December 2013 – Volume 06, Issue 04 2 Editorial CNSNewsletter December 2013 Page 3 - 14 FOCUS Best Regards to All of You! Evidence-Based Medicine: In Search of Proof for Practice Let’s Have a Cup of Green Tea! Integrative Medicine rom time to time, you read about people who recovered The Placebo Effect – is it all in my from cancer after none of the standard therapies Brain? Fseemed to be working. A miracle? Or could it have Research on Researchers: Dr. Michael something to do with the herbs they took or the spiritual Teut therapy they underwent? In this issue – our longest issue ever with 24 pages in total What else can Be Helpful for our – we would like to unravel the mysteries behind therapies Unhappy Brain? other than conventional medicine. Whereas alternative Holistic Healing – Homeopathy medicine describes practices that have healing effects but The Healing Power of Self Control are not evidence-based, integrative medicine is alternative medicine used together with conventional medical treatment Meditation – The Art of Healing emphasizing the treatment of the whole person, with a focus Autogenic Training or the Power of on overall wellness and health, and on the patient-physician Self-Suggestion relationship. In our issue, we give an overview of integrative Hypnotherapy in Action medicine, explain the concept of evidence-based medicine and the placebo effect. Nature as a Toolbox for Drugs in Why is it that drinking tea is good for your health? Neuroscience and Beyond What is biofeedback? And how do autogenic training and Green Tea and its Extracts for Healthy meditation improve your health? Is there any scientific basis Brains for hypnotherapy and homeopathy? How do music and The Venom Cur(s)e chromotherapy act on your brain? And can venoms really cure you without killing you beforehand? Curious? Well, the Chromotherapy – Colorful Nonsense? next 24 pages seek to answer all of these questions. Simply Put, Music Can Heal Our loyal readers instinctively know that there must be Page 14 Conference Report more! Exciting summer school and conference reports are waiting for you as well. Have you ever wondered how time Bernstein Conference 2013 is perceived? Are you fluent in German? In this issue, we Page 15 Paper Review provide an extensive collection of Berlin-based German Once upon a TiMe language classes. The CNS team changes once more. We would like to Page 16-18 German Courses in Berlin welcome the newest member of our editorial team Yasmine Said, who is a MSc student in the Neurasmus program. Page 19 Dr. Harebrained Knows it All ... However, we also have to say good-bye to a few people: For Neuroscience in Your Everyday Life the last ten issues, Benedikt has given the CNS newsletter a facelift. With almost 50 illustrations and cartoons, he has Page 19 Course Watch enriched a tremendous amount of articles making it much 13th Berlin Summer School “Psychiatry more fun to read the newsletter. On this jubilee, we are sad as a Science and as a Profession” to tell you that Benedikt will leave our team as he moves on Page 20 Berlin School of Mind and Brain in his career as a postdoc at Harvard! He left us with a final piece of art in this issue; go and find it! Believe it or not, also Ellie Rea has to leave too. Ellie Rea, graduate of the Master Page 21 Open Positions program of 2012, is starting medical school at the Imperial College in London. The CNS editorial team and Medical Neurosciences team wish Ellie and Benedikt all the best for Page 22 Collage Benedikt Brommer their future. This issue’s winner is Nikolas Karalis who contributed two Page 24 News in Brief & WhazzUp? articles: Meditation – The Art of Healing" and the conference report on the Bernstein Conference 2013. He will now be able to answer the question “So You Want to Be a Scientist?”. The Page 24 Imprint winner of the second book, “Cantor's Dilemma”, and master of the CNS crossword is Betty Jurek. The mystery word was BRAIN. Lots of fun reading to our two winners. Letter to the Editors What drives you ‘insane’? What do you want to have light Apparently the cover of our last edition “Heat or cold- what’s shed on? Any intriguing topics/ideas should be submitted good for the brain?” caused some astonishment. What was to [email protected]. Any questions or comments it on the picture? Some sort of glowing about this or any other issue? Just let us know! Do you want brain? A jelly fish? It’s actually a brain ice to join the proofreading or editorial team? Just email us! We cube! This little thingamajig is available are always happy to receive fresh ideas and great articles. in those stores that sell things no one really needs and can be purchased both Enjoy reading! online and offline . A clear must-have for neuroscientists! – Marietta, Editor-in-Chief Cover: Julia Rummel 2013 International Graduate Program Medical Neurosciences CNSNewsletter December 2013 FOCUS 3 Evidence-Based Medicine: In Search of Proof for Practice t the cornerstone