Revista CEFAC
https://revistacefac.org.br/article/doi/10.1590/1982-0216/20262816125
Revista CEFAC
Case Reports

Galvanic vestibular stimulation in improving balance in an individual with Parkinson's disease totally dependent for activities of daily living: A case report

A estimulação vestibular galvânica na melhora do equilíbrio de um indivíduo com doença de Parkinson e dependência total para atividades de vida diária: relato de caso

Maria Luiza Diniz; Stéfane Laura Brandão; Alessandra Cardoso Ribeiro; Anna Paula Batista de Ávila Pires; Renata Cristina Cordeiro Diniz Oliveira; Denise Utsch Gonçalves; Ludimila Labanca

http://dx.doi.org/10.1590/1982-0216/20262816125 Revista CEFAC, vol.28, n1, e6125, 2026
PDF English
PDF Português
SciELO
Downloads: 0
Views: 803

Abstract

This report describes the immediate and late effects of galvanic vestibular stimulation (GVS) on postural instability in a 75-year-old man with Parkinson's disease (PD) and dementia, who was totally dependent for basic activities of daily living. Postural instability was assessed using the Berg Balance Scale (BBS) and the Timed Up and Go Test (TUG). Analytical measures were taken before, immediately after, and 12 months after the intervention, designated pre-GVS, post-GVS, and post-12m-GVS, respectively. GVS was applied once a week for 8 consecutive weeks, using alternating currents ranging from 1 mA to 3.5 mA. The stimulation duration was 11 minutes in the first week, 18 minutes in the second week, and 30 minutes from the third to the eighth week. TUG values were 26 seconds (pre-GVS), 15 seconds (post-GVS), and 29 seconds (post-12m-GVS). BBS scores were 4 points (pre-GVS), 16 points (post-GVS), and 10 points (post-12m-GVS). Therefore, his postural instability improved, but the effects were not maintained after 12 months.

Keywords

Parkinson Disease; Dementia; Postural Balance; Electric Stimulation Therapy; Vestibular System

Resumo

Descreveram-se os efeitos imediatos e tardios da intervenção Estimulação Vestibular Galvânica (EVG) na instabilidade postural de um homem, 75 anos, com doença de Parkinson (DP), demência e dependência total para atividades de vida diária básicas. A instabilidade postural foi avaliada por meio da Escala de Equilíbrio de Berg (EEB) e pelo Timed Up and Go Test (TUG). As medidas de análise foram feitas antes, logo após e doze meses após a intervenção, denominados Pré-EVG, Pós-EVG e após12m-EVG, respectivamente. A EVG foi aplicada uma vez por semana por oito semanas consecutivas. Utilizou-se corrente do tipo alternada com intensidade variando de 1mA a 3,5mA. A duração do estímulo foi de 11 minutos na 1ª semana, 18 minutos na 2ª semana e, da 3ª à 8ª semana, foi de 30 minutos. Para o TUG, no momento Pré-EVG o tempo de execução foi de 26 segundos, no Pós-EVG foi de 15 segundos e Após-12m-EVG foi de 29 segundos. Para a EEB, o Pré-EVG foi de 4 pontos, o Pós-EVG foi de 16 pontos e Após12m-EVG foi de 10 pontos. Assim, percebe-se que houve melhora da instabilidade postural; no entanto, os efeitos não se mantiveram após 12 meses.

Palavras-chave

Doença de Parkinson; Demência; Equilíbrio Postural; Terapia por Estimulação Elétrica; Sistema Vestibular

Referencias

1. Henderson MX, Trojanowski JQ, Lee VMY. a-Synuclein pathology in Parkinson's disease and related a-synucleinopathies. Neurosci Lett. 2019;709:134316. https://doi.org/10.1016/j.neulet.2019.134316 PMID:31170426.

2. Kataoka H, Okada Y, Kiriyama T, Kita Y, Nakamura J, Shomoto K et al. Effect of galvanic vestibular stimulation on axial symptoms in Parkinson's disease. J Cent Nerv Syst Dis. 2022;14:1-5. https://doi.org/10.1177/11795735221081 PMID: 35237093.

3. Smith PF. Vestibular functions and Parkinson's disease. Front Neurol. 2018;9:1085. https://doi.org/10.3389/fneur.2018.01085 PMID: 30619045.

4. Hoehn MM, Yahr MD. Parkinsonism: Onset, progression, and mortality. Neurology. 1967;17(5):427-42. https://doi.org/10.1212/WNL.17.5.427 PMID: 6067254.

