Fabrizio Benedetti

Last updated
Fabrizio Benedetti
Scientific career
Fields Neuroscience, Placebo studies.
Institutions University of Turin Medical School

Fabrizio Benedetti is professor of physiology and neuroscience at the University of Turin Medical School in Turin, Italy and a researcher in the field of placebo studies. [1] He is known for his research into the placebo and nocebo effects. [2] [3]

Contents

Placebo and nocebo research

Benedetti began studying placebos in the 1990s while researching pain. [4] His research has found that "the promise of treatment activates areas of the brain involved in weighing the significance of events and the seriousness of threats." [4] Another of Benedetti's studies examined the effectiveness of placebos in the treatment of Parkinson's disease, and the effect of this treatment on neurons that control movement. He found that giving these patients a placebo led to a decrease in the rate at which these neurons fired of about 40%, and that this enabled the patients to move more easily. [5] In 2007, Benedetti published a study in which he and his co-authors gave subjects morphine during a hand-squeezing exercise, and later replaced the morphine with a placebo without the subjects' knowledge. In this study, the subjects who received morphine and then a placebo endured significantly more pain than did patients in any of the control groups. [6] [7] In a 2011 paper, Benedetti and co-authors argued that there exist many different placebo effects, "with different mechanisms and in different diseases, systems, and therapeutic interventions." [8]

He has also published research on the nocebo effect, in which adverse events are produced as a result of negative expectations. In some of these studies, he found that cholecystokinin is responsible for the transmission of pain by the nocebo effect. This research also found that drugs used to block this chemical, such as proglumide, can also stop nocebo pain. [9] [10] [11] Another of Benedetti's studies found that when individuals were told about a possible link between high altitudes and headaches before going on a high-altitude hike in the Italian Alps, it led to an enhancement of the cyclooxygenase-prostaglandin pathway in those individuals, and that they developed significantly more headaches than the control group did. [12] [13]

Impact

Benedetti has been credited as being partly responsible for the increasing respectability of research into the placebo effect. [14] A review of his book Placebo Effects: Understanding the mechanisms in health and disease in the New England Journal of Medicine stated that he runs "the foremost laboratory for the study of placebo effects in the world." [15]

Awards and honors

Benedetti is a member of the Academy of Europe and the European Dana Alliance for the Brain. Additionally, his book Placebo Effects: Understanding the mechanisms in health and disease won the British Medical Association's Highly Commended Book Award. [16]

Books

Related Research Articles

<span class="mw-page-title-main">Aspirin</span> Medication

Aspirin, also known as acetylsalicylic acid (ASA), is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain, fever, and/or inflammation, and as an antithrombotic. Specific inflammatory conditions which aspirin is used to treat include Kawasaki disease, pericarditis, and rheumatic fever.

<span class="mw-page-title-main">Migraine</span> Disorder resulting in recurrent moderate-severe headaches

Migraine is a genetically-influenced complex neurological disorder characterized by episodes of moderate-to-severe headache, most often unilateral and generally associated with nausea and light and sound sensitivity. Other characterizing symptoms may include nausea, vomiting, cognitive dysfunction, allodynia, and dizziness. Exacerbation of headache symptoms during physical activity is another distinguishing feature.

<span class="mw-page-title-main">Nonsteroidal anti-inflammatory drug</span> Class of therapeutic drug for relieving pain and inflammation

Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration of use, but largely include an increased risk of gastrointestinal ulcers and bleeds, heart attack, and kidney disease.

<span class="mw-page-title-main">Placebo</span> Substance or treatment of no therapeutic value

A placebo is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets, inert injections, sham surgery, and other procedures.

<span class="mw-page-title-main">Diclofenac</span> Nonsteroidal anti-inflammatory drug

Diclofenac, sold under the brand name Voltaren, among others, is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammatory diseases such as gout. It can be taken orally, inserted rectally as a suppository, injected intramuscularly (IM), injected intravenously (IV), or applied to the skin topically. Improvements in pain last up to eight hours. It is also available in combination with misoprostol in an effort to decrease stomach problems.

Cyclooxygenase-2 inhibitors, also known as coxibs, are a type of nonsteroidal anti-inflammatory drug (NSAID) that directly target cyclooxygenase-2 (COX-2), an enzyme responsible for inflammation and pain. Targeting selectivity for COX-2 reduces the risk of peptic ulceration and is the main feature of celecoxib, rofecoxib, and other members of this drug class.

