title: Effects of Stochastic Vestibular Galvanic Stimulation and LDOPA on Balance and Motor Symptoms in Patients With Parkinson's Disease.
abstract: BACKGROUND
  Balance problems contribute to reduced quality of life in Parkinson's disease (PD) and available treatments are often insufficient for treating axial and postural motor symptoms.
  
  
  OBJECTIVE
  To investigate the safety of use and possible effects of stochastic vestibular stimulation (SVS) alone and combined with LDOPA in patients with PD.
  
  
  METHODS
  SVS or sham stimulation was administered to 10 PD patients in a double-blind placebo controlled cross-over pilot study. Motor symptoms and balance were evaluated in a defined off-medication state and after a 200 mg test dose of LDOPA, using UPDRS-III, Posturo-Locomotor-Manual (PLM) movement times (MT), static posturography and force plate measurements of the correcting response to a balance perturbation.
  
  
  RESULTS
  Patients did not detect when SVS was active, but SVS increased nausea after LDOPA in two patients. Mixed model analysis demonstrated that SVS improved balance corrections after a backward perturbation and shortened the postural response time. In static posturography there was significant interaction between effects of SVS, medication and proprioceptive input (standing on foam vs. on hard support) and SVS decreased the total sway-path with eyes closed and off medication. As expected, LDOPA improved the UPDRS-III scores and MT. There was an interaction between the effect of SVS and LDOPA on UPDRS-III partly because of reduced UPDRS-III scores with SVS in the off-medication state.
  
  
  CONCLUSIONS
  Short term use of SVS is safe, improves corrective postural responses and may have a small positive effect on motor symptoms in PD patients off treatment.
authors.affiliation: Department of Pharmacology, Inst of Neuroscience and Physiology, University of Gothenburg, Box 431, 405 30 Göteborg, Sweden.
authors.forename: Ghazaleh
authors.initials: G
authors.lastname: Samoudi
authors.affiliation: Department of Pharmacology, Inst of Neuroscience and Physiology, University of Gothenburg, Box 431, 405 30 Göteborg, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Jivegård
authors.affiliation: Universities Space Research Association, Houston, TX, USA.
authors.forename: Ajitkumar P
authors.initials: AP
authors.lastname: Mulavara
authors.affiliation: Department of Pharmacology, Inst of Neuroscience and Physiology, University of Gothenburg, Box 431, 405 30 Göteborg, Sweden. Electronic address: filip.bergquist@gu.se.
authors.forename: Filip
authors.initials: F
authors.lastname: Bergquist
mesh_terms: D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D004856:Postural Balance; D011930:Reaction Time / Q000187:drug effects; D013269:Stochastic Processes; D016896:Treatment Outcome; D014722:Vestibule, Labyrinth / Q000187:drug effects* / Q000503:physiopathology*
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Levodopa; Parkinson's disease; Posture; Vestibular stimulation