Expectation modulates the response to subthalamic nucleus stimulation in Parkinsonian patients
Pollo, A., Torre, E., Lopiano, L., Rizzone, M., Lanotte, M., Cavanna, A., Bergamasco, B., & Benedetti, F. (2002) Expectation modulates the response to subthalamic nucleus stimulation in Parkinsonian patients NeuroReport, 13, 1383-1386
These investigators suggest that patient expectations can play a significant role in treatment outcome. They analyzed right hand movement, during various intensity levels of STN stimulation, of 7 patients with PD that had previously undergone DBS-STN. There were two conditions, either the patient was told exactly what would happen (e.g. expect worsening) or they were told good expectations of what would happen (e.g. they should expect no change or big improvement in motor performance when really they may not) during various levels of STN stimulation. These investigators found that when patients were given instructions regarding good expectations about their performance that they had less motor slowing than those patients given instructions for poor expectations, although the stimulation was the same. These authors suggest that there may be a placebo-activated process in the brain that will affect the motor system, as has been shown in pain patients. This study suggests that positive instructions and attitudes should be taken into account during the treatment of all patients.