<span class="mw-page-title-main">Prostacyclin</span> Chemical compound

Prostacyclin (also called prostaglandin I2 or PGI2) is a prostaglandin member of the eicosanoid family of lipid molecules. It inhibits platelet activation and is also an effective vasodilator.

A nocebo effect is said to occur when a patient's negative expectations for a treatment cause the treatment to have a worse effect than it otherwise would have. For example, when a patient anticipates a side effect of a medication, they can experience that effect even if the "medication" is actually an inert substance. The complementary concept, the placebo effect, is said to occur when positive expectations improve an outcome. The nocebo effect is also said to occur in someone who falls ill owing to the erroneous belief that they were exposed to a physical phenomenon they believe is harmful, such as EM radiation.

<span class="mw-page-title-main">Hyperalgesia</span> Abnormally increased sensitivity to pain

Hyperalgesia is an abnormally increased sensitivity to pain, which may be caused by damage to nociceptors or peripheral nerves and can cause hypersensitivity to stimulus. Prostaglandins E and F are largely responsible for sensitizing the nociceptors. Temporary increased sensitivity to pain also occurs as part of sickness behavior, the evolved response to infection.

<span class="mw-page-title-main">Indometacin</span> Anti-inflammatory drug

Indometacin, also known as indomethacin, is a nonsteroidal anti-inflammatory drug (NSAID) commonly used as a prescription medication to reduce fever, pain, stiffness, and swelling from inflammation. It works by inhibiting the production of prostaglandins, endogenous signaling molecules known to cause these symptoms. It does this by inhibiting cyclooxygenase, an enzyme that catalyzes the production of prostaglandins.

A prostaglandin antagonist is a hormone antagonist acting upon one or more prostaglandins, a subclass of eicosanoid compounds which function as signaling molecules in numerous types of animal tissues.

Pain tolerance is the maximum level of pain that a person is able to tolerate. Pain tolerance is distinct from pain threshold. The perception of pain that goes in to pain tolerance has two major components. First is the biological component—the headache or skin prickling that activates pain receptors. Second is the brain’s perception of pain—how much focus is spent paying attention to or ignoring the pain. The brain’s perception of pain is a response to signals from pain receptors that sensed the pain in the first place.

<span class="mw-page-title-main">Proglumide</span> Chemical compound

Proglumide (Milid) is a drug that inhibits gastrointestinal motility and reduces gastric secretions. It acts as a cholecystokinin antagonist, which blocks both the CCKA and CCKB subtypes. It was used mainly in the treatment of stomach ulcers, although it has now been largely replaced by newer drugs for this application.

<span class="mw-page-title-main">Mechanism of action of aspirin</span>

Aspirin causes several different effects in the body, mainly the reduction of inflammation, analgesia, the prevention of clotting, and the reduction of fever. Much of this is believed to be due to decreased production of prostaglandins and TXA2. Aspirin's ability to suppress the production of prostaglandins and thromboxanes is due to its irreversible inactivation of the cyclooxygenase (COX) enzyme. Cyclooxygenase is required for prostaglandin and thromboxane synthesis. Aspirin acts as an acetylating agent where an acetyl group is covalently attached to a serine residue in the active site of the COX enzyme. This makes aspirin different from other NSAIDs, which are reversible inhibitors; aspirin creates an allosteric change in the structure of the COX enzyme. However, other effects of aspirin, such as uncoupling oxidative phosphorylation in mitochondria, and the modulation of signaling through NF-κB, are also being investigated. Some of its effects are like those of salicylic acid, which is not an acetylating agent.

The word placebo was used in a medicinal context in the late 18th century to describe a "commonplace method or medicine" and in 1811 it was defined as "any medicine adapted more to please than to benefit the patient". Although this definition contained a derogatory implication, it did not necessarily imply that the remedy had no effect.

<span class="mw-page-title-main">Emoxypine</span> Chemical compound

Emoxypine (2-ethyl-6-methyl-3-hydroxypyridine), also known as Mexidol or Mexifin, a succinate salt, is chemical compound which is claimed by its manufacturer, the Russian company Pharmasoft Pharmaceuticals, to have antioxidant and actoprotector properties,, but these purported properties of emoxypine have not been proven. Its chemical structure resembles that of pyridoxine (a type of vitamin B6).

Tor D. Wager is the Diana L. Taylor Distinguished Professor in Neuroscience at Dartmouth College, as well as the director of the Cognitive and Affective Neuroscience Laboratory at this university. He is known for his research into the placebo effect and into the way the brain processes pain.

