Objective: Here we propose to test whether bradykinesia in Parkinson’s disease (PD) can be ameliorated by non-invasive interventions (peripheral tactile vibration) that decrease sensory precision.

Background: Recently, it has been proposed that in healthy individuals the down weighting of sensory afferents prior to and during active movement is an essential step in initiating movement. Within this framework, sensory attenuation is a necessary consequence of reducing the precision (synaptic gain) of sensory evidence to allow the expression of the prior beliefs that incite movement.Furthermore, it has been proposed that bradykinesia in PD can be recast as a result of a pathology in down weighting the somatosensory signal.

Methods: We assessed motor performance in three groups of 18 right-handed healthy subjects using three tasks: the box and blocks test, the nine hole peg test and a reaction time task. We also measured the frequency and amplitude of tapping performed with the right hand using a cyber glove. In addition, we performed the same protocol in 18 PD patients (ON medication). Each task was repeated under three conditions: 1) with no external stimulus; and 2,3) following 30 seconds of a vibratory stimulus applied to the dominant wrist at a frequency of either 20Hz or 80Hz. We recorded EEG from healthy subjects in the absence and presence of a vibratory stimulus (at 20 and 80Hz) to investigate how this peripheral stimulus may modulate oscillatory activity over the sensorimotor cortex in order to understand the mechanism by which peripheral vibration at 80Hz can improve motor performance.

Results: As expected healthy controls showed a significant improvement in motor performance when a vibratory stimulus at 80 Hz was applied compared to 20 Hz vibration (p<0.05) and in absence of vibration. There was no significant difference in motor performance following no vibration and 20 Hz vibration (p>0.5). Interestingly, PD patients ON medication showed similar results.

Conclusions: These preliminary data are consistent with a novel and exciting hypothesis to explain that vibrotactile stimulationat 80 Hz results in less slowing and decrement in amplitude of a repetitive hand movement compared to baseline measures.These results can open an interesting scenario in the new potential treatment of this common neurodegenerative disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-vibration-on-motor-performance-a-new-intervention-to-improve-bradykinesia-in-parkinsons-disease/