eric_topol's picture
Professor of Genomics, The Scripps Translational Science Institute; Author, The Patient Will See You Now

Seeing Is Believing: From Placebos To Movies In Our Brain

Our brain of one hundred billion neurons and a quadrillion of synapses, give or take a few billion here or there, has to be considered one of the most complex entities to demystify. And that may be a good thing, since we don't necessarily want others to be able to read our minds, which would not only be regarded as terribly invasive, but also taking the recent megatrend of transparency much too far.

But the ability to use functional magnetic resonance (fMRI) and positron emission tomography (PET) to image the brain and construct sophisticated activation maps is fulfilling the "seeing is believing" aphorism for any skeptics. One of the longest controversies in medicine has been whether the placebo effect, a notoriously complex, mind-body end product, has a genuine biological mechanism. That now seems to be resolved with the recognition that the opiod drug pathway — the one that is induced by drugs like morphine and oxycontin—shares the same brain activation pattern as seen with the administration of placebo for pain relief. And just like we have seen neuroimaging evidence of dopamine "squirts" from our Web-based networking and social media engagement, dopamine release from specific regions of the brain has been directly visualized after administering a placebo to patients with Parkinson's disease. Indeed, the upgrading of the placebo effect to having discrete, distinguishable psychobiological mechanisms has now even evoked the notion of deliberately administering placebo medications as therapeutics and Harvard recently set up a dedicated institute called "The Program in Placebo Studies and the Therapeutic Encounter."

The decoding of the placebo effect seems to be just a nascent step along the way to the more ambitious quest of mind reading. This past summer a group at UC Berkeley was able to show, via reconstructing brain imaging activation maps, a reasonable facsimile of short YouTube movies that were shown to individuals. In fact, it is pretty awe-inspiring and downright scary to see the resemblance of the frame-by-frame comparison of the movie shown and what was reconstructed from the brain imaging.

Coupled with the new initiative of developing miniature, eminently portable MRIs, are we on the way to watching our dreams in the morning on our iPad? Or, even more worrisome, potentially having others see the movies in our brain. I wonder what placebo effect that might have.