Yankho la placebo-malingaliro pa chinthu, kuphatikiza malingaliro ndizofunikira

Kwa zaka zambiri, kuyankha kwa placebo muzamankhwala komanso m'maphunziro azachipatala kunali kuyankha kopindulitsa kwamankhwala ochizira. Sayansi inazindikira kuti izi ndi kusinthasintha kwa chiwerengero cha anthu omwe ali ndi psychosomatic, maganizo ndi thupi - kuyankha komwe kumapangitsa kuti munthu akhale ndi thanzi labwino chifukwa cha chikhulupiriro ndi malingaliro abwino ndi kuyembekezera zotsatira zabwino. Zinali zoyambira kuyankha kwa odwala m'maphunziro azachipatala kuti azichita bwino. Koma m'zaka makumi angapo zapitazi, zakhala zodziwika bwino chifukwa chogwira ntchito mofanana ndi mankhwala pamayesero azachipatala a antidepressants.

Wofufuza wa Placebo, Fabrizio Benedetii, ku yunivesite ya Turin, wagwirizanitsa machitidwe ambiri a biochemical omwe amachititsa kuyankha kwa placebo. Anayamba ndi kupeza kafukufuku wakale wopangidwa ndi asayansi aku US omwe adawonetsa kuti naloxone imatha kuletsa mphamvu yochepetsera ululu ya kuyankha kwa placebo. Ubongo umatulutsa ma opioid, mankhwala opha ululu achilengedwe, ndi placebos amatulutsa ma opioid omwewa kuphatikiza ma neurotransmitters monga dopamine, zomwe zimathandiza kuthetsa ululu komanso kukhala ndi moyo wabwino. Komanso, adawonetsa kuti odwala a Alzheimer omwe ali ndi vuto lachidziwitso chosagwira ntchito omwe sanathe kupanga malingaliro okhudza zam'tsogolo, mwachitsanzo, kupanga malingaliro a ziyembekezo zabwino, sanathe kumva ululu uliwonse kuchokera ku mankhwala a placebo. Maziko a neurophysiological a matenda ambiri amisala, monga nkhawa zamagulu, kupweteka kosalekeza, ndi kupsinjika maganizo sizimamveka bwino, ndipo izi ndizomwe zimakhala ndi mayankho opindulitsa pamankhwala a placebo. 

Mwezi watha, akatswiri ofufuza za sayansi ya ubongo ku yunivesite ya Northwestern University adafalitsa zatsopano zomwe zimathandizidwa ndi mapangidwe amphamvu oyesera ndi ziwerengero zosonyeza kuti kuyankha kwa placebo kwa wodwala ndi quantifiable ndipo mosiyana akhoza kuneneratu molondola 95% yankho la placebo la wodwala malinga ndi ubongo wa wodwalayo. kulumikizana kogwira ntchito musanayambe phunziro. Adagwiritsa ntchito kupuma kwanthawi yayitali kwa maginito, rs-fMRI, makamaka odalira magazi-oxygen-level (BOLD) rs-fMRI. Mumtundu uwu wa MRI, lingaliro lovomerezeka kuti kuchuluka kwa okosijeni m'magazi muubongo kumasinthasintha kutengera zochitika za neural ndipo kusintha kwa kagayidwe kachakudya muubongo kumawonedwa pogwiritsa ntchito BOLD fMRI. Ofufuzawa amawerengera kusintha kwa kagayidwe kachakudya muubongo wa wodwala kukhala mphamvu ya chithunzi ndipo kuchokera pachimake chojambula amatha kuwonetsa ndi kupeza kulumikizana kwaubongo, mwachitsanzo, kugawana zambiri muubongo. 

Ofufuza azachipatala ku Northwestern, adayang'ana zochitika zaubongo zochokera ku fMRI za odwala osteoarthritis poyankha placebo ndi mankhwala opweteka a duloxetine. Mu kafukufuku woyamba, ofufuzawo adayesa kuyesa kwa placebo kwakhungu limodzi. Anapeza kuti theka la odwala adayankha placebo ndipo theka lina sanatero. Oyankha a placebo adawonetsa kulumikizana kokulirapo kwaubongo poyerekeza ndi omwe sanayankhe a placebo kudera laubongo lotchedwa right midfrontal gyrus, r-MFG. 

Mu kafukufuku wachiwiri, ofufuzawo adagwiritsa ntchito mulingo wolumikizana ndi ubongo wa r-MFG kulosera odwala omwe angayankhe ku placebo molondola 95%. 

Mu kafukufuku womaliza wachitatu, adayang'ana odwala omwe adangoyankha ku duloxetine ndikupeza kulumikizana kochokera ku fMRI kudera lina laubongo (parahippocampus gyrus, r-PHG) monga kulosera za kuyankha kwa analgesic ku duloxetine. Kupeza komaliza kumagwirizana ndi zomwe zimadziwika kuti duloxetine muubongo. 

Potsirizira pake, iwo anawonjezera zomwe apeza za r-PHG kugwirizanitsa ntchito kuti adziwiretu kuyankha kwa duloxetine mu gulu lonse la odwala ndikukonzekera yankho loloseredwa la analgesic ku placebo. Adapeza kuti duloxetine imathandizira ndikuchepetsa kuyankha kwa placebo. Izi zimabweretsa zotsatira zoyipa zomwe sizinachitikepo za mankhwala omwe amachepetsa kuyankha kwa placebo. Njira yolumikizirana pakati pa r-PHG ndi r-MFG ikadali yotsimikizika.