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In a message dated 19/09/2007 07:01:16 GMT Standard Time,  [log in to unmask] 
writes:

Amanda  wrote:
<<Has anyone got better as a result of the sham surgery  ?
That'd muck up the figures?>>

Double-blind,  placebo-controlled trials are considered to be the gold 
standard in clinical  research. Many investigators cite the Freed  fetal cell tissue 
transplant  study (in the late 1990's) for advanced Parkinson’s disease and 
subsequent  follow- up studies as evidence that the placebo effect may be 
especially  strong and long lasting—as much as a year or more—in surgical 
treatments for  Parkinson’s patients. And it is also currently being cited as evidence 
that  sham surgery as a placebo control is necessary in testing new surgical  
treatments for PD - such as gene therapies.
In the Freed study  half  of the participants received fetal tissue 
transplant - the other half had sham  surgery - holes were drilled into the skull, but 
no treatment was received.  Both groups were given anesthesia and intravenous 
antibiotics. Researchers  argued that the risks associated with the surgery 
were reasonable in relation  to the possible benefits from the outcome of the 
study.
During the 12 month  follow up, those who thought they received the fetal 
tissue implant scored  higher on Quality of Life scales  - whether they actually 
did receive  treatment or not. One theory is that the expectation of getting 
better itself  causes more dopamine to be released in the brain, and thus one 
feels better.  However there was no improvement in actual motor scores in the 
sham surgery  group .

Definitely the placebo effect in PD needs to be studied  further. Current 
insistence on the need for sham surgery as a placebo seems to  be largely  based 
on this one study. And it's use is supported mostly  among North American 
scientists. Researchers in other parts of the world seem  to be able to conduct 
valuable Parkinson's research without having to resort  to doing sham brain 
surgery.

Linda  Herman
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recovery (eveen temporarily) due to the placebo effect - suggests dead  brain 
cells being revived by a change in emotional balance ?   Am I  missing 
something ?



   

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