{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T09:57:36Z","timestamp":1777888656819,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPD"],"published-print":{"date-parts":[[2022,7,8]]},"abstract":"<jats:p>Background: Postural instability is a major disabling factor in patients with advanced Parkinson\u2019s disease (PD) and often resistant to treatment. Previous studies indicated that imbalance in PD may be reduced by low-intensity noisy galvanic vestibular stimulation (nGVS). Objective: To investigate the potential mode of action of this therapeutic effect. In particular, we examined whether nGVS-induced reductions of body sway in PD are compatible with stochastic resonance (SR), a mechanism by which weak sensory noise stimulation can paradoxically enhance sensory information transfer. Methods: Effects of nGVS of varying intensities (0\u20130.7\u200amA) on body sway were examined in 15 patients with PD standing with eye closed on a posturographic force plate. We assumed a bell-shaped response curve with maximal reductions of sway at intermediate nGVS intensities to be indicative of SR. An established SR-curve model was fitted on individual patient outcomes and three experienced human raters had to judge whether responses to nGVS were consistent with the exhibition of SR. Results: nGVS-induced reductions of body sway compatible with SR were found in 10 patients (67%) with optimal improvements of 23\u00b113%. In 7 patients (47%), nGVS-induced sway reductions exceeded the minimally important clinical difference (optimal improvement: 30\u00b110%), indicative of strong SR. This beneficial effect was more likely in patients with advanced PD (R\u200a=\u200a0.45; p\u200a=\u200a0.045). Conclusions: At least half of the assessed patients showed robust improvements in postural balance compatible with SR when treated with low-intensity nGVS. In particular, patients with more advanced disease stages and imbalance may benefit from the non-invasive and well-tolerated treatment with nGVS.<\/jats:p>","DOI":"10.3233\/jpd-213127","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T12:22:54Z","timestamp":1651234974000},"page":"1611-1618","source":"Crossref","is-referenced-by-count":18,"title":["Effects of Low-Intensity Vestibular Noise Stimulation on Postural Instability in Patients with Parkinson\u2019s Disease"],"prefix":"10.1177","volume":"12","author":[{"given":"Max","family":"Wuehr","sequence":"first","affiliation":[{"name":"German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Schmidmeier","sequence":"additional","affiliation":[{"name":"German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Katzdobler","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany"},{"name":"Deutsches Zentrum f\u00fcr Neurodegenerative Erkrankungen (DZNE) e.V., Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Urban M.","family":"Fietzek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany"},{"name":"Department of Neurology and Clinical Neurophysiology, Sch\u00f6n Klinik M\u00fcnchen Schwabing, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Levin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany"},{"name":"Deutsches Zentrum f\u00fcr Neurodegenerative Erkrankungen (DZNE) e.V., Munich, Germany"},{"name":"Munich Cluster of Systems Neurology (SyNergy), Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Zwergal","sequence":"additional","affiliation":[{"name":"German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, Munich, Germany"},{"name":"Department of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/JPD-213127_ref1","doi-asserted-by":"crossref","first-page":"17013","DOI":"10.1038\/nrdp.2017.13","article-title":"Parkinson disease","volume":"3","author":"Poewe","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"10.3233\/JPD-213127_ref2","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1002\/mds.27195","article-title":"Falls in Parkinson\u2019s disease: A complex and evolving picture","volume":"32","author":"Fasano","year":"2017","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-213127_ref3","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1002\/mds.26269","article-title":"Levodopa Is a double-edged sword for balance and gait in people with Parkinson\u2019s disease","volume":"30","author":"Curtze","year":"2015","journal-title":"Mov Disord"},{"issue":"Suppl 11","key":"10.3233\/JPD-213127_ref4","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1002\/mds.20458","article-title":"Motor fluctuations and dyskinesias in Parkinson\u2019s disease: Clinical manifestations","volume":"20","author":"Jankovic","year":"2005","journal-title":"Mov Disord"},{"issue":"Suppl 3","key":"10.3233\/JPD-213127_ref5","doi-asserted-by":"crossref","first-page":"S521","DOI":"10.1002\/mds.22049","article-title":"Levodopa unresponsive symptoms in Parkinson disease","volume":"23","author":"Sethi","year":"2008","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-213127_ref6","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1093\/brain\/awg100","article-title":"Effect of chronic bilateral subthalamic nucleus (STN) stimulation on postural control in Parkinson\u2019s disease","volume":"126","author":"Maurer","year":"2003","journal-title":"Brain"},{"key":"10.3233\/JPD-213127_ref7","doi-asserted-by":"crossref","unstructured":"Dlugaiczyk J , Wuehr M , Straka H (2020) Electrical stimulation of vestibular endorgans. 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