Complementary/Alternative Medicine: Expectancy & Outcomes (CAMEO)
Barry S. Oken, M.D.
CAMEO is a three-year grant from the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health. CAMEO is one of four Developmental Centers for Research on Complementary and Alternative Medicine funded by NCCAM. There are two broad goals of CAMEO. The first goal concerns the scientific study of expectancy effects. There are factors related to a person and a clinical interaction that may improve patient outcomes without directly affecting the underlying cause of a disease. The belief, or expectancy, that one’s health is going to improve has an impact on one’s health outcomes. How expectancies translate from thoughts into processes impacting health is of great interest, particularly in the field of mind-body medicine.
Overall CAMEO hopes to establish experimental models of expectancy effects that can be utilized to explore underlying cognitive and physiological mechanisms that contribute to the expectancy effect. Proposed mechanisms range from perceived self-efficacy to hypothalamic-pituitary-adrenal axis activity to genetic polymorphisms affecting neurotransmitter and other signaling systems such as dopamine, serotonin and opioid. This better understanding will contribute to improved clinical care by allowing clinicians to maximize non-specific healing effects. It will additionally enable improved clinical trial design through an awareness of how individual differences contribute to variability of clinical responses to medical interventions.
Barry S. Oken, MD is the director and Carlo Calabrese, ND, MPH is the associate director of the CAMEO center. There are four projects in the center, each having two leaders, one from a conventional and one from a CAM institution, and each pair studying a different clinical condition: Parkinson’s disease; metabolic syndrome; Alzheimer’s disease; and experimental allergic encephalomyelitis in mice (an established model for multiple sclerosis). The non-specific factors that may contribute to clinical benefit that will be studied include stress and markers for hypothalamic-pituitary-adrenal axis activity, personality and related traits, and certain genetic polymorphisms affecting function of potentially relevant signaling systems.
The second broad goal of CAMEO is to enhance the research infrastructure of the Portland area complementary medicine academic institutions. The grant will continue to build upon previously existing collaborations between Oregon Health & Science University, the National College of Natural Medicine, the Oregon College of Oriental Medicine, and Western States Chiropractic College. These collaborations were developed through a previous center grant from NCCAM, the Oregon Center for Complementary and Alternative Medicine Research in Neurological Disorders. This successful prior center, also directed by Dr. Oken, primarily focused on the role of stress and natural antioxidants in neurological disorders. The current CAMEO grant will further strengthen the research infrastructure at CAM institutions, especially at the National College of Naturopathic Medicine. CAMEO will utilize the laboratory resources of the OHSU General Clinical Research Center, allowing CAM institutions access to the larger scientific community research infrastructure. CAMEO has incorporated collaboration between basic scientists from OHSU and NCNM that will facilitate translational research and provide CAM institutions further access to the larger scientific community.