5. Krüger R, Klucken J, Weiss D, Tönges L, Kolber P, Unterecker S et al. Classification of advanced stages of Parkinson's disease: Translation into stratified treatments. J Neural Transm. 2017;124:1015-27. https://doi.org/10.1007/s00702-017-1707-x PMID: 28342083.

6. França C, Carra RB, Diniz JM, Munhoz RP, Cury RG. Deep brain stimulation in Parkinson's disease: State of the art and future perspectives. Arq Neuropsiquiatr. 2022;80(5 Suppl 1):105-15. https://doi.org/10.1590/0004-282X-ANP-2022-S133 PMID: 35976323.

7. Samoudi G, Jivegard M, Mulavara AP, Bergquist F. Effects of stochastic vestibular galvanic stimulation and L-DOPA on balance and motor symptoms in patients with Parkinson's disease. Brain Stimul. 2015;8(3):474-80. https://doi.org/10.1016/j.brs.2014.11.019 PMID: 25573070.

8. Curthoys IS, MacDougall HG. What galvanic vestibular stimulation actually activates. Front Neurol. 2012;3:117. https://doi.org/10.3389/fneur.2012.00117 PMID: 22833733.

9. Tohyama T, Kondo K, Otaka Y. Effects of galvanic vestibular stimulation on visual verticality and standing posture differ based on the polarity of the stimulation and hemispheric lesion side in patients with stroke. Front Neurol. 2021;12:768663. https://doi.org/10.3389/fneur.2021.768663 PMID: 34858316.

10. Ceylan DS, Atas A, Kaya M. The effect of galvanic vestibular stimulation in the rehabilitation of patients with vestibular disorders. ORL J Otorhinolaryngol Relat Spec. 2021;83(1):25-34. https://doi.org/10.1159/000509971 PMID: 32992316.

11. Kataoka H, Okada Y, Kiriyama T, Kita Y, Nakamura J, Morioka S et al. Can postural instability respond to galvanic vestibular stimulation in patients with Parkinson's disease? J Mov Disord. 2016;9(1):40-3. https://doi.org/10.14802/jmd.15030 PMID: 26648182.

12. MacDougall HG, Moore ST, Curthoys IS, Black FO. Modeling postural instability with galvanic vestibular stimulation. Exp Brain Res. 2006;172(2):208-20. https://doi.org/10.1007/s00221-005-0329-y PMID: 16432695.

13. Khoshnam M, Häner DMC, Kuatsjah E, Zhang X, Menon C. Effects of galvanic vestibular stimulation on upper and lower extremities motor symptoms in Parkinson's disease. Front Neurosci. 2018;12:633. https://doi.org/10.3389/fnins.2018.00633 PMID: 30254564.

14. Nackachima MA, Souza ML, Scheicher ME. Determination of reference values for the Berg Balance Scale and Gait Speed in institutionalized elderly. Rev Kairos Gerontol. 2020;23(3):241-52. https://doi.org/10.23925/2176-901X.2020v23i3p241-252

15. Bretan O, Elias Silva J, Ribeiro OR, Eduardo Corrente J. Risk of falling among elderly persons living in the community: Assessment by the Timed Up and Go test. Braz J Otorhinolaryngol. 2013;79(1):18-21. https://doi.org/10.5935/1808-8694.20130004 PMID: 23503902.

16. Scalzo PL, Nova IC, Perracini MR, Sacramento DRC, Cardoso F, Ferraz HB et al. Validation of the Brazilian version of the Berg Balance Scale for patients with Parkinson's disease. 2009;67(3-B):831-5. Arq Neuropsiquiatr. https://doi.org/10.1590/s0004-282x2009000500010 PMID: 19838513.

17. Oliveira RCCD, Labanca L, Meireles PGZ, Diniz ML, Pires APB de Á, Barroso JC et al. Galvanic vestibular stimulation to improve postural instability, voluntary attention, and quality of life in Parkinson's disease patients. Rev. CEFAC. 2023;25(4):e0423. https://doi.org/10.1590/1982-0216/20232540423

18. Liu A, Bi H, Li Y, Lee S, Cai J, Mi T et al. Galvanic vestibular stimulation improves subnetwork interactions in Parkinson's disease. J Healthc Eng. 2021;2021:6632394. https://doi.org/10.1155/2021/6632394 PMID: 34094040.
 

Submitted date:
19/06/2025

Accepted date:
23/09/2025

6942aa14a953955af1438055 cefac Articles
1982-0216 (Electrónico) 1516-1846 (Impreso)
Revista CEFAC ©2026 Todos los derechos reservados sobre el contenido de este sitio web. Los artículos siguen sus propias licencias.

Revista CEFAC

Share this page
Page Sections