OHSU studies effects of wellness expectations.

Byline: THE HEALTH FILES By Tim Christie The Register-Guard

Ever since Dr. Henry Beecher found that injections of saline controlled the pain of some wounded soldiers in World War II after the morphine ran out, Western scientists have been trying to figure out what role the mind plays in overcoming illness.

Beecher, a renowned Harvard anesthesiologist, coined the term "placebo effect," and reported in studies that up to 35 percent of a therapeutic response to any medical treatment could be the result of belief.

Now, Oregon researchers are embarking on a major study to determine how a person's expectation of getting well actually can improve his or her overall health.

They call it the "expectancy effect," and while it may not influence the underlying cause of a disease necessarily, evidence suggests that it may have an effect on a patient's health outcomes, the researchers say.

Oregon Health & Science University School of Medicine has been awarded a three-year, $2.4 million grant from the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, to study the expectancy effect.

The grant will fund the development of "Complementary and Alternative Medicine: Expectancy and Outcomes," or CAMEO for short. The study's goal is to develop models that can be used to study cognitive and physiological changes that contribute to the expectancy effect.

The models could range from perceived self-efficacy - the belief that a person can influence his or her own health - to hormonal activity and genetic changes that affect the brain's neurotransmitter systems, said Dr. Barry Oken, director of the Oregon Center for Complementary and Alternative Medicine in Neurological Disorders at OHSU.

The researchers also hope to improve the design of clinical trials by learning how individual differences contribute to variability in responses to medical treatments.

The expectancy effect is related to the placebo effect, in which a patient reports a positive response to an inactive medical treatment, such as a sugar pill, as if it were an active medical treatment. But the expectancy effect is broader than the placebo effect and includes all processes and influences that may affect the brain's anticipation of a response.

"We're not talking about patient-physician interaction, which, to some people, is considered part of placebo effect - the contact, the handholding, the bedside manners," Oken said. "We're really thinking about people's hope or expectation that they're going to get better."

For example, one recent study showed that Parkinson's disease patients who were administered a placebo experienced changes in brain chemistry similar to those caused by symptom-treating drugs levodopa and apomorphine.

CAMEO will focus on four areas: Parkinson's disease, metabolic syndromes, Alzheimer's disease and a mouse model from multiple sclerosis. Each area is led by a two-person team that includes a conventional-medicine physician and a complementary-medicine practitioner.

Working with complementary practitioners is important because many have "succeeded in harnessing this effect," Oken said. "From my point of view, they have a much better handle on how to maximize this effect than conventional practitioners."

Tim Christie can be reached at 338-2572 or [e-mail].