Caloric vestibular stimulation for the management of motor and non-motor symptoms in Parkinson's disease.

Autor: Wilkinson D; School of Psychology, University of Kent, Canterbury, UK. Electronic address: dtw@kent.ac.uk., Podlewska A; School of Psychology, University of Kent, Canterbury, UK., Banducci SE; Scion NeuroStim, LLC, Durham, NC, USA., Pellat-Higgins T; Centre for Health Services Studies, University of Kent, Canterbury, UK., Slade M; Yale University, School of Public Health, New Haven, CT, 06510, USA., Bodani M; Neuropsychiatry Service, Kent & Medway NHS and Social Care Partnership Trust, UK., Sakel M; East Kent Neuro-Rehabilitation Service, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK., Smith L; Scion NeuroStim, LLC, Durham, NC, USA., LeWitt P; Parkinson's Disease & Movement Disorders Program, Henry Ford Hospital and Wayne State University School of Medicine, West Bloomfield, MI, 48322, USA., Ade KK; Scion NeuroStim, LLC, Durham, NC, USA.
Jazyk: angličtina
Zdroj: Parkinsonism & related disorders [Parkinsonism Relat Disord] 2019 Aug; Vol. 65, pp. 261-266. Date of Electronic Publication: 2019 May 31.
DOI: 10.1016/j.parkreldis.2019.05.031
Abstrakt: Introduction: A recent case study showed that repeated sessions of caloric vestibular stimulation (CVS) relieved motor and non-motor symptoms associated with Parkinson's disease (PD). Here we sought to confirm these results in a prospective, double-blind, randomized, placebo treatment-controlled study.
Methods: 33 PD subjects receiving stable anti-Parkinsonian therapy completed an active (n = 16) or placebo (n = 17) treatment period. Subjects self-administered CVS at home twice-daily via a portable, pre-programmed, solid-state ThermoNeuroModulation (TNM™) device, which delivered continually-varying thermal waveforms through aluminum ear-probes mounted on a wearable headset. Subjects were followed over a 4-week baseline period, 8 weeks of treatment and then at 5- and 24-weeks post-treatment. At each study visit, standardized clinical assessments were conducted during ON-medication states to evaluate changes in motor and non-motor symptoms, activities of daily living, and quality of life ratings.
Results: Change scores between baseline and the end of treatment showed that active-arm subjects demonstrated clinically-relevant reductions in motor and non-motor symptoms that were significantly greater than placebo-arm subjects. Active treatment was also associated with improved scores on activities of daily living assessments. Therapeutic gains were still evident 5 weeks after the end of active treatment but had started to recede at 24 weeks follow-up. No serious adverse events were associated with device use, and there was high participant satisfaction and tolerability of treatment.
Conclusion: The results provide evidence that repeated CVS can provide safe and enduring adjuvant relief for motor and non-motor symptoms associated with PD.
(Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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