of modern the benefit of the drug must exceed its highly restricted manner; the patients healthcare is a concept that risk. EBM aims to determine whether involved in the trial as well as the Ahas become ubiquitous in the this is true for every diagnostic or intervention itself are often specifically field – evidence-based medicine (EBM). therapeutic intervention. It does this by defined, with the study being optimized The concept of EBM – medical practice referring to multiple levels of evidence, to avoid being influenced by additional built on high-quality evidence to guide factors. This is done to make sure that any decision making – is simple, but the treatment effect detected by the study is rationale behind it and the mechanisms “Evidence-based medicine due to the treatment itself and not due to by which medicine has become inherently involves the collection, other influences, such as placebo effect. connected to the need for ‘proof, proof, This approach is somewhat unrealistic – and more proof’ are complex. analysis and translation in practice, patients are heterogeneous; Centuries ago, doctors practiced of evidence into each person’s illness is different from medicine based on what they had applicable guidelines.” the other, and they accordingly receive learned from their more experienced different treatments optimized to their peers. Treatments were either given to condition, often including multiple patients based on undocumented and each with its own level of reliability. interventions simultaneously. often unreliable observations that they During this process, the evidence is In alternative medicine, the primary had worked before in similar conditions, collected, critically analyzed for quality treatment is usually coupled with or on logical steps linking the disease and dependability, and then translated various lifestyle and social changes that process – or what was understood of it – into guidelines for implementation. The complete the patient’s management. to the treatment. process doesn’t stop there – it is followed These factors may be neglected in RCTs, These approaches seem reasonable, by a period of thorough evaluation and thereby reducing the chance that a yet they disregard the fact that the continuous modification of the existing treatment effect will be detected. Some human body is both complex and highly guidelines. people have suggested a need for more variable from person to person. Soon Evidence can be gathered from pragmatic trials, so called because they people realized that a single observation expert opinions, observational reports deviate from the classical methodology of treatment effect is rarely useful, since or from various types of research of clinical trials and allow for multiple it often proves unrepeatable. Moreover, studies including randomized controlled interventions, including ones that are people recognized that taking ‘logical trials (RCTs). Moreover, evidence can be difficult to quantify precisely such leaps’ from science’s understanding of acquired by grouping a large number as physiotherapy, psychotherapy or an illness to its treatment often leads to a of similar studies and analyzing them counselling [1]. dead end. Numerous currently available together in order to answer a specific Another issue with RCTs is that they drugs that have been proven to help question. Known as meta-analyses, usually compare novel interventions relieve illness have no obvious link to these provide robust evidence not only to placebo (an intervention similar to the disease itself, or have a mechanism due to their large size, but also due to the treatment being tested but which of action seemingly unrelated to the the scrutiny that the individual studies has no direct biological effect). In many disease process. receive. The overall appropriateness alternative treatment strategies such of the study design, the selection as acupuncture, producing a convincing Benefit and Risk of involved subjects, the outcomes placebo is challenging. In fact, there EBM as we know it, is a new concept measured, and the statistical methods is much debate surrounding whether that was established at the end of the used are some of the factors assessed. comparing any new intervention to last century. With a plethora of new placebo is appropriate – the placebo, by pharmacological agents and treatment Shortcomings of Evidence-Based definition, produces a change (usually a options becoming available to doctors, Medicine positive one) in the patient’s outcome. the importance of the above mentioned By definition, alternative medicine is Therefore, stating that an intervention shortcomings in medical practice any treatment approach that has either shows no effect ‘beyond placebo’ is not became more apparent. Doctors soon not been subjected to the scrutiny of necessarily the same thing as stating agreed on one guiding principle: every EBM, or that has failed to show benefit that it is useless.