Vibrotactile Coordinated Reset: A Non-invasive Treatment for Parkinson's Disease

Spontaneous EEG is recorded at baseline, 3, 6 and 7 months. 3 types of recordings will occur per visit:5 minute Baseline, 16 minute during vibrotactile therapy (sham or active vCR depending on the participant group) and post vibrotactile therapy. Power spectral density (PSD) will be calculated from source constructed EEG activity for each frequency band of interest (Delta: 2-4 Hz; Theta: 5-7 Hz; Alpha: 8-12 Hz; Low Beta: 13-16 Hz; Mid Beta: 17-20 Hz; High Beta: 21-30 Hz; and Gamma: 31-50 Hz) using the Welch method with a 2-s window overlapping by 50%. Relative power (RP) is calculated by taking the sum of each frequency band and dividing it by the total power across the spectrum (2-50 Hz).

Sensorimotor activity during the EEG will be recorded at baseline, 3, 6 and 7 months. Patients receive a single vibratory stimulus to a random finger (excluding the thumb) on their left or right hand and are instructed with their non-stimulated hand to push the response button as fast as possible when they feel the vibratory burst. Each finger receives an equal number of vibratory pulses (50 per finger, equaling 200 trials per hand) in a randomized order. Cortically, we expect to look at motor evoked potentials in response to cued vibration by means of their amplitude (micro-volts) and latency (time in milliseconds) and their changes throughout the course of treatment. Reaction time (in milliseconds) will also be documented.

We will record vibration-only evoked EEG potentials at baseline, 3, 6 and 7 months.We will look at how single vibratory pulses to each finger (excluding the thumb) affect different motor and sensory areas of the brain.Each finger receives an equal number of vibratory pulses (50 per finger, equaling 200 trials per hand) in a randomized order. Cortically, we expect to look at sensory evoked potentials in response to vibration by means of their amplitude (micro-volts) and latency (time in milliseconds) and their changes throughout the course of treatment.

The PD Quality of Life Questionnaire-39 (PDQ-39) is a self-report questionnaire that examines health related difficulties specific to PD in eight quality of life categories within the last month. Items are grouped into eight scales that are scored by expressing summed item scores as a percentage score ranging between 0 and 100, with higher % indicating more health problems. This questionnaire will be taken at baseline, 3, 6, 7, 10, 13 and 14 months.

The Parkinson's disease sleep scale (PDSS) is a visual analogue scale addressing 15 commonly reported symptoms associated with sleep disturbance in the past week. The scores for each item range from 0 (symptom severe and always experienced) to 10 (symptom-free). The maximum cumulative score for the PDSS is 150 This questionnaire will be taken at baseline, 3, 6, 7, 10, 13 and 14 months.

University of Pennsylvania Smell Identification Test (UPSIT) is a smell test comprised of 40 odors, in which patients try to correctly identify the odor presented. The test is a forced choice paradigm, that is, if an individual is unsure of an answer they are forced to guess a response hence a score of 25% on average would reflect random guessing. An UPSIT result is scored out of 40 where a higher score indicates better olfaction.This test will be taken at baseline, 3, 6, and 7 months

The vibratory temporal discrimination task (VTDT) consists of two vibratory bursts, with one burst delivered to the index finger and one burst to the middle finger. This procedure will be performed on the right and left hand separately. The patient is instructed to judge if he/she felt a delay between the two vibratory bursts. This task was designed as a possible calibration method for future vCR studies by serving as a sensitivity measure for vibratory temporal changes, in which reduced perceived vibratory time differences (in milliseconds) correspond to increased vibratory temporal discrimination. This task will be done at at baseline, 3, 6 and 7 months.

To collect samples, a head-worn, unidirectional microphone will be placed over the participant's ears and the microphone will be adjusted so that it is 6 cm from the participant's mouth. Specific samples will include sustained vowel phonations, sentence and paragraph length reading passages, and spontaneous speech. From these samples, speech and voice assessments will be conducted including measures of articulatory precision, speech intelligibility, speech rate, auditory-perceptual ratings of voice, and acoustic measures of vocal fundamental frequency, vocal intensity, and fundamental frequency and intensity variability. The speech and voice evaluation will be done at baseline, 3, 6 and 7 months

The Kinesia One motor evaluation, which uses a wearable accelerometer to assess Movement Disorders Society Unified Parkinson's Disease Rating Scale Part 3. Kinesia-ONE scores ranged from 0 to 4 (where 0 is normal and 4 represents severe abnormalities). Patients will perform this test at baseline, 3, 6,7 months in person and at home at 10, 13 and 14 months.

Levodopa equivalent daily dose (LEDD) will measured at baseline, 3,6,7,10,13 and 14 months. LEDD is calculated as a sum of each Parkinson's medication.

The Freezing of Gait Questionnaire (FOGQ) assesses Freezing of Gait (FOG) severity unrelated to falls in patients with Parkinson's Disease (PD), FOG frequency, disturbances in gait, and relationship to clinical features conceptually associated with gait and motor aspects (e.g., turning). The FOG is comprised of 6 questions measured on a 0 to 4 scale (where 0 is normal and 4 represents severe abnormalities). The scores are summed together with 0 representing the best possible score and 24 representing the worst possible score. FOG will measured at baseline, 3,6,7,10,13 and 14 month