Abstract
Objective: To determine whether remotely monitored at-home Transcranial Alternating Current Stimulation (tACS) may be an effective and safe treatment option for Mal de Débarquement Syndrome (MdDS).
Background: Treatment options for MdDS are limited, costly, and difficult to access. This study explored the viability of an at-home, self-administered tACS program for treatment of MdDS. The study was added as an extension of an on-site tACS study for medically refractory MdDS.
Design/Methods: Thirteen participants (all women) ages 22–67 years with duration of illness ranging from 11–72 months were initially part of an on-site study in which they were administered 3 counter-balanced tACS protocols relative to their individual alpha frequency (IAF): (1) in-phase, (2) anti-phase, or (3) 40Hz control. Participants in this extension phase were selected because they did not respond to the on-site protocol or they had responded but the effect had waned. A tablet controlled tACS stimulator (Pulvinar XCSITE100) remotely controlled by the investigators along with treatment accessories were mailed to participants’ homes. Teaching sessions were performed via webcam. Daily treatment sessions of 20-minutes continued until an effective protocol was reached for 4 weeks. Ineffective protocols could be remotely changed after a 2-week trial. Participants underwent a tapering phase and completed post-treatment questionnaires. Participants completed weekly diaries and a blinded satisfaction survey at the completion of the study.
Results: Of the 13 participants: 1) Seven agreed/strongly agreed that tACS treatment was beneficial; 2) Eight showed a lasting decrease in symptoms; 3) Eleven preferred stimulation above their IAF; 4) Eight preferred in-phase versus five preferring anti-phase stimulation; 5) Twelve were comfortable utilizing tACS on their own after study conclusion.
Conclusions: At-home tACS is a viable treatment alternative for MdDS, with the possibility of lasting outcomes, increased accessibility, and benefit of reduction in travel. Larger studies are necessary to assess the role of the IAF in protocol selection.
Disclosure: Jeffrey Riley has nothing to disclose. Mrs. Gleghorn has received personal compensation for serving as an employee of Laureate Institute for Brain Research. Mr. Doudican has nothing to disclose. The institution of Dr. Cha has received research support from Mal de Debarquement Balance Disorders Foundation. Dr. Cha has received research support from University of Minnesota. Dr. Cha has received research support from MNDrive.
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
