Stimulation of the ear can help manage Parkinson’s symptoms

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EarA study has shown that gentle, controlled stimulation of the ear canal can help reduce symptoms of Parkinson’s disease. The randomised, controlled study, led by the University of Kent, UK, showed that twice daily stimulation for two months was associated with a significant reduction in both motor and non-motor features of Parkinson’s disease.

Participants reported greater movement and mobility, and also showed improvements in decision-making, attention, memory, mood, and sleep. Participants also said that by the end of the study they found it easier to perform everyday activities by themselves.
Most of the therapeutic gains were greatest five weeks after the end of treatment suggesting that the treatment may have long lasting effects.

The stimulation therapy was performed at home using a portable headset produced exclusively for clinical investigations by Scion Neurostim, a US-based device company. Participants continued to take their regular dopamine replacement therapy while using the “easy to use” device.

The study, led by Professor David Wilkinson at Kent’s School of Psychology, was conducted on 46 individuals with Parkinson’s disease. The research was supported by Dr Mohamed Sakel, director of the East Kent NHS Neuro-rehabilitation Service and Dr Mayur Bodani, consultant neuropsychiatrist, Kent & Medway NHS and Social Care Partnership Trust, UK. Additional help with participant recruitment was given by the national charity Parkinsons UK.

Wilkinson said: “This study raises the intriguing possibility that some aspects of Parkinson’s disease may be better managed if traditional drug-therapies are combined with gentle, non-invasive stimulation of the balance organs”.

Dr Beckie Port, research manager at Parkinson’s UK, said: “The results from this small scale study are very exciting. While more research is needed to better understand how delivering this kind of non-invasive stimulation to the nerve in the ear works, it holds a lot of promise to relieve troublesome symptoms that many with Parkinson’s experience.”

Professor Ray Chaudhuri, director of the National Parkinson Foundation Centre of Excellence at King’s College Hospital, said: “The results are very encouraging. Achieving both widespread efficacy and durable gains in motor and specifically non-motor aspects of Parkinson’s disease would be quite novel, and improvements in non-motor symptoms would be especially notable. Those symptoms are often untreated or poorly treated and have a particularly detrimental impact on quality of life, and their treatment is a key unmet need. I am intrigued and want to see where this device technology might go.”

The results build on other work conducted by Wilkinson’s research group at Kent’s School of Psychology, which has shown that gentle stimulation of the inner ear can also improve neurological symptoms associated with stroke and traumatic brain injury.

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 (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.

Authors
David Wilkinson, Aleksandra Podlewska, Sarah E Banducci, Tracy Pellat-Higgins, Martin Slade, Mayur Bodani, Mohamed Sakel, Lanty Smith, Peter LeWitt, Kristen K Ade

University of Kent material
Parkinsonism & Related Disorders abstract


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