Raúl de la Fuente-Fernández1. 1. Division of Neurology, Hospital Arquitecto Marcide, Estrada San Pedro - Catabois s/n, 15405 Ferrol, A Coruña, Spain. rfuente@medynet.com
Abstract
OBJECTIVE: To determine the magnitude of the placebo effect in deep-brain stimulation (DBS) for Parkinson's disease (PD). BACKGROUND: The placebo effect in PD is related to the expectation of clinical benefit. Changes in expectation occurring in DBS crossover studies can be used to estimate the associated placebo effect. For example, the response to active-DBS is predicted to be greater in patients who have previously experienced the effect of placebo-DBS than in those without such an experience. METHODS: Data were obtained by searches of Medline and PubMed using three keywords: Parkinson's disease, deep-brain stimulation, and crossover study. Between-group comparisons of the effect of active-DBS were performed by t-test and analysis of covariance. RESULTS: Data on 126 PD patients were available for analysis. These patients participated in a multicenter, two-period, placebo-controlled crossover study on the efficacy of DBS for PD. As predicted, active-DBS was found to be more effective when preceded by placebo-DBS (i.e. in the high expectation group) than when not (i.e. in the lower expectation group). The estimated magnitude of the placebo effect in DBS was equivalent to 39% of the magnitude of the effect of active-DBS. CONCLUSIONS: There is a prominent placebo effect associated with DBS in PD. Crossover studies may be useful for estimating the placebo effect in other medical conditions.
OBJECTIVE: To determine the magnitude of the placebo effect in deep-brain stimulation (DBS) for Parkinson's disease (PD). BACKGROUND: The placebo effect in PD is related to the expectation of clinical benefit. Changes in expectation occurring in DBS crossover studies can be used to estimate the associated placebo effect. For example, the response to active-DBS is predicted to be greater in patients who have previously experienced the effect of placebo-DBS than in those without such an experience. METHODS: Data were obtained by searches of Medline and PubMed using three keywords: Parkinson's disease, deep-brain stimulation, and crossover study. Between-group comparisons of the effect of active-DBS were performed by t-test and analysis of covariance. RESULTS: Data on 126 PDpatients were available for analysis. These patients participated in a multicenter, two-period, placebo-controlled crossover study on the efficacy of DBS for PD. As predicted, active-DBS was found to be more effective when preceded by placebo-DBS (i.e. in the high expectation group) than when not (i.e. in the lower expectation group). The estimated magnitude of the placebo effect in DBS was equivalent to 39% of the magnitude of the effect of active-DBS. CONCLUSIONS: There is a prominent placebo effect associated with DBS in PD. Crossover studies may be useful for estimating the placebo effect in other medical conditions.
Authors: Sarah J L Edward; Andrew J Stevens; David A Braunholtz; Richard J Lilford; Teresa Swift Journal: World J Surg Date: 2005-05 Impact factor: 3.352
Authors: Aysegul Gunduz; Hokuto Morita; P Justin Rossi; William L Allen; Ron L Alterman; Helen Bronte-Stewart; Christopher R Butson; David Charles; Sjaak Deckers; Coralie de Hemptinne; Mahlon DeLong; Darin Dougherty; Jens Ellrich; Kelly D Foote; James Giordano; Wayne Goodman; Benjamin D Greenberg; David Greene; Robert Gross; Jack W Judy; Edward Karst; Alexander Kent; Brian Kopell; Anthony Lang; Andres Lozano; Codrin Lungu; Kelly E Lyons; Andre Machado; Hubert Martens; Cameron McIntyre; Hoon-Ki Min; Joseph Neimat; Jill Ostrem; Sat Pannu; Francisco Ponce; Nader Pouratian; Donnie Reymers; Lauren Schrock; Sameer Sheth; Ludy Shih; Scott Stanslaski; G Karl Steinke; Paul Stypulkowski; Alexander I Tröster; Leo Verhagen; Harrison Walker; Michael S Okun Journal: Int J Neurosci Date: 2015-05-25 Impact factor: 2.292