Therapeutic application of transcranial magnetic stimulation in Parkinson’s disease: The contribution of expectation
Identifieur interne : 002706 ( Main/Exploration ); précédent : 002705; suivant : 002707Therapeutic application of transcranial magnetic stimulation in Parkinson’s disease: The contribution of expectation
Auteurs : Antonio P. Strafella [Canada] ; Ji Hyun Ko [Canada] ; Oury Monchi [Canada]Source :
- NeuroImage [ 1053-8119 ] ; 2006.
English descriptors
- KwdEn :
- Brain Chemistry (physiology), Dopamine (metabolism), Dopamine Antagonists, Female, Functional Laterality (physiology), Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Neostriatum (diagnostic imaging), Neostriatum (metabolism), Nerve Net (diagnostic imaging), Nerve Net (metabolism), Neural Pathways (diagnostic imaging), Neural Pathways (metabolism), Parkinson Disease (diagnostic imaging), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Placebo Effect, Positron-Emission Tomography, Raclopride, Transcranial Magnetic Stimulation.
- MESH :
- chemical , metabolism : Dopamine.
- diagnostic imaging : Neostriatum, Nerve Net, Neural Pathways, Parkinson Disease.
- metabolism : Neostriatum, Nerve Net, Neural Pathways.
- physiology : Brain Chemistry, Functional Laterality.
- physiopathology : Parkinson Disease.
- therapy : Parkinson Disease.
- chemical : Dopamine Antagonists, Female, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Placebo Effect, Positron-Emission Tomography, Raclopride, Transcranial Magnetic Stimulation.
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a valuable probe of brain function. Ever since its adoption as a research tool, there has been great interest regarding its potential clinical role. Presently, it is unclear whether rTMS will have some role as an alternative treatment for neuropsychiatric and neurological disorders such as Parkinson’s disease (PD). To date, studies addressing the contribution of placebo during rTMS are missing. The placebo effect has been shown to be associated either with release of dopamine in the striatum or with changes in brain glucose metabolism. The main objective of this study was to test whether, in patients with PD, the expectation of therapeutic benefit from rTMS, which actually was delivered only as sham rTMS (placebo-rTMS) induced changes in striatal [11C] raclopride binding potentials (BP) as measured with positron emission tomography (PET). Placebo-rTMS induced a significant bilateral reduction in [11C] raclopride BP in dorsal and ventral striatum as compared to the baseline condition. This reduction BP is indicative of an increase in dopamine neurotransmission. The changes in [11C] raclopride binding were more evident in the hemisphere contralateral to the more affected side supporting the hypothesis that the more severe the symptoms, the greater the drive for symptom relief, and therefore the placebo response. This is the first study addressing the placebo contribution during rTMS. While our results seem to confirm earlier evidence that expectation induces dopaminergic placebo effects, they also suggest the importance of placebo-controlled studies for future clinical trials involving brain stimulation techniques.
Url:
DOI: 10.1016/j.neuroimage.2006.02.005
PubMed: 16545582
PubMed Central: 2967525
Affiliations:
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Le document en format XML
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<front><div type="abstract" xml:lang="en"><p id="P1">Repetitive transcranial magnetic stimulation (rTMS) is a valuable probe of brain function. Ever since its adoption as a research tool, there has been great interest regarding its potential clinical role. Presently, it is unclear whether rTMS will have some role as an alternative treatment for neuropsychiatric and neurological disorders such as Parkinson’s disease (PD). To date, studies addressing the contribution of placebo during rTMS are missing. The placebo effect has been shown to be associated either with release of dopamine in the striatum or with changes in brain glucose metabolism. The main objective of this study was to test whether, in patients with PD, the expectation of therapeutic benefit from rTMS, which actually was delivered only as sham rTMS (placebo-rTMS) induced changes in striatal [<sup>11</sup>
C] raclopride binding potentials (BP) as measured with positron emission tomography (PET). Placebo-rTMS induced a significant bilateral reduction in [<sup>11</sup>
C] raclopride BP in dorsal and ventral striatum as compared to the baseline condition. This reduction BP is indicative of an increase in dopamine neurotransmission. The changes in [<sup>11</sup>
C] raclopride binding were more evident in the hemisphere contralateral to the more affected side supporting the hypothesis that the more severe the symptoms, the greater the drive for symptom relief, and therefore the placebo response. This is the first study addressing the placebo contribution during rTMS. While our results seem to confirm earlier evidence that expectation induces dopaminergic placebo effects, they also suggest the importance of placebo-controlled studies for future clinical trials involving brain stimulation techniques.</p>
</div>
</front>
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