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

Wilkinson, David, Podlewska, Aleksandra, Banducci, Sarah, Pellatt-Higgins, Tracy, Slade, Martin, Bodani, Mayur, Sakel, Mohamed, Smith, Lanty, LeWitt, Peter, Ade, Kristen and others. (2019) Caloric vestibular stimulation for the management of motor and non-motor symptoms in Parkinson's disease. Parkinsonism and Related Disorders, . ISSN 1353-8020. (doi:10.1016/j.parkreldis.2019.05.031) (KAR id:75268)

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https://doi.org/10.1016/j.parkreldis.2019.05.031

Abstract

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 (TNMTM) 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.

Item Type: Article
DOI/Identification number: 10.1016/j.parkreldis.2019.05.031
Uncontrolled keywords: Non-invasive Brainstem modulation Caloric vestibular stimulation Parkinson's disease Motor symptoms Non-motor symptoms
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine
Divisions: Faculties > Social Sciences > School of Psychology
Depositing User: David Wilkinson
Date Deposited: 09 Jul 2019 12:37 UTC
Last Modified: 19 Aug 2019 08:41 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/75268 (The current URI for this page, for reference purposes)
Wilkinson, David: https://orcid.org/0000-0002-9973-6477
Pellatt-Higgins, Tracy: https://orcid.org/0000-0002-2543-461X
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