Evidence map›Paper›PMID 25632091›Full record

Trial reportNeurology2015

Placebo effect of medication cost in Parkinson disease: a randomized double-blind study.

Alberto J Espay, Matthew M Norris, James C Eliassen, Alok Dwivedi, Matthew S Smith, Christi Banks, Jane B Allendorfer, Anthony E Lang, David E Fleck, Michael J Linke and 1 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 6 pooled it
10.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 6 syntheses or guidelines pooled it, 138 citations in OpenAlex.

  1. Evaluating the neuroprotective effect of GLP-1 receptor agonists in parkinson's disease: a systematic review and meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Pooled it
  2. Pooled it
  3. Does the placebo effect on hot flashes depend on the placebo dose?Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021
    Pooled it
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  12. Constraint-Induced Aphasia Therapy for Treatment of Chronic Post-Stroke Aphasia: A Randomized, Blinded, Controlled Pilot Trial.Medical science monitor : international medical journal of experimental and clinical research · 2015
    Trial
  13. Review
  14. Article
  15. Review
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  17. Article
  18. A Dose of Reality About Dose-Response Relationships.Journal of general internal medicine · 2023
    Review
  19. Immunotherapy trials in Parkinson's disease: challenges.Journal of translational medicine · 2023
    Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Alberto J EspayFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH. alberto.espay@uc.edu.
Matthew M NorrisFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
James C EliassenFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
Alok DwivediFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
Matthew S SmithFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
Christi BanksFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
Jane B AllendorferFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
Anthony E LangFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
David E FleckFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
Michael J LinkeFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
Jerzy P SzaflarskiFrom the UC Neuroscience Institute, Department of Neurology (A.J.E., C.B., J.P.S.), and Department of Internal Medicine (M.J.L.), University of Cincinnati; Gardner Family Center for Parkinson's Disease and Movement Disorders (A.J.E.), Cincinnati; University of Cincinnati Center for Imaging Research (M.M.N., J.C.E., M.S.S., D.E.F.), OH; Division of Biostatistics and Epidemiology (A.D.), Texas Tech University Health Sciences Center, El Paso; The Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease (A.E.L.), University Health Network and the University of Toronto, Canada; University of Alabama at Birmingham (J.B.A., J.P.S.); and Department of Veterans Affairs Medical Center (M.J.L.), Research Service, Cincinnati, OH.
University of Toronto · CATexas Tech University · USTexas Tech University Health Sciences Center · USUniversity of Alabama at Birmingham · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine the effect of cost, a traditionally "inactive" trait of intervention, as contributor to the response to therapeutic interventions.

methodsWe conducted a prospective double-blind study in 12 patients with moderate to severe Parkinson disease and motor fluctuations (mean age 62.4 ± 7.9 years; mean disease duration 11 ± 6 years) who were randomized to a "cheap" or "expensive" subcutaneous "novel injectable dopamine agonist" placebo (normal saline). Patients were crossed over to the alternate arm approximately 4 hours later. Blinded motor assessments in the "practically defined off" state, before and after each intervention, included the Unified Parkinson's Disease Rating Scale motor subscale, the Purdue Pegboard Test, and a tapping task. Measurements of brain activity were performed using a feedback-based visual-motor associative learning functional MRI task. Order effect was examined using stratified analysis.

resultsAlthough both placebos improved motor function, benefit was greater when patients were randomized first to expensive placebo, with a magnitude halfway between that of cheap placebo and levodopa. Brain activation was greater upon first-given cheap but not upon first-given expensive placebo or by levodopa. Regardless of order of administration, only cheap placebo increased activation in the left lateral sensorimotor cortex and other regions.

conclusionExpensive placebo significantly improved motor function and decreased brain activation in a direction and magnitude comparable to, albeit less than, levodopa. Perceptions of cost are capable of altering the placebo response in clinical studies. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that perception of cost is capable of influencing motor function and brain activation in Parkinson disease.

Indexed as

Placebo EffectAgedAntiparkinson AgentsCost of IllnessCross-Over StudiesDopamine AgonistsDouble-Blind MethodFemaleHumansInjections, SubcutaneousLevodopaMaleMiddle AgedParkinson DiseaseProspective StudiesTreatment OutcomeAntiparkinson AgentsDopamine AgonistsLevodopa

Identifiers

PMID25632091
PMCPMC4345649
OpenAlexW2171504304

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.