ParkinsonCanadaV1, Main, Exploration, bibRecord, 001D19

Effects of Expectation on Placebo-Induced Dopamine Release in Parkinson Disease

Identifieur interne : 001D19 ( Main/Exploration ); précédent : 001D18; suivant : 001D20

Effects of Expectation on Placebo-Induced Dopamine Release in Parkinson Disease

Auteurs : Sarah C. Lidstone [Canada] ; Michael Schulzer [Canada] ; Katherine Dinelle [Canada] ; Edwin Mak [Canada] ; Vesna Sossi [Canada] ; Thomas J. Ruth [Canada] ; Raul De La Fuente-Fernandez [Canada] ; Anthony G. Phillips [Canada] ; A. Jon Stoessl [Canada]

Source :

Archives of general psychiatry [ 0003-990X ] ; 2010.

RBID : Pascal:10-0465293

Descripteurs français

Pascal (Inist)
- Attente, Effet placebo, Dopamine, Induction, Maladie de Parkinson, Tomographie par émission de positons, Fixation biologique, Etude comparative, Pharmacothérapie, Lévodopa, Etude expérimentale, Homme, Antiparkinsonien.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Antiparkinson agent, Biological fixation, Comparative study, Dopamine, Expectation, Experimental study, Human, Induction, Levodopa, Parkinson disease, Pharmacotherapy, Placebo effect, Positron emission tomography.

Abstract

Context: Expectations play a central role in the mechanism of the placebo effect. In Parkinson disease (PD), the placebo effect is associated with release of endogenous dopamine in both nigrostriatal and mesoaccumbens projections, yet the factors that control this dopamine release are undetermined. Objective: To determine how the strength of expectation of clinical improvement influences the degree of striatal dopamine release in response to placebo in patients with moderate PD. Design: Randomized, repeated-measures study with perceived expectation as the independent between-subjects variable. Setting: University of British Columbia Hospital, Vancouver, British Columbia, Canada. Patients: Thirty-five patients with mild to moderate PD undergoing levodopa treatment. Intervention: Verbal manipulation was used to modulate the expectations of patients, who were told that they had a particular probability (25%, 50%, 75%, or 100%) of receiving active medication when they in fact received placebo. Main Outcome Measures: The dopaminergic response to placebo was measured using [¹¹C]raclopride positron emission tomography. The clinical response was also measured (Unified Parkinson Disease Rating Scale) and subjective responses were ascertained using patient self-report. Results: Significant dopamine release occurred when the declared probability of receiving active medication was 75%, but not at other probabilities. Placebo-induced dopamine release in all regions of the striatum was also highly correlated with the dopaminergic response to open administration of active medication. Whereas response to prior medication was the major determinant of placebo-induced dopamine release in the motor striatum, expectation of clinical improvement was additionally required to drive dopamine release in the ventral striatum. Conclusions: The strength of belief of improvement can directly modulate dopamine release in patients with PD. Our findings demonstrate the importance of uncertainty and/or salience over and above a patient's prior treatment response in regulating the placebo effect and have important implications for the interpretation and design of clinical trials.

Affiliations:

Canada

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Le document en format XML

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<term>Expectation</term>
<term>Experimental study</term>
<term>Human</term>
<term>Induction</term>
<term>Levodopa</term>
<term>Parkinson disease</term>
<term>Pharmacotherapy</term>
<term>Placebo effect</term>
<term>Positron emission tomography</term>
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<term>Effet placebo</term>
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<term>Tomographie par émission de positons</term>
<term>Fixation biologique</term>
<term>Etude comparative</term>
<term>Pharmacothérapie</term>
<term>Lévodopa</term>
<term>Etude expérimentale</term>
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<front><div type="abstract" xml:lang="en">Context: Expectations play a central role in the mechanism of the placebo effect. In Parkinson disease (PD), the placebo effect is associated with release of endogenous dopamine in both nigrostriatal and mesoaccumbens projections, yet the factors that control this dopamine release are undetermined. Objective: To determine how the strength of expectation of clinical improvement influences the degree of striatal dopamine release in response to placebo in patients with moderate PD. Design: Randomized, repeated-measures study with perceived expectation as the independent between-subjects variable. Setting: University of British Columbia Hospital, Vancouver, British Columbia, Canada. Patients: Thirty-five patients with mild to moderate PD undergoing levodopa treatment. Intervention: Verbal manipulation was used to modulate the expectations of patients, who were told that they had a particular probability (25%, 50%, 75%, or 100%) of receiving active medication when they in fact received placebo. Main Outcome Measures: The dopaminergic response to placebo was measured using [<sup>11</sup>
C]raclopride positron emission tomography. The clinical response was also measured (Unified Parkinson Disease Rating Scale) and subjective responses were ascertained using patient self-report. Results: Significant dopamine release occurred when the declared probability of receiving active medication was 75%, but not at other probabilities. Placebo-induced dopamine release in all regions of the striatum was also highly correlated with the dopaminergic response to open administration of active medication. Whereas response to prior medication was the major determinant of placebo-induced dopamine release in the motor striatum, expectation of clinical improvement was additionally required to drive dopamine release in the ventral striatum. Conclusions: The strength of belief of improvement can directly modulate dopamine release in patients with PD. Our findings demonstrate the importance of uncertainty and/or salience over and above a patient's prior treatment response in regulating the placebo effect and have important implications for the interpretation and design of clinical trials.</div>
</front>
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	La maladie de Parkinson au Canada (serveur d'exploration)
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La maladie de Parkinson au Canada (serveur d'exploration)

Effects of Expectation on Placebo-Induced Dopamine Release in Parkinson Disease

Effects of Expectation on Placebo-Induced Dopamine Release in Parkinson Disease

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri