Vibro-tactile stimulation of the neck reduces pain in people with cervical dystonia: a proof-of-concept study

Abstract

Background Pain is a common non-motor symptom in patients with cervical dystonia (CD), severely impacting their quality of life. The pathophysiology of CD is incompletely understood but it involves altered processing of proprioceptive and pain signals. Objectives The purpose of this proof-of-concept study was to determine if vibro-tactile stimulation (VTS)—a non-invasive form of neuromodulation targeting the somatosensory system—can modulate neck pain in people with CD. Methods In a multi-center study, 44 CD patients received VTS to sternocleidomastoid and/or trapezius muscles for up to 45 min under 9 different stimulation conditions that either targeted a single or a pair of muscles. The primary outcome measure was a perceived pain score (PPS) rated by participants on a 100-point analogue scale. Results During VTS, 29/44 (66%) of participants experienced a reduction in PPS of at least 10% with 17/44 (39%) reporting a reduction in pain of 50% or higher. After VTS cessation, 57% of participants still reported a 10% or higher reduction in PPS. Effects were significant at the group level and persisted for up to 20 min post-treatment. No distinct optimal stimulation profiles were identified for specific CD phenotypes. Clinical markers of disease severity or duration did not predict the degree of VTS-induced pain reduction. Conclusion This proof-of-concept study demonstrates the potential of VTS as a new non-invasive therapeutic option for treating neck pain associated with CD. Further research needs to delineate optimal dosage and long-term effects.

Effects of an 11-week vibro-tactile stimulation treatment on voice symptoms in laryngeal dystonia

“…This VTS-induced electrocortical effect is similar in nature to what is observable in people with cervical dystonia who apply sensory tricks ( 23 ) suggesting that effectiveness of VTS and sensory tricks may share a similar neural mechanism. With respect to other forms of focal dystonia, a case study ( 24 ) reported that VTS applied to trapezius muscles normalized the head posture of a patient with torticollis and neck muscle VTS may reduce pain associated with cervical dystonia ( 25 ). In summary, previous research established proof-of-concept of the short-term effectiveness of VTS in treating the symptoms of focal dystonia and provided insights into the underlying neural mechanism behind its effectiveness.…”