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Influence of transcutaneous vagal nerve stimulation on non-motor symptoms in Parkinson's disease

Description

Parkinson's disease (PD) is a neurodegenerative disease in which non-motor symptoms (NMS) occur in addition to the classic core motor symptoms (bradykinesia, rigidity and tremor). These NMS, such as affective symptoms or gastrointestinal dysmotility, have a significant impact on the quality of life of people with the disease and are often present many years before diagnosis, making them an increasing focus of research.

Antral dysmotility and consequent constipation occur in the prodromal stage and accompany many patients into the advanced stages of the disease. In particular, the absorption of oral dopaminergic preparations is severely impaired, which explains the benefit of bypassing the disturbed gastric passage by alternative application of the substances. Impaired gastric motility is therefore closely related to the development of motor fluctuations and dyskinesias. However, effective therapies to improve gastric motility in iPS are rare despite their enormous clinical importance.

In addition to vegetative symptoms, iPS patients also suffer from significant affective symptoms. Depressive symptoms are common at all stages of the disease and affect quality of life. Similar to people with major depression, iPS patients suffer from anhedonia. The cause is thought to be disruption of monoaminergic transmission by Lewy bodies in the corresponding brainstem nuclei or secondary effects at the network level, although the exact pathophysiology is unclear.

Transcutaneous vagus nerve stimulation (tVNS) at the auricle has been shown to be a safe and non-invasive alternative to conventional stimulation. In particular, the non-invasiveness makes it interesting to investigate the mechanism of action and a possible influence on the pathophysiology of iPS. However, it is unclear whether and to what extent tVNS is able to modulate afferent and efferent pathways of the VN and interact with the above-mentioned processes.

This work aims to investigate the influence of 1 week of tVNS on gastric motility and affective symptomatology in people with iPS. Real-time MRI of the stomach will be used to visualise gastric motility, which has been used in a previous study by the research group. Affective symptoms will be tested using reinforcement learning and emotion recognition through computer tasks. The study will be randomised, controlled and double-blind.

Contact

Dr. Kenan Steidel
Mrs. Sophia Westphal, Mr. Felix Klein and Mrs, Maxine Kuntz
Telephone: 06421/58 - 65299
Telefax: 06421/58 - 67055
steidel@staff.*

* please add "uni-marburg.de" for a full email-address.