This study was sponsored by the Partnership for Cures, grant number UWM Rockford #20082, the Wisconsin Alumni Research Foundation Lab Share Program. The project period was 9/1/08–5/31/09. The research took place at the University of Wisconsin-Madison, and the principal investigator was Kurt Kaczmarek.
A variety of chronic nervous system diseases such as multiple sclerosis (MS) result in reduced ability to control movement, i.e. balance, posture, gait, and hand control. Increased tremor and stiffness are also common symptoms in these diseases. Current treatment methods (typically drugs and physical therapy) aim to slow the progress of the disease and help the patient to compensate for loss of function. In some cases symptoms may be temporarily reduced by drugs or implantable brain “pacemakers”, which require expensive surgery. A new technology called cranial-nerve non-invasive neuromodulation (CN-NINM) has been developed to improve the brain’s ability to reorganize and “normalize” its activity during special physical and occupational therapy exercises.
The goals of this research are to (1) investigate how well CN-NINM improves general movement control in ten patients with MS when combined with specially-designed exercises, and (2) develop optimized training protocols, tailored to the unique rehabilitation requirement of MS by developing an estimate of the best combination of device settings and both the duration and progression of exercises to result in greatest reduction of symptoms.
Anticipated outcome: If successful, this work will demonstrate effectiveness of a new non-invasive neuromodulation treatment for movement disorders associated with multiple sclerosis.
Summary of Results
Cranial-Nerve Non-Invasive NeuroModulation (CN-NINM) was investigated for reduction of movement-control symptoms of multiple sclerosis (MS). CN-NINM treatment comprised specially-designed, comfortable, pulsed electrical stimulation of the tongue in conjunction with specific sensory-motor conditioning exercises designed for each subject according to their abilities. Nine subjects with stable symptoms and medication, and Kurtzke EDSS scores 3.0–7.0 participated.
After two weeks of intervention, all nine showed improvement in quantitative measurements of sensory organization, balance, posture, gait, neural function, and in physical, cognitive, and psychological abilities. Metrics included NeuroCom SOT, DGI, Kurtzke FSS and EDSS, and MSIS-29 (physical and cognitive). Out of the 54 functional measurements (9 subjects X 6 metrics), analysis of results revealed that 48 improved, 1 decreased, and 5 remained the same after the 2-week intervention. The mean values of all six composite metrics for the nine subjects showed clinically-significant improvements; many of these were also statistically significant.
This pilot project is complete. Please see our poster Rehabilitation of multiple sclerosis symptoms using cranial nerve non-invasive neuromodulation (CN-NINM), a poster given at the 2009 Society for Neuroscience Annual Meeting (3 MB PDF file)