Anna Paula Batista de Ávila Pires, Ludimila Labanca, Paulo Pereira Christo, Maurício Campelo Tavares, Jordana Carvalhais Barroso, Maria Luiza Diniz, Denise Utsch Gonçalves
{"title":"前庭电刺激对帕金森病患者体位不稳定的修复作用。","authors":"Anna Paula Batista de Ávila Pires, Ludimila Labanca, Paulo Pereira Christo, Maurício Campelo Tavares, Jordana Carvalhais Barroso, Maria Luiza Diniz, Denise Utsch Gonçalves","doi":"10.1055/s-0045-1806812","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong> Galvanic vestibular stimulation (GVS) is a non-invasive technique employed to rehabilitate balance by delivering low-intensity, short-duration electrical stimulation to the mastoid bones, effectively activating the vestibulospinal tract.</p><p><strong>Objective: </strong> To evaluate the effects of GVS on balance in patients with Parkinson's disease (PD) and postural instability.</p><p><strong>Methods: </strong> In this clinical study, 25 PD patients with postural instability in the ON phase (best effect of dopaminergic medication) underwent GVS. Balance was assessed using the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, and posturography on a force platform. Electrical current intensity was progressively increased between the mastoids, starting at 1.0 mA and reaching 3.5 mA by the 6th session, with this level maintained until the 8th session. Stimulation duration began at 9 minutes in the 1st session, increased to 30 minutes by the 3rd session, and was sustained through the 8th session.</p><p><strong>Results: </strong> A blinded comparison of pre- and post-GVS evaluations demonstrated significant improvements in BBS (<i>p</i> = 0.00001) and TUG (<i>p</i> = 0.00003) scores. Posturography showed an increase in the stability limit area (<i>p</i> = 0.026) and the general balance index (<i>p</i> = 0.001).</p><p><strong>Conclusion: </strong> In the therapeutic management of postural instability in PD, GVS emerges as a promising complementary strategy for enhancing balance. Further research is needed to determine whether these improvements persist after GVS cessation.</p><p><strong>Registration of clinical trial: </strong> https://ensaiosclinicos.gov.br/rg/RBR-22j8728.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 3","pages":"1-8"},"PeriodicalIF":1.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Galvanic vestibular stimulation to rehabilitate postural instability in Parkinson's disease.\",\"authors\":\"Anna Paula Batista de Ávila Pires, Ludimila Labanca, Paulo Pereira Christo, Maurício Campelo Tavares, Jordana Carvalhais Barroso, Maria Luiza Diniz, Denise Utsch Gonçalves\",\"doi\":\"10.1055/s-0045-1806812\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong> Galvanic vestibular stimulation (GVS) is a non-invasive technique employed to rehabilitate balance by delivering low-intensity, short-duration electrical stimulation to the mastoid bones, effectively activating the vestibulospinal tract.</p><p><strong>Objective: </strong> To evaluate the effects of GVS on balance in patients with Parkinson's disease (PD) and postural instability.</p><p><strong>Methods: </strong> In this clinical study, 25 PD patients with postural instability in the ON phase (best effect of dopaminergic medication) underwent GVS. Balance was assessed using the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, and posturography on a force platform. Electrical current intensity was progressively increased between the mastoids, starting at 1.0 mA and reaching 3.5 mA by the 6th session, with this level maintained until the 8th session. Stimulation duration began at 9 minutes in the 1st session, increased to 30 minutes by the 3rd session, and was sustained through the 8th session.</p><p><strong>Results: </strong> A blinded comparison of pre- and post-GVS evaluations demonstrated significant improvements in BBS (<i>p</i> = 0.00001) and TUG (<i>p</i> = 0.00003) scores. Posturography showed an increase in the stability limit area (<i>p</i> = 0.026) and the general balance index (<i>p</i> = 0.001).</p><p><strong>Conclusion: </strong> In the therapeutic management of postural instability in PD, GVS emerges as a promising complementary strategy for enhancing balance. Further research is needed to determine whether these improvements persist after GVS cessation.</p><p><strong>Registration of clinical trial: </strong> https://ensaiosclinicos.gov.br/rg/RBR-22j8728.</p>\",\"PeriodicalId\":8694,\"journal\":{\"name\":\"Arquivos de neuro-psiquiatria\",\"volume\":\"83 3\",\"pages\":\"1-8\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arquivos de neuro-psiquiatria\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0045-1806812\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arquivos de neuro-psiquiatria","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/s-0045-1806812","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/22 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Galvanic vestibular stimulation to rehabilitate postural instability in Parkinson's disease.
Background: Galvanic vestibular stimulation (GVS) is a non-invasive technique employed to rehabilitate balance by delivering low-intensity, short-duration electrical stimulation to the mastoid bones, effectively activating the vestibulospinal tract.
Objective: To evaluate the effects of GVS on balance in patients with Parkinson's disease (PD) and postural instability.
Methods: In this clinical study, 25 PD patients with postural instability in the ON phase (best effect of dopaminergic medication) underwent GVS. Balance was assessed using the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, and posturography on a force platform. Electrical current intensity was progressively increased between the mastoids, starting at 1.0 mA and reaching 3.5 mA by the 6th session, with this level maintained until the 8th session. Stimulation duration began at 9 minutes in the 1st session, increased to 30 minutes by the 3rd session, and was sustained through the 8th session.
Results: A blinded comparison of pre- and post-GVS evaluations demonstrated significant improvements in BBS (p = 0.00001) and TUG (p = 0.00003) scores. Posturography showed an increase in the stability limit area (p = 0.026) and the general balance index (p = 0.001).
Conclusion: In the therapeutic management of postural instability in PD, GVS emerges as a promising complementary strategy for enhancing balance. Further research is needed to determine whether these improvements persist after GVS cessation.
Registration of clinical trial: https://ensaiosclinicos.gov.br/rg/RBR-22j8728.
期刊介绍：
Arquivos de Neuro-Psiquiatria is the official journal of the Brazilian Academy of Neurology. The mission of the journal is to provide neurologists, specialists and researchers in Neurology and related fields with open access to original articles (clinical and translational research), editorials, reviews, historical papers, neuroimages and letters about published manuscripts. It also publishes the consensus and guidelines on Neurology, as well as educational and scientific material from the different scientific departments of the Brazilian Academy of Neurology.
The ultimate goals of the journal are to contribute to advance knowledge in the areas of Neurology and Neuroscience, and to provide valuable material for training and continuing education for neurologists and other health professionals working in the area. These goals might contribute to improving care for patients with neurological diseases. We aim to be the best Neuroscience journal in Latin America within the peer review system.
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