This study is designed to better understand the mechanisms contributing to impaired activation of leg muscles in people with Parkinson's disease (PD) and to test if stimulation of a nerve at the neck can improve muscle activation, walking and balance.
The goals of this project are twofold: (i) to test the hypothesis that persistent inward currents (PICs) in spinal motoneurons of the ankle extensors are reduced in people with Parkinson's disease and that these changes are associated with impaired postural control and (ii) to examine the acute effects of non-invasive vagus nerve stimulation (nVNS) on PICs and postural control. This project will conduct experiments to test the hypothesis that the firing properties of muscles that control the ankle are significantly altered in people with PD compared to matched healthy adults and that these changes in activity are related to the severity of postural control deficits. In addition, this project will examine the acute effects of non-invasive vagal nerve stimulation (nVNS), an intervention that increases activity in the locus coeruleus and raphe nucleus, on the firing properties of ankle muscles and postural control. If successful, this work will be the first to demonstrate that brainstem pathways that control muscle firing properties are altered in people with PD and are associated with postural impairment. The preliminary trial of nVNS will provide evidence that postural muscle activity can be improved with stimulation and improve postural control. These findings will provide critical preliminary data required to move forward with a clinical trial of nVNS in PD.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
75
The gammaCore non-invasive vagus nerve stimulator (nVNS) is a hand-held portable device that is used to apply electrical stimulation to the vagus nerve via two electrodes.
No nVNS is applied in the baseline experiment. Sham nVNS is applied for experiment two
Movement Disorders Laboratory
Minneapolis, Minnesota, United States
RECRUITINGChange in delta-F
Difference between baseline and post-VNS delta-F measure
Time frame: Within-session VNS: 0-60 minutes. Between VNS sessions: 1 - 4 weeks.
Change in Braceheight
Change in brace height measure between before and after VNS
Time frame: Within-session VNS: 0 -60 minutes; between VNS sessions: 1-4 weeks
Step length
Average step length
Time frame: Within-session VNS: 0-60 minutes; between VNS sessions: 1-4 weeks
Peak magnitude force on step leg
peak magnitude of the step leg loading force during gait initiation
Time frame: Within-session VNS: 0-60 minutes; between VNS sessions: 1-4 weeks
Postural sway magnitude
Root mean square (RMS) of the center of pressure smoothness (jerk) in the medial-lateral plane.
Time frame: Within-session VNS: 0-60 minutes; between VNS sessions: 1-4 weeks
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