Introduction of the treatment concept: Regular deep brain stimulation (rDBS) is the standard therapy for the treatment of medically refractory Parkinson's disease (PD) (Benabid et al., 2009). Notwithstanding its significant therapeutic effects, rDBS may cause side effects, characterized as rDBS-induced movement disorders (Baizabal-Carvallo and Jankovic, 2016). Abnormal neuronal synchrony is a hallmark of Parkinson's disease (Hammond et al., 2007). Coordinated reset (CR) stimulation was computationally developed to cause an "unlearning" of pathologically persistent synchrony and synaptic connectivity, thereby inducing long-lasting therapeutic effects (Tass and Majtanik, 2006; Tass, 2017). The CR approach was initially developed for DBS (Tass and Majtanik, 2006; Tass et al., 2012; Adamchic et al., 2014) and thereafter, employing vibratory CR stimuli enabled the development of vibrotactile CR (vCR) fingertip stimulation (Tass, 2017). Two recent clinical feasibility studies with vCR in PD patients demonstrated that delivery of vCR for four hours per day for 3+ months is feasible, has no side effects, and leads to a clinically and statistically significant reduction of Movement Disorders Society-Unified Parkinson's Disease Rating Scale part Ⅲ(MDS-UPRDS Ⅲ) scores (Pfeifer et al., 2012). In one of these feasibility studies, electroencephalography (EEG) recordings demonstrated that cortical sensorimotor high beta power (21–30 Hz) at rest was significantly reduced after three months of daily vCR therapy (Pfeifer et al., 2021). Remarkably, in both studies MDS-UPDRS exams as well as EEG recordings were performed off medication, where PD medication was properly withdrawn for 12–48 hours prior to the patients' morning MDS-UPDRS exams and EEG recordings, depending on the PD medication's half-life. These encouraging results enable the development of a proof-of-concept study with vCR for the treatment of PD. In addition, these results highlight the potential for vibrotactile, non-invasive neuromodulation approaches employing dedicated multichannel stimulus patterns for the treatment of PD.

Department of Neurosurgery,Stanford University School of Medicine,Stanford,CA,USA

[1]Peter A.Tass-.Vibrotactile coordinated reset stimulation for the treatment of Parkinson's disease)[J].中国神经再生研究（英文版）,2022(07):1495-1497

Vibrotactile,rDBS,Benabid,Baizabal,Carvallo,Jankovic,Hammond,unlearning,Tass,Majtanik,Adamchic,vibrotactile,vCR,UPRDS,Pfeifer,exams

coordinated,reset,stimulation,treatment,Parkinson,disease,Introduction,concept,Regular,deep,brain,standard,therapy,medically,refractory,Notwithstanding,its,therapeutic,effects,may,cause,side,characterized,induced,movement,disorders,Abnormal,neuronal,synchrony,hallmark,Coordinated,was,computationally,developed,pathologically,persistent,synaptic,connectivity,thereby,inducing,long,lasting,initially,thereafter,employing,vibratory,stimuli,enabled,development,fingertip,Two,recent,feasibility,studies,patients,demonstrated,that,delivery,four,hours,day,3+,months,feasible,has,leads,clinically,statistically,reduction,Movement,Disorders,Society,Unified,Disease,Rating,Scale,part,MDS,scores,one,these,electroencephalography,EEG,recordings,cortical,sensorimotor,beta,power,rest,significantly,reduced,three,daily,Remarkably,both,UPDRS,well,were,performed,off,medication,where,properly,withdrawn,prior,morning,depending,half,life,These,encouraging,results,proof,study,addition,highlight,potential,invasive,neuromodulation,approaches,dedicated,multichannel,stimulus,patterns

0.450508