Expectation and the placebo effect in Parkinson's disease patients with subthalamic nucleus deep brain stimulation
Identifieur interne : 002510 ( Main/Corpus ); précédent : 002509; suivant : 002511Expectation and the placebo effect in Parkinson's disease patients with subthalamic nucleus deep brain stimulation
Auteurs : Rodrigo Mercado ; Constantine Constantoyannis ; Tomasz Mandat ; Ajit Kumar ; Michael Schulzer ; A. Jon Stoessl ; Christopher R. HoneySource :
- Movement Disorders [ 0885-3185 ] ; 2006-09.
English descriptors
Abstract
To determine whether the degree to which a patient with Parkinson's disease expects therapeutic benefit from subthalamic nucleus–deep brain stimulation (STN‐DBS) influences the magnitude of his or her improved motor response, 10 patients with idiopathic Parkinson's and bilateral STN‐DBS were tested after a 12‐hour period off medication and stimulation. Four consecutive UPDRS III scores were performed in the following conditions: (a) stimulation OFF, patient aware; (b) stimulation OFF, patient blind; (c) stimulation ON, patient aware; and (d) stimulation ON, patient blind. Statistical significance (P = 0.0001) was observed when comparing main effect ON versus OFF (mean ON: 32.55; mean OFF: 49.15). When the stimulation was OFF, patients aware of this condition had higher UPDRS motor scores than when they were blinded (mean: 50.7 vs. 47.6). With the stimulation ON, UPDRS motor scores were lower when the patients were aware of the stimulation compared with when they were blinded (mean: 30.6 vs. 34.5). The interaction between these levels was significant (P = 0.049). This variation was important for bradykinesia and was not significant for tremor and rigidity. The authors conclude that the information about the condition of the stimulation enhanced the final clinical effect in opposite directions. The results presented support the role of expectation and placebo effects in STN‐DBS in Parkinson's disease patients. © 2006 Movement Disorder Society
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DOI: 10.1002/mds.20935
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ISTEX:77875AEC8040A0C1B423F9C7E2142361503A27E9Le document en format XML
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Four consecutive UPDRS III scores were performed in the following conditions: (a) stimulation OFF, patient aware; (b) stimulation OFF, patient blind; (c) stimulation ON, patient aware; and (d) stimulation ON, patient blind. Statistical significance (P = 0.0001) was observed when comparing main effect ON versus OFF (mean ON: 32.55; mean OFF: 49.15). When the stimulation was OFF, patients aware of this condition had higher UPDRS motor scores than when they were blinded (mean: 50.7 vs. 47.6). With the stimulation ON, UPDRS motor scores were lower when the patients were aware of the stimulation compared with when they were blinded (mean: 30.6 vs. 34.5). The interaction between these levels was significant (P = 0.049). This variation was important for bradykinesia and was not significant for tremor and rigidity. The authors conclude that the information about the condition of the stimulation enhanced the final clinical effect in opposite directions. The results presented support the role of expectation and placebo effects in STN‐DBS in Parkinson's disease patients. © 2006 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Rodrigo Mercado MD</name><affiliations><json:string>Surgical Centre for Movement Disorders, University of British Columbia, British Columbia, Canada</json:string></affiliations></json:item><json:item><name>Constantine Constantoyannis MD</name><affiliations><json:string>Surgical Centre for Movement Disorders, University of British Columbia, British Columbia, Canada</json:string></affiliations></json:item><json:item><name>Tomasz Mandat MD, PhD</name><affiliations><json:string>Surgical Centre for Movement Disorders, University of British Columbia, British Columbia, Canada</json:string></affiliations></json:item><json:item><name>Ajit Kumar MD</name><affiliations><json:string>Pacific Parkinson's Disease Research Center, University of British Columbia, British Columbia, Canada</json:string></affiliations></json:item><json:item><name>Michael Schulzer MD</name><affiliations><json:string>Pacific Parkinson's Disease Research Center, University of British Columbia, British Columbia, Canada</json:string></affiliations></json:item><json:item><name>A. 