication.

It is noted that the discovery would be of great help in clinical trials involving pain medication since patients experiencing high placebo effects could be eliminated from the study beforehand.

In the first trial, the investigators identified a region in the mid-frontal gyrus that identifies the placebo responders, which is then validated in the second trial with about 95 percent accuracy.

Marwan Baliki, a research scientist at RIC said that the recent findings are useful for clinical trials as well as for providing personalized medication for some people in the society suffering from chronic pain.

Traditionally, doctors would prescribe one or another type of medication to patients and sometimes adjust the dosage on trial and error basis to treat chronic pain.

Now, with this novel technology, doctors can identify which region of the brain is activated during pain and choose medications that target that particular area, said Vania Apkarian, professor of physiology at Feinberg, according to a press release. Apkarian also noted that the findings also help doctors to measure how the drugs affect the patient’s pain region.

The researchers used the functional magnetic resonance imaging (fMRI) in the standard clinical design to identify the brain-based neurological marker to detect the pain relief experienced with placebo treatment in chronic knee osteoarthritis patients. It was found that the placebo pills produced an analgesic effect in patients, where at least half the study population experienced some pain relief.

“If future similar studies can further expand and eventually provide a brain-based predictive best-therapy option for individual patients, it would dramatically decrease unnecessary exposure of patients to ineffective therapies and decrease the duration and magnitude of pain suffering,” read the study published in the journal PLOS Biology on Oct. 27.

The researchers also concluded that if patients showing placebo responses are eliminated from the study, it will not only help reducing the cost involved in the clinical trials but also help in identifying the efficacy and neurobiology of therapies at the individual level.

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