Fabrizio Benedetti

Fabrizio Benedetti
Professor of Physiology and Neuroscience, University of Turin Medical School, Turin, Italy

Placebo effects at great heights
Placebo effects have been found and described in a variety of systems, ranging from sensory and motor systems to immune and endocrine systems. What has emerged from these studies is that placebos induce powerful psychological effects that can change the physiology of different body functions, and that these changes are very similar to those induced by drugs. However, it is not surprising that there are some limits of these psychological effects in a variety of conditions. For example, can placebo effects occur for functions that are crucial for survival? For instance, can a placebo replace oxygen during respiration? Or, in other words, is it possible to breathe without oxygen by merely using a placebo procedure? Although the answers to these questions may seem quite obvious at first sight, several years ago we started a project to assess the role of placebo effects for critical physiological functions in extreme environmental conditions, where survival is at stake. Indeed, we have investigated the role of placebo effects at high altitudes (3500 m), where oxygen pressure drops to 102 mmHg (159 mmHg at sea level). This corresponds to an oxygen concentration in the air of only 12%, compared to 21% at the sea level. In these extreme conditions, where both physical and cognitive performance deteriorate very quickly, we found that a conditioned placebo procedure can mimic the effects of oxygen, including ventilation, blood pH, heart activity and cyclooxygenase activity, and these effects are still present, albeit to a lesser extent, at altitudes as high as 4500 and 5500 m, where oxygen pressure drops to 92 and 81 mmHg, respectively. Interestingly, opposite effects (nocebo effects) can be elicited as well. A crucial question is to understand the limits of these effects, at altitudes of 8000 m and beyond, where oxygen pressure and concentration approach zero.

Fabrizio Benedetti, M.D. is Professor of Neurophysiology and Human Physiology at the University of Turin Medical School, Turin (Italy), and Director of the Center for Hypoxia at the Plateau Rosà Labs, Plateau Rosà (Italy/Switzerland). He has been nominated member of The Academy of Europe and of the European Dana Alliance for the Brain. He identified some basic mechanisms of placebo responses across a variety of medical conditions.
Recent  books: Placebo Effects (Oxford, 2nd Edition, 2014), The Patient’s Brain (Oxford 2010), Placebo (Springer 2014).
Recent awards: Highly Commended Book Award of the British Medical Association in 2009, Seymour Solomon Award of the American Headache Society in 2012, William S. Kroger Award of the American Society of Clinical Hypnosis in 2015.

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