People are notoriously susceptible to the placebo effect, in which a fake treatment can improve our condition simply because we, believing it's real, expect it to work. Clinical trials for new drugs compensate for this tendency by administering sugar pills or other inactive treatments to some patients to tease out whether a medication is actually effective or if people are merely fooling themselves into believing their condition has improved.
While it’s important for scientists to find treatments that actually do help people, the placebo effect may not be all bad. A new study of pain medication placebos finds that even when people know they’re not taking a real medication, they can be conditioned to feel pain relief from the fake treatment.
The study, published in the Journal of Pain, included 54 participants who were told they were going to receive either a “pain-relieving” cream or a cream with no active ingredients. (Both "creams" were actually just petroleum jelly.) Researchers from the University of Colorado at Boulder's Cognitive and Affective Neuroscience Lab administered both creams to participants, describing the blue cream as pain relieving (the placebo) and the neutral jelly as inactive (the control).They then advised the participants on potential side effects.
After each cream had been put on their arm, the participants received a hot stimulus designed to measure their perception of pain. In the placebo condition, the researchers turned down the heat after the fake pain-relief cream was administered, leading the patients to believe the blue cream was working.
Over the next few weeks, some participants received four of these "treatments," or conditioning sessions. The rest of the subjects received just one. Then the researchers revealed to the participants that both the "pain relief" blue cream and the clear petroleum jelly were actually both inactive.
They then re-tested all participants' responses to the blue cream placebo. And here's the interesting twist: the participants who had four treatments reported feeling pain relief from the blue cream—even though they knew the treatment was fake. Meanwhile, the participants who had experienced only one treatment did not.
This suggests that conditioning someone through repeated "treatments" to expect pain relief from a placebo can lead to real pain relief.
"We're still learning a lot about the critical ingredients of placebo effects," Tor Wager, senior author of the study, said in a press statement. "What we think now is that they require both belief in the power of the treatment and experiences that are consistent with those beliefs. Those experiences make the brain learn to respond to the treatment as a real event. After the learning has occurred, your brain can still respond to the placebo even if you no longer believe in it."
One potential use for this finding is that people might be able to stop taking drugs but continue feeling similar levels of relief. "If a child has experience with a drug working, you could wean them off the drug, or switch that drug [with] a placebo, and have them continue taking it," as study co-author Scott Schafer explains.
However, it might not work equally for all patients. Previous research indicates that there may be a genetic underpinning that makes some people more susceptible to the placebo effect than others.
In medicine, magnetic resonance imaging (MRI) uses powerful magnetic fields and radio waves to show what's happening inside the body, producing dynamic images of our internal organs. Using similar technology that tracks blood flow, functional magnetic resonance imaging (fMRI) scans can show neuroscientists neural activity, indicating what parts of the brain light up when, for instance, a person thinks of an upsetting memory or starts craving cocaine. Both require staying within a massive MRI machine for the length of the scan.
There's some controversy over how scientists interpret fMRI data in particular—fMRI studies are based on the idea that an increase of blood flow to a region of the brain means more cellular activity there, but that might not be a completely accurate measure, and a 2016 report found that fMRI studies may have stunning rates of false positives.
But we're not here to talk about results. We're here to talk about all the weird, weird things scientists have asked people to do in MRI machines so that they could look at their brains and bodies. From getting naked to going to the bathroom, people have been willing to do some unexpected activities in the name of science. Here are just a few of the oddest things that people have done in scanners at the behest of curious researchers.
1. SING OPERA
Researchers once invited world-famous opera singer Michael Volle to sing inside an MRI at the University of Freiburg in Germany. The baritone sang a piece from Richard Wagner's opera Tannhäuser as part of a 2016 study on how the vocal tract moves during singing at different pitches and while changing volume. The study asked 11 other professional singers with different voice types to participate as well. They found that the larynx rose with a singer's pitch, but got lower as the song got louder, and that certain factors, like how open their lips were, correlated more with how loud the singer was than how high they were singing. The scientists concluded that future research on the larynx and the physical aspects of singing should take loudness into consideration.
That study wasn't the first to take MRI images of singers. In 2015, researchers at the University of Illinois demonstrated their technique for recording dynamic MRI imaging of speech using video of U of I speech specialist Aaron Johnson singing "If I Only Had a Brain" from The Wizard of Oz.
2. REACT TO ROBOT-DINOSAUR ABUSE
Stills from the videos participants watched of robot dinosaurs being treated kindly or unkindly.
To test whether or not humans can feel empathy with robots for a 2013 study, researchers put participants into an fMRI machine and made them watch videos of humans and robotic dinosaurs. The videos either included footage of the human or robot being stroked or tickled, or the subject being beaten and choked. The brain scans showed similar activity for people viewing both videos, suggesting that people might be able to feel similar empathy for robots as for people.
To see whether the brain responds to emotional pain in similar ways to physical pain, researchers asked participants in a 2003 study to experience social rejection within an fMRI machine. During the scans, participants played a virtual ball-tossing game against two other players—whom they believed to be other study participants in other scanners—by watching a screen through goggles and pressing one of two keys to toss the ball to one of the other players. They were actually playing against a computer that was programmed to eventually exclude the human player. At some point during the game, the computer-controlled players stopped throwing the human player the ball, causing them to feel excluded and ignored. The researchers found that the excluded study subjects showed brain activation in regions similar to the ones seen in studies of physical pain.
