{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:05:28Z","timestamp":1791223528306,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T00:00:00Z","timestamp":1719532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>The impact of treatment expectations on active treatment outcomes has not been specifically investigated in neuromuscular disorders. We thus explored in myasthenia gravis (MG) the contribution of patients' pre\u2010treatment expectations combined with an immunosuppressant drug on treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This pilot correlational study involved 17 patients with generalized MG, scheduled to start immunosuppressant azathioprine. At baseline, a healthcare professional administered: (i) the Stanford Expectations of Treatment Scale; (ii) a structured checklist paper form asking patients which side\u2010effects they expected to develop after starting azathioprine, coupled with a standardized framing of statements. Quantitative Myasthenia Gravis (QMG) score and daily dose of concomitant drugs were assessed by neurologists as clinical outcomes. Clinical outcomes and side\u2010effects were re\u2010assessed at 3 and 6\u2009months, and clinical outcomes were monitored at 18\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinically significant improvement in the QMG scores was achieved at 3 or 6\u2009months. The level of state anxiety appeared to act as moderator of pre\u2010treatment negative expectations (strong, positive, indicative correlation, <jats:italic>r<\/jats:italic>s\u2009=\u2009.733, <jats:italic>p<\/jats:italic>\u2009=\u2009.001). The latter were, in turn, associated with the fulfillment of side\u2010effects that patients expected to develop with the new treatment (moderate, positive, indicative correlation, <jats:italic>r<\/jats:italic>s\u2009=\u2009.699, <jats:italic>p<\/jats:italic>\u2009=\u2009.002). No significant correlation emerged between positive and negative expectations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Our findings show a very quick clinical response and also suggest that patients' expectations and anxiety contributed to treatment outcomes, highlighting the importance of promoting safety messages and education strategies around newly introduced treatments. Future goals include evaluating a larger cohort that includes a matched control group.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28189","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T11:00:46Z","timestamp":1719572446000},"page":"413-419","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The impact of patients' pre\u2010treatment expectations on immunosuppressive treatment outcomes in myasthenia gravis: A pilot correlational study"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3783-1997","authenticated-orcid":false,"given":"Elisa","family":"Frisaldi","sequence":"first","affiliation":[{"name":"Rita Levi Montalcini Department of Neuroscience University of Turin Medical School  Turin Italy"},{"name":"Clinical Neurosciences, Department of Neurology and Center for Translational Neuro\u2010 and Behavioral Sciences (C\u2010TNBS) University Hospital Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Ferrero","sequence":"additional","affiliation":[{"name":"Rita Levi Montalcini Department of Neuroscience University of Turin Medical School  Turin Italy"},{"name":"Neurology 2 Unit A.O.U. Citt\u00e0 Della Salute e Della Scienza di Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Di Liberto","sequence":"additional","affiliation":[{"name":"Rita Levi Montalcini Department of Neuroscience University of Turin Medical School  Turin Italy"},{"name":"Neurology 2 Unit A.O.U. Citt\u00e0 Della Salute e Della Scienza di Torino  Turin Italy"},{"name":"Neurology Unit San Giovanni Bosco Hospital  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8703-6687","authenticated-orcid":false,"given":"Diletta","family":"Barbiani","sequence":"additional","affiliation":[{"name":"Rita Levi Montalcini Department of Neuroscience University of Turin Medical School  Turin Italy"},{"name":"Department of Psychology Universit\u00e0 Cattolica del Sacro Cuore  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4771-2836","authenticated-orcid":false,"given":"Eleonora Maria","family":"Camerone","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa  Savona Italy"},{"name":"Department of Psychology University of Milan\u2010Bicocca  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5705-2173","authenticated-orcid":false,"given":"Alessandro","family":"Piedimonte","sequence":"additional","affiliation":[{"name":"Rita Levi Montalcini Department of Neuroscience University of Turin Medical School  Turin Italy"},{"name":"Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione Ospedale San Giuseppe  Piancavallo (VCO) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0733-5201","authenticated-orcid":false,"given":"Jan","family":"Vollert","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Neurology Unit San Giovanni Bosco Hospital  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2939-343X","authenticated-orcid":false,"given":"Maurizio","family":"Zibetti","sequence":"additional","affiliation":[{"name":"Rita Levi Montalcini Department of Neuroscience University of Turin Medical School  Turin Italy"},{"name":"Neurology 2 Unit A.O.U. Citt\u00e0 Della Salute e Della Scienza di Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9098-387X","authenticated-orcid":false,"given":"Leonardo","family":"Lopiano","sequence":"additional","affiliation":[{"name":"Rita Levi Montalcini Department of Neuroscience University of Turin Medical School  Turin Italy"},{"name":"Neurology 2 Unit A.O.U. 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