Objective: In this first ever, randomized, double-blind control trial we explored the role of noninvasive VNS (nVNS) in the treatment of gait and motor symptoms of PD patients.

Background: Abnormal and unstable walking in patients with Parkinson’s disease (PD) often leads to recurrent falls. Hence,neurostimulation techniques were explored for treating of gait dysfunction. Vagus nerve stimulation (VNS), a neurostimulation treatment has gained popularity in the treatment of migraine and epilepsy in last decade. Some animal work has also shown potential of VNS in treating motor and nonmotor features of PD. In our open label pilot study, we found an encouraging result in the treatment of gait freezing in PD patients.

Method: Twenty PD patients with gait disorder were recruited from Institute of Neurosciences, Kolkata. Patients were allocated randomly on two intervention arms – active nVNS or sham VNS
(devices provided by electrocore LLC, NJ, USA) such that both patient and experimenter were blinded to the intervention. After the baseline assessments patients and carers were trained and asked to deliver the intervention in their home for one month using a standard dose (total 12 minutes of stimulation per day). At the end of one month they were re-assessed. After a one month washout period the same patients were allocated to alternate arm and same process was followed. No changes were made to patients’ medications throughout the study.

Results: We observed significant improvements in some key gait parameters including walking speed (p 0.012), stance time (p 0 .001) and step length (p .008) following active nVNS stimulation, but not after sham stimulation. Similarly, the overall motor function (MDS-UPDRS III) also improved (p 0 .001) significantly following active nVNS stimulation and not following sham stimulation. The cognitive function did not show any change following any of the treatment (active or sham).  The total time taken for Timed up and Go (P 0.033) test also improved significantly after VNS. None of the patients had any adverse effect related to administration of nVNS.

Conclusion: For the first time ever, a high level evidence regarding the efficacy and safety of nVNS in the treatment of gait and motor function in PD patients has been generated. This treatment modality may be useful as an adjunct to the standard pharmacotherapy or physical therapy of PD.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-effect-of-non-invasive-vagus-nerve-stimulation-in-parkinsons-disease-patients/