Effects of galvanic vestibular stimulation on upper and lower extremities motor symptoms in parkinson's disease

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.