A Sternum-Worn, Non-Invasive Vibrotactile Device to Alleviate Symptoms in Parkinson's: a Multi-Site Double-Blind Randomised Controlled Trial.
Azoidou, V.; Bhadra, E.; Camboe, E.; Dey, K. C.; Zirra, A.; Quah, C.; Budu, C.; Boyle, T.; Gallagher, D.; Bestwick, J. P.; Noyce, A. J.; Simonet, C.
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BackgroundEffective, measurable, and non-invasive treatments for motor symptoms, gait and balance difficulties, and associated non-motor burden in Parkinsons disease (PD) remain limited. We aimed to assess the usability, safety/tolerability, and clinical efficacy of CUE1+, a wearable cueing and vibrotactile stimulation non-invasive device, in people with PD. MethodsThis 12-week, double-blind, randomised controlled trial was conducted at two UK sites in adults with idiopathic PD. Participants were randomly assigned (1:1) to receive either an active CUE1+ device or a sham device, worn on the sternum for 8 hours daily. Participants, investigators, and assessors were blinded to treatment allocation. The primary outcomes were usability and safety/tolerability of CUE1+. Secondary outcomes, including Movement Disorder Society-sponsored revision of the Unified PD Rating Scale (MDS-UPDRS) Part III, were assessed in the ON-medication state at baseline and week 13. FindingsFifty participants were randomised to sham stimulation (Group A; n=25) or active CUE1+ stimulation (Group B; n=25). Median age was 70.0 years (IQR 65.0-75.5) in Group A and 68.0 years (62.0-75.0) in Group B. Group A included 14 (56%) men; Group B, 13 (52%) men. Four participants (8.0%) discontinued: three (6.3%) from Group A, one (2.0%) from Group B. Compliance to allocated intervention was equally excellent in both groups. Mild, transient skin irritation occurred in two participants (4.2%). MDS-UPDRS Part III scores improved by -4.5 points (95%CI: -8.7, -0.4; p=0.043), in Group A and -15.6 points (95%CI: - 20.3, -10.9; p<0.0001) in Group B, with a between-group difference of 11.08 points (95%CI: 4.85-17.31; p=0.002). InterpretationCUE1+ is a safe and well-tolerated non-invasive device that improves motor and non-motor outcomes in PD. These findings suggest a potential therapeutic benefit and support further evaluation in large-scale RCTs and consideration for integration into health care pathways. FundingUKRI Knowledge Transfer Partnership, 2021-2022, round 4 and Charco Neurotech Ltd.