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Prostaglandin inhibitors are drugs that inhibit the synthesis of prostaglandin in human body. There are various types of prostaglandins responsible for different physiological reactions such as maintaining the blood flow in stomach and kidney, regulating the contraction of involuntary muscles and blood vessels, and act as a mediator of inflammation and pain. Cyclooxygenase (COX) and Phospholipase A2 are the major enzymes involved in prostaglandin production, and they are the drug targets for prostaglandin inhibitors. There are mainly 2 classes of prostaglandin inhibitors, namely non- steroidal anti- inflammatory drugs (NSAIDs) and glucocorticoids. In the following sections, the medical uses, side effects, contraindications, toxicity and the pharmacology of these prostaglandin inhibitors will be discussed.

<span class="mw-page-title-main">Sonlicromanol</span> Chemical compound

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References

  1. ↑ "Placebo Effects in Psychology". Oxford Bibliographies. Retrieved 17 March 2022.
  2. ↑ Planès, Sara; Villier, Céline; Mallaret, Michel (17 March 2016). "The nocebo effect of drugs". Pharmacology Research & Perspectives. 4 (2): e00208. doi:10.1002/prp2.208. ISSN   2052-1707. PMC   4804316 . PMID   27069627.
  3. ↑ Benedetti, Fabrizio (3 March 2022). "The science of placebos is fuelling quackery". Knowable Magazine. doi: 10.1146/knowable-030222-3 . S2CID   247265071 . Retrieved 17 March 2022.
  4. 1 2 Silberman, Steve (24 August 2009). "Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why". Wired. Retrieved 25 October 2014.
  5. ↑ Neergaard, Lauren (28 November 2005). "Expecting benefit really can help healing". USA Today. Retrieved 25 October 2014.
  6. ↑ Benedetti, F.; Pollo, A.; Colloca, L. (31 October 2007). "Opioid-Mediated Placebo Responses Boost Pain Endurance and Physical Performance: Is It Doping in Sport Competitions?". Journal of Neuroscience. 27 (44): 11934–11939. doi: 10.1523/JNEUROSCI.3330-07.2007 . PMC   6673345 . PMID   17978033.
  7. ↑ "How to cheat without cheating". The Economist. 1 November 2007. Retrieved 3 August 2015.
  8. ↑ Benedetti, Fabrizio; Carlino, Elisa; Pollo, Antonella (30 June 2010). "How Placebos Change the Patient's Brain". Neuropsychopharmacology. 36 (1): 339–354. doi:10.1038/npp.2010.81. PMC   3055515 . PMID   20592717.
  9. ↑ Benedetti, F.; Amanzio, M.; Vighetti, S.; Asteggiano, G. (15 November 2006). "The Biochemical and Neuroendocrine Bases of the Hyperalgesic Nocebo Effect". Journal of Neuroscience. 26 (46): 12014–12022. doi: 10.1523/JNEUROSCI.2947-06.2006 . PMC   6674855 . PMID   17108175.
  10. ↑ Sarchet, Penny (13 November 2011). "The nocebo effect: Wellcome Trust science writing prize essay". The Guardian. Retrieved 25 October 2014.
  11. ↑ Scudellari, Megan (1 July 2013). "Worried Sick". The Scientist. Retrieved 26 October 2014.
  12. ↑ Benedetti, Fabrizio; Durando, Jennifer; Vighetti, Sergio (May 2014). "Nocebo and placebo modulation of hypobaric hypoxia headache involves the cyclooxygenase-prostaglandins pathway". Pain. 155 (5): 921–928. doi:10.1016/j.pain.2014.01.016. hdl: 2318/151583 . PMID   24462931. S2CID   207310855.
  13. ↑ Robson, David (11 February 2015). "The contagious thought that could kill you". BBC. Retrieved 11 February 2015.
  14. ↑ Vance, Erik (27 July 2010). "Get to Know the Placebo Effect". Chicago Tribune. Archived from the original on July 23, 2018. Retrieved 25 October 2014.
  15. ↑ Brody, Howard A. (9 April 2009). "Book Review Placebo Effects: Understanding the Mechanisms in Health and Disease By Fabrizio Benedetti. 295 pp., illustrated. New York, Oxford University Press, 2009. $59.95. 978-0-19-955912-1". New England Journal of Medicine. 360 (15): 1576–1577. doi:10.1056/NEJMbkrev0810817.
  16. ↑ Benedetti, Fabrizio (May 2011). "Ask the Experts: Is there a place for placebo analgesia in everyday clinical practice?". Pain Management. 1 (3): 211–212. doi:10.2217/pmt.11.16. ISSN   1758-1869. PMID   24646386.
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