Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol

Enhanced neuronal synchronization of the subthalamic nucleus (STN) is commonly found in PD patients and corresponds to decreased motor ability. Coordinated reset (CR) was developed to decouple synchronized states causing long lasting desynchronization of neural networks. Vibrotactile CR stimulation...

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Autores principales:	Kristina J. Pfeifer, Alex J. Cook, Jessica K. Yankulova, Bruce J. P. Mortimer, Elizabeth Erickson-DiRenzo, Rohit Dhall, Leila Montaser-Kouhsari, Peter A. Tass
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	coordinated reset vibrotactile stimulation Parkinson's disease study protocol sensorimotor non-motor symptoms Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ecea948f30ad417e905db2e67187929b
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spelling	oai:doaj.org-article:ecea948f30ad417e905db2e67187929b2021-11-18T06:11:36ZClinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol1664-229510.3389/fneur.2021.758481https://doaj.org/article/ecea948f30ad417e905db2e67187929b2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.758481/fullhttps://doaj.org/toc/1664-2295Enhanced neuronal synchronization of the subthalamic nucleus (STN) is commonly found in PD patients and corresponds to decreased motor ability. Coordinated reset (CR) was developed to decouple synchronized states causing long lasting desynchronization of neural networks. Vibrotactile CR stimulation (vCR) was developed as non-invasive therapeutic that delivers gentle vibrations to the fingertips. A previous study has shown that vCR can desynchronize abnormal brain rhythms within the sensorimotor cortex of PD patients, corresponding to sustained motor relief after 3 months of daily treatment. To further develop vCR, we created a protocol that has two phases. Study 1, a double blinded randomized sham-controlled study, is designed to address motor and non-motor symptoms, sensorimotor integration, and potential calibration methods. Study 2 examines dosing effects of vCR using a remote study design. In Study 1, we will perform a 7-month double-blind sham-controlled study including 30 PD patients randomly placed into an active vCR or inactive (sham) vCR condition. Patients will receive stimulation for 4 h a day in 2-h blocks for 6 months followed by a 1-month pause in stimulation to assess long lasting effects. Our primary outcome measure is the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III off medication after 6 months of treatment. Secondary measures include a freezing of gait (FOG) questionnaire, objective motor evaluations, sensorimotor electroencephalography (EEG) results, a vibratory temporal discrimination task (VTDT), non-motor symptom evaluations/tests such as sleep, smell, speech, quality of life measurements and Levodopa Equivalent Daily Dose (LEDD). Patients will be evaluated at baseline, 3, 6, and 7 months. In the second, unblinded study phase (Study 2), all patients will be given the option to receive active vCR stimulation at a reduced dose for an additional 6 months remotely. The remote MDS-UPDRS part III off medication will be our primary outcome measure. Secondary measures include sleep, quality of life, objective motor evaluations, FOG and LEDD. Patients will be evaluated in the same time periods as the first study. Results from this study will provide clinical efficacy of vCR and help validate our investigational vibrotactile device for the purpose of obtaining FDA clearance.Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT04877015.Kristina J. PfeiferAlex J. CookJessica K. YankulovaBruce J. P. MortimerElizabeth Erickson-DiRenzoRohit DhallLeila Montaser-KouhsariPeter A. TassFrontiers Media S.A.articlecoordinated resetvibrotactile stimulationParkinson's diseasestudy protocolsensorimotornon-motor symptomsNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	coordinated reset vibrotactile stimulation Parkinson's disease study protocol sensorimotor non-motor symptoms Neurology. Diseases of the nervous system RC346-429
spellingShingle	coordinated reset vibrotactile stimulation Parkinson's disease study protocol sensorimotor non-motor symptoms Neurology. Diseases of the nervous system RC346-429 Kristina J. Pfeifer Alex J. Cook Jessica K. Yankulova Bruce J. P. Mortimer Elizabeth Erickson-DiRenzo Rohit Dhall Leila Montaser-Kouhsari Peter A. Tass Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol
description	Enhanced neuronal synchronization of the subthalamic nucleus (STN) is commonly found in PD patients and corresponds to decreased motor ability. Coordinated reset (CR) was developed to decouple synchronized states causing long lasting desynchronization of neural networks. Vibrotactile CR stimulation (vCR) was developed as non-invasive therapeutic that delivers gentle vibrations to the fingertips. A previous study has shown that vCR can desynchronize abnormal brain rhythms within the sensorimotor cortex of PD patients, corresponding to sustained motor relief after 3 months of daily treatment. To further develop vCR, we created a protocol that has two phases. Study 1, a double blinded randomized sham-controlled study, is designed to address motor and non-motor symptoms, sensorimotor integration, and potential calibration methods. Study 2 examines dosing effects of vCR using a remote study design. In Study 1, we will perform a 7-month double-blind sham-controlled study including 30 PD patients randomly placed into an active vCR or inactive (sham) vCR condition. Patients will receive stimulation for 4 h a day in 2-h blocks for 6 months followed by a 1-month pause in stimulation to assess long lasting effects. Our primary outcome measure is the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III off medication after 6 months of treatment. Secondary measures include a freezing of gait (FOG) questionnaire, objective motor evaluations, sensorimotor electroencephalography (EEG) results, a vibratory temporal discrimination task (VTDT), non-motor symptom evaluations/tests such as sleep, smell, speech, quality of life measurements and Levodopa Equivalent Daily Dose (LEDD). Patients will be evaluated at baseline, 3, 6, and 7 months. In the second, unblinded study phase (Study 2), all patients will be given the option to receive active vCR stimulation at a reduced dose for an additional 6 months remotely. The remote MDS-UPDRS part III off medication will be our primary outcome measure. Secondary measures include sleep, quality of life, objective motor evaluations, FOG and LEDD. Patients will be evaluated in the same time periods as the first study. Results from this study will provide clinical efficacy of vCR and help validate our investigational vibrotactile device for the purpose of obtaining FDA clearance.Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT04877015.
format	article
author	Kristina J. Pfeifer Alex J. Cook Jessica K. Yankulova Bruce J. P. Mortimer Elizabeth Erickson-DiRenzo Rohit Dhall Leila Montaser-Kouhsari Peter A. Tass
author_facet	Kristina J. Pfeifer Alex J. Cook Jessica K. Yankulova Bruce J. P. Mortimer Elizabeth Erickson-DiRenzo Rohit Dhall Leila Montaser-Kouhsari Peter A. Tass
author_sort	Kristina J. Pfeifer
title	Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol
title_short	Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol
title_full	Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol
title_fullStr	Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol
title_full_unstemmed	Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol
title_sort	clinical efficacy and dosing of vibrotactile coordinated reset stimulation in motor and non-motor symptoms of parkinson's disease: a study protocol
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/ecea948f30ad417e905db2e67187929b
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Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol

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