Abstract
As a neurodegenerative movement disorder, Parkinson’s disease (PD) is commonly characterized by motor symptoms such as resting tremor, rigidity, bradykinesia, and balance and postural impairments. While the main cause of PD is still not clear, it is shown that the basal ganglia loop, which has a role in adjusting a planned movement execution through fine motor control, is altered during this disease and contributes toward the manifested motor symptoms. Galvanic vestibular stimulation (GVS) is a non-invasive technique to influence the vestibular system and stimulate the motor system. This study explores how the motor symptoms of upper and lower extremities in PD are instantly affected by vestibular stimulation. In this regard, direct current GVS was applied to 11 individuals with PD on medication while they were performing two sets of experiments: (1) Instrumented Timed Up and Go (iTUG) test and (2) finger tapping task. The performance of participants was recorded with accelerometers and cameras for offline processing of data. Several outcome measures including coefficient of variation of the step duration, gait phase, phase coordination index, tapping score, and the number and duration of manual motor blocks (MMBs) were considered for objective quantifying of performance. Results showed that almost all of considered outcome measures were improved with the application of GVS and that the improvement in the coefficient of variation of the step duration, the tapping score, and the number of MMBs was statistically significant (p-value < 0.05). The results of this study suggest that GVS can be used to alleviate some of the common motor symptoms of PD. Further research is required to fully characterize the effects of GVS and determine its efficacy in the long term.
Highlights
Parkinson’s disease (PD) is the second most common neurodegenerative disease (Hirtz et al, 2007) that is often accompanied by degradation of motor performance manifested by symptoms such as tremor, rigidity, bradykinesia, akinesia, postural instability, and freezing episodes (Lee et al, 2015)
The outcome measures defined in Section “Outcome Measures” were calculated for the data collected during the walking and finger tapping tasks
Considering that 11 subjects participated in the study and each subject completed three “Galvanic vestibular stimulation (GVS) off ” and three “GVS on” trials, each of the outcome measures described in Section “Outcome Measures” contained 33 samples for each of these two cases
Summary
Parkinson’s disease (PD) is the second most common neurodegenerative disease (Hirtz et al, 2007) that is often accompanied by degradation of motor performance manifested by symptoms such as tremor, rigidity, bradykinesia, akinesia (especially of the face), postural instability, and freezing episodes (Lee et al, 2015). The effect of GVS on postural stability and balance has been reported (Pal et al, 2009; Kataoka et al, 2015; Samoudi et al, 2015) It is well-established that altered posture, reduced balance, and abnormal gait patterns are common functional disorders experienced by individuals with PD (Rogers, 1996; Yogev et al, 2005). While GVS has been shown to reduce postural instability and sway (Pal et al, 2009; Kataoka et al, 2015) and improve balance (Samoudi et al, 2015) in PD, its effects on gait characteristics have not yet been studied in PD population. This study investigates the instant effects of supra-threshold GVS on gait characteristics and manual motor performance of individuals with PD. Results show that the application of GVS improves motor performance in both upper and lower limbs
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