title: A durable gain in motor and non-motor symptoms of Parkinson's Disease following repeated caloric vestibular stimulation: A single-case study.
abstract: OBJECTIVE
  To gain 'first-in-man' evidence that repeated caloric vestibular stimulation (CVS), a non-invasive form of neuro-modulation, can induce a lasting and clinically-relevant reduction in Parkinson's Disease (PD) symptoms.
  
  
  METHODS
  A 70  yr old male, diagnosed with PD 7 years prior to study enrolment, self-administered CVS at home 2×20 minutes per day for three months using a solid-state portable device. Standardised neuropsychological assessments of motor, cognitive, affective and independent function were carried out prior to stimulation, at the start and end of the sham (month 1) and active (months 2-3) phases, and 5 months post-stimulation.
  
  
  RESULTS
  Relative to the pre-stimulation baseline, behavioural improvements that exceeded the minimal detectable change were observed on the EQ5D, Unified Parkinson's Disease Rating Scale, Schwab and England scale, 2 minute walk, Timed up and go, Non-motor symptom assessment scale for PD, Montreal cognitive assessment, Hospital depression scale and Epworth sleepiness scale. The level of change exceeded the threshold for a minimal clinically important difference on all scales for which a threshold has been published. By contrast, little improvement was seen during the sham (i.e., placebo) phase.
  
  
  CONCLUSIONS
  Caloric vestibular stimulation may offer a novel, home-based method of relieving everyday symptoms of PD, and merits further evaluative study.
authors.affiliation: School of Psychology, University of Kent, Canterbury, Kent, UK.
authors.forename: David
authors.initials: D
authors.lastname: Wilkinson
authors.affiliation: School of Psychology, University of Kent, Canterbury, Kent, UK.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Podlewska
authors.affiliation: East Kent Neuro-Rehabilitation Service, East Kent Hospitals University NHS Foundation Trust, Kent, UK.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Sakel
mesh_terms: D000339:Affect; D000368:Aged; D003071:Cognition; D003863:Depression / Q000523:psychology; D006358:Hot Temperature; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D004856:Postural Balance; D016896:Treatment Outcome; D014722:Vestibule, Labyrinth
keywords: Treatment; balance; neuro-degeneration