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Four consecutive UPDRS III scores were performed in the following conditions: (a) stimulation OFF, patient aware; (b) stimulation OFF, patient blind; (c) stimulation ON, patient aware; and (d) stimulation ON, patient blind. Statistical significance (P = 0.0001) was observed when comparing main effect ON versus OFF (mean ON: 32.55; mean OFF: 49.15). When the stimulation was OFF, patients aware of this condition had higher UPDRS motor scores than when they were blinded (mean: 50.7 vs. 47.6). With the stimulation ON, UPDRS motor scores were lower when the patients were aware of the stimulation compared with when they were blinded (mean: 30.6 vs. 34.5). The interaction between these levels was significant (P = 0.049). This variation was important for bradykinesia and was not significant for tremor and rigidity. The authors conclude that the information about the condition of the stimulation enhanced the final clinical effect in opposite directions. 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Four consecutive UPDRS III scores were performed in the following conditions: (a) stimulation OFF, patient aware; (b) stimulation OFF, patient blind; (c) stimulation ON, patient aware; and (d) stimulation ON, patient blind. Statistical significance (P = 0.0001) was observed when comparing main effect ON versus OFF (mean ON: 32.55; mean OFF: 49.15). When the stimulation was OFF, patients aware of this condition had higher UPDRS motor scores than when they were blinded (mean: 50.7 vs. 47.6). With the stimulation ON, UPDRS motor scores were lower when the patients were aware of the stimulation compared with when they were blinded (mean: 30.6 vs. 34.5). The interaction between these levels was significant (P = 0.049). This variation was important for bradykinesia and was not significant for tremor and rigidity. The authors conclude that the information about the condition of the stimulation enhanced the final clinical effect in opposite directions. 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Jon</givenNames><familyName>Stoessl</familyName><degrees>MD, FRCPC</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Christopher R.</givenNames><familyName>Honey</familyName><degrees>MD, DPhil, FRCSC</degrees></personName><contactDetails><email>Chris.honey@telus.net</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="CA" type="organization"><unparsedAffiliation>Surgical Centre for Movement Disorders, University of British Columbia, British Columbia, Canada</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="CA" type="organization"><unparsedAffiliation>Pacific Parkinson's Disease Research Center, University of British Columbia, British Columbia, Canada</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">placebo</keyword><keyword xml:id="kwd2">nocebo</keyword><keyword xml:id="kwd3">Parkinson's disease</keyword><keyword xml:id="kwd4">subthalamic nucleus</keyword><keyword xml:id="kwd5">deep brain stimulation</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>To determine whether the degree to which a patient with Parkinson's disease expects therapeutic benefit from subthalamic nucleus–deep brain stimulation (STN‐DBS) influences the magnitude of his or her improved motor response, 10 patients with idiopathic Parkinson's and bilateral STN‐DBS were tested after a 12‐hour period off medication and stimulation. Four consecutive UPDRS III scores were performed in the following conditions: (a) stimulation OFF, patient aware; (b) stimulation OFF, patient blind; (c) stimulation ON, patient aware; and (d) stimulation ON, patient blind. Statistical significance (<i>P</i> = 0.0001) was observed when comparing main effect ON versus OFF (mean ON: 32.55; mean OFF: 49.15). When the stimulation was OFF, patients aware of this condition had higher UPDRS motor scores than when they were blinded (mean: 50.7 vs. 47.6). With the stimulation ON, UPDRS motor scores were lower when the patients were aware of the stimulation compared with when they were blinded (mean: 30.6 vs. 34.5). The interaction between these levels was significant (<i>P</i> = 0.049). This variation was important for bradykinesia and was not significant for tremor and rigidity. The authors conclude that the information about the condition of the stimulation enhanced the final clinical effect in opposite directions. The results presented support the role of expectation and placebo effects in STN‐DBS in Parkinson's disease patients. © 2006 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Expectation and the placebo effect in Parkinson's disease patients with subthalamic nucleus deep brain stimulation</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Expectation and Placebo Effect</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Expectation and the