Watching people poop through MRI imaging is a surprisingly common medical technique. It's called magnetic resonance defecography. Doctors use it to diagnose issues with rectal function, analyzing how the muscles of the pelvis are working and the cause of bowel issues. The scan involves having ultrasound jelly and a catheter inserted into your butt, donning a diaper, and crawling inside an MRI scanner. Then, on command, you clench your pelvic muscles in various ways as ordered by the doctor, eventually resulting in pooping out the ultrasound jelly and whatever else you might need to evacuate. No pressure.
5. HAVE SEX …
MRI images of a woman at rest, in a pre-orgasmic phase, and 20 minutes after orgasm (L–R)
Schultz et al. in BMJ, 1999
Scientists have also recorded MRI body scans of couples having sex. In the late '90s, Dutch researcher Pek Van Andel and his colleagues at the University Hospital Groningen asked eight couples to come into their lab on a Saturday and have sex in the tube of an MRI scanner in order to analyze how genitals fit together during heterosexual intercourse. Despite the surroundings, they apparently had a fine time. "The subjective level of sexual arousal of the participants, men and women, during the experiment was described afterwards as average," the study noted.
Meanwhile, other researchers are trying to capture scientific images of sex in different, sometimes even more awkward ways. For her 2008 bookBonk: The Curious Coupling Of Sex And Science, science writer Mary Roach and her husband had sex in a lab at University College London while a researcher stood next to them and held an ultrasound wand to her abdomen.
Scientists still don't know all that much about how orgasms work, so various studies have asked participants to come into the lab, lay down in an fMRI scanner, and stimulate themselves to orgasm. (A reporter at Inside Jersey went to Rutgers to take part in the university's orgasm research herself in 2010. She brought her own sex toy, but the lab was kind enough to provide the lube.)
Over the course of their work, Rutgers researchers have found that when people bring themselves to orgasm within an fMRI machine, it activates more than 30 brain systems, including ones that you wouldn't think would be involved in getting off, like the prefrontal cortex, which is associated with problem solving and judgment.
Singers aren't the only music professionals to get inside an fMRI machine for science. For a study published in 2015, 17 young composers were asked to create a piece of music while Chinese researchers examined their brain activity. While all of them played the piano, they were asked to compose a piece for an instrument none of them know how to play—the zheng, a traditional Chinese string instrument. They were given a musical staff with just a few introductory notes already written as inspiration and asked to come up with something from there. As soon as they exited the scanner, they wrote down the notes they had imagined during the imaging process. The researchers found that the composers' visual and motor cortex showed less activity than usual, the opposite of what researchers have seen in studies of musical improvisation.
8. HAVE AN OUT-OF-BODY EXPERIENCE
Activated portions of the brain during an out-of-body experience
In a 2014 study, psychologists at the University of Ottawa recruited an undergraduate student who reported that she could have out-of-body experiences at will to do so within the confines of an fMRI scanner.
"She was able to see herself rotating in the air above her body, lying flat, and rolling along with the horizontal plane," the researchers wrote. "She reported sometimes watching herself move from above but remained aware of her unmoving 'real' body."
She entered the scanner six times, reporting out-of-body experiences that included feeling as if she were above her body and spinning or rocking side-to-side. The researchers found that the experience activated regions of her brain associated with kinesthetic imagery, the feeling of visualizing movement (as athletes often do during training and competitions, for instance), and a deactivated the visual cortex.
Many people at risk for severe allergic reactions to things like peanuts and bee stings carry EpiPens. These tools inject the medication epinephrine into one's bloodstream to control immune responses immediately. But exposure can turn into life-threatening situations in a flash: Without EpiPens, people could suffer anaphylactic shock in less than 15 minutes as they wait for an ambulance. Being without an EpiPen or other auto-injector can have deadly consequences.
EPIMADA, a new app created by researchers at Israel's Bar-Ilan University, is designed to save the lives of people who go into anaphylactic shock when they don't have EpiPens handy. The app uses the same type of algorithms that ride-hailing services use to match drivers and riders by location—in this case, EPIMADA matches people in distress with nearby strangers carrying EpiPens. David Schwartz, director of the university's Social Intelligence Lab and one of the app's co-creators, toldThe Jerusalem Post that the app currently has hundreds of users. Registered users are required to have an epinephrine prescription, and must apply (by emailing firstname.lastname@example.org) to join the community.
EPIMADA serves as a way to crowdsource medication from fellow patients who might be close by and able to help. While it may seem unlikely that people would rush to give up their own expensive life-saving tool for a stranger, EPIMADA co-creator Michal Gaziel Yablowitz, a doctoral student in the Social Intelligence Lab, explained in a press release that "preliminary research results show that allergy patients are highly motivated to give their personal EpiPen to patient-peers in immediate need."
EpiPen is easy to use, so even though fellow allergy sufferers may not have medical training, it's a relatively low-risk venture to ask them to treat a stranger the same way they'd treat themselves. The tool could be especially useful for children, who may be most likely to forget their EpiPens.
The app is currently available only in Israel, but the idea could be applicable across the world, for multiple life-threatening conditions. The researchers are collaborating on similar patient-to-patient apps elsewhere, including one in Philadelphia connecting people who carry the opioid overdose reversal medication naloxone.