Doctors' brain activity studied
Using fMRI, researchers at Karolinska Institutet and their US colleagues have studied the brain activity of doctors when treating patients. The study, which is published in Molecular Psychiatry, is an attempt to pin down the role of the therapist in the so-called placebo effect.
The successful treatment of pain, anxiety and depression is very much dependent on factors extraneous to the therapeutic components the placebo effect, in other words. Previous research has shown that an important driver of the placebo effect is the relationship between therapist and patient, and according to clinical trials the effect of different therapists can be even greater than the difference between placebo and active drug. But while the psychological and neurological processes behind the placebo effect have been examined for over a decade in the patient, very little is known about what happens in the brain of the practitioner.
In the present study, researchers at Karolinska Institutet, Harvard Medical School and Massachusetts General Hospital, both based in Boston, USA, used fMRI (functional Magnetic Resonance Imaging) to examine the brain activity of doctors while treating a patient for pain. Firstly, the patient, convincingly played by an actor, would meet the doctor as though for a regular appointment. The doctor would then be asked to lie in an MR scanner with the patient in full view, and instructed either to administer pain relief via a handheld consol or to observe the patient suffering the pain untreated.
"During active treatment we saw that the doctors activated the areas in the brain that are associated with empathy, therapeutic expectation and reward," says Karin Jensen, researcher at Harvard and affiliate of the Osher Centre for Integrative Medicine at Karolinska Institutet. "One interpretation is that doctors internalise their patients' experiences and that this expectation-effect influences how they interact with them and, ultimately, the outcome of the treatment they administer."
The study was financed through grants from a number of bodies, including the Swedish Research Council, Swedish Society for Medical Research (SSMF) and the Swedish Council for Working Life and Social Research (FAS).
Sharing pain and relief: neural correlates of physicians during treatment of patients.
Mol. Psychiatry 2014 Mar;19(3):392-8