placebo effect in Parkinson's disease patients with subthalamic nucleus deep brain stimulation</title></titleInfo><name type="personal"><namePart type="given">Rodrigo</namePart><namePart type="family">Mercado</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Surgical Centre for Movement Disorders, University of British Columbia, British Columbia, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Constantine</namePart><namePart type="family">Constantoyannis</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Surgical Centre for Movement Disorders, University of British Columbia, British Columbia, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tomasz</namePart><namePart type="family">Mandat</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Surgical Centre for Movement Disorders, University of British Columbia, British Columbia, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ajit</namePart><namePart type="family">Kumar</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Pacific Parkinson's Disease Research Center, University of British Columbia, British Columbia, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michael</namePart><namePart type="family">Schulzer</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Pacific Parkinson's Disease Research Center, University of British Columbia, British Columbia, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A. Jon</namePart><namePart type="family">Stoessl</namePart><namePart type="termsOfAddress">MD, FRCPC</namePart><affiliation>Pacific Parkinson's Disease Research Center, University of British Columbia, British Columbia, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Christopher R.</namePart><namePart type="family">Honey</namePart><namePart type="termsOfAddress">MD, DPhil, FRCSC</namePart><affiliation>Surgical Centre for Movement Disorders, University of British Columbia, British Columbia, Canada</affiliation><description>Correspondence: Surgical Centre for Movement Disorders, Room 325, C Floor, 700 West 10th Avenue, Vancouver, BC V5Z 4E5, Canada</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2006-09</dateIssued><dateCaptured encoding="w3cdtf">2005-04-20</dateCaptured><dateValid encoding="w3cdtf">2005-12-21</dateValid><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="references">32</extent><extent unit="words">3259</extent></physicalDescription><abstract lang="en">To determine whether the degree to which a patient with Parkinson's disease expects therapeutic benefit from subthalamic nucleus–deep brain stimulation (STN‐DBS) influences the magnitude of his or her improved motor response, 10 patients with idiopathic Parkinson's and bilateral STN‐DBS were tested after a 12‐hour period off medication and stimulation. Four consecutive UPDRS III scores were performed in the following conditions: (a) stimulation OFF, patient aware; (b) stimulation OFF, patient blind; (c) stimulation ON, patient aware; and (d) stimulation ON, patient blind. Statistical significance (P = 0.0001) was observed when comparing main effect ON versus OFF (mean ON: 32.55; mean OFF: 49.15). When the stimulation was OFF, patients aware of this condition had higher UPDRS motor scores than when they were blinded (mean: 50.7 vs. 47.6). With the stimulation ON, UPDRS motor scores were lower when the patients were aware of the stimulation compared with when they were blinded (mean: 30.6 vs. 34.5). The interaction between these levels was significant (P = 0.049). This variation was important for bradykinesia and was not significant for tremor and rigidity. The authors conclude that the information about the condition of the stimulation enhanced the final clinical effect in opposite directions. The results presented support the role of expectation and placebo effects in STN‐DBS in Parkinson's disease patients. © 2006 Movement Disorder Society</abstract><subject lang="en"><genre>Keywords</genre><topic>placebo</topic><topic>nocebo</topic><topic>Parkinson's disease</topic><topic>subthalamic nucleus</topic><topic>deep brain stimulation</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Brief Report</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>21</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>1457</start><end>1461</end><total>5</total></extent></part></relatedItem><identifier type="istex">77875AEC8040A0C1B423F9C7E2142361503A27E9</identifier><identifier type="DOI">10.1002/mds.20935</identifier><identifier type="ArticleID">MDS20935</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2006 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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