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Article type: Research Article
Authors: Wilkinson, Davida; * | Podlewska, Aleksandraa | Sakel, Mohamedb
Affiliations: [a] School of Psychology, University of Kent, Canterbury, Kent, UK | [b] East Kent Neuro-Rehabilitation Service, East Kent Hospitals University NHS Foundation Trust, Kent, UK
Correspondence: [*] Address for correspondence: David Wilkinson, School of Psychology, University of Kent, Canterbury, Kent, CT2 7NP, UK. Tel.: +44 (0)1227 824772; Fax: +44 (0)1227 8247030; E-mail: dtw@kent.ac.uk.
Abstract: OBJECTIVE:To gain ‘first-in-man’ evidence that repeated caloric vestibular stimulation (CVS), a non-invasive form of neuro-modulation, can induce a lasting and clinically-relevant reduction in Parkinson’s Disease (PD) symptoms. METHODS:A 70 yr old male, diagnosed with PD 7 years prior to study enrolment, self-administered CVS at home 2×20 minutes per day for three months using a solid-state portable device. Standardised neuropsychological assessments of motor, cognitive, affective and independent function were carried out prior to stimulation, at the start and end of the sham (month 1) and active (months 2–3) phases, and 5 months post-stimulation. RESULTS:Relative to the pre-stimulation baseline, behavioural improvements that exceeded the minimal detectable change were observed on the EQ5D, Unified Parkinson’s Disease Rating Scale, Schwab and England scale, 2 minute walk, Timed up and go, Non-motor symptom assessment scale for PD, Montreal cognitive assessment, Hospital depression scale and Epworth sleepiness scale. The level of change exceeded the threshold for a minimal clinically important difference on all scales for which a threshold has been published. By contrast, little improvement was seen during the sham (i.e. placebo) phase. CONCLUSION:Caloric vestibular stimulation may offer a novel, home-based method of relieving everyday symptoms of PD, and merits further evaluative study.
Keywords: Treatment, neuro-degeneration, balance
DOI: 10.3233/NRE-161308
Journal: NeuroRehabilitation, vol. 38, no. 2, pp. 179-182, 2016
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