The Vibrating Glove for Parkinson’s: Hope, Hype or Both?
by Michael S. Okun, M.D.
Holly Alyssa MacCormick wrote a great summary article for the Stanford Magazine and this illustration by Harry Campbell captures the technology through illustration.
The ‘buzz’ on the Parkinson’s street for 2023 has been about these new ‘gloves’ which when worn have been observed to improve many of the symptoms of Parkinson’s disease. The recent story on the Today Show took the ‘Parkinson’s gloves’ viral, and I thought to start the year— together we could focus exploring this new technology.
Throughout the year Indu, Jonny and I will be posting on Parkinsonsecrets.com on topics such as progress in Parkinson’s, updates in research and integrative medicine. Jonny will be adding an ‘illustrative voice’ through his art. Jonny is a doctor, a person with Parkinson’s and a gifted artist.
Why would a vibration therapy help Parkinson’s disease?
So you think vibration therapy is crazy? Think again as Adam Grant likes to say.
Gustav Zander built ‘vibrating’ Swedish exercise machines in 1857 and displayed his products at two World’s Fairs.
Gustav Zander, the father of the modern concept of a gym.
Richard Naples in 2016 commented that ‘Zander’s machines make today’s ‘bow flex’ equipment look like child’s play.’
Could the ‘bow flex’ compete with Zander’s machine from the 1800’s?
Zander’s machines were as complex as modern day gym equipment.
Gutav Zander’s ‘Horse Riding Simulator’ was known to apply therapeutic vibration
The famous John Harvey Kellogg used vibrating machines for his ‘wellness’ prescriptions.
John Harvey Kellogg was all about wellness and was early to ‘condemn’ tobacco use.
Kellogg drew people from around the world to his Battle Creek Michigan Sanitarium ~1876-1930, and was known for his ‘eccentric’ inventions. Some of Kellogg’s techniques used vibration.
Pictured is one of many interesting inventions by Kellogg.
It was however, Jean-Martin Charcot who brought vibration therapy to neurology and specifically to Parkinson’s disease. Chris Goetz has written extensively on this topic in Neurology; and in many other books and journal articles. The main take home point from Goetz’s work is that Charcot developed a vibration chair for Parkinson’s disease. Why did he develop it? His idea was that Parkinson’s patients ‘were more comfortable and slept better after a train or carriage ride.’ Charcot prescribed daily 30-minute sessions in his vibratory chair.
One of Charcot’s original ‘vibration chairs.’
One of Charcot’s students, Gilles de la Tourette later developed the vibration helmet. Tourette of course became better known for the syndrome which bears his name.
His pupil Tourette tested a vibration helmet,
Dincher and colleagues recently examined 244 papers and found 17 of them contained experimental and control groups for Parkinson’s vibration therapy. These authors concluded that ‘whole body vibration’ lacked sufficient evidence for use in Parkinson’s. Thigpen and colleagues also recently reviewed this topic and concluded there were mixed results when applying whole body vibration for Parkinson’s symptoms.
A picture from Dincher’s recent review of full body vibration and Parkinson’s.
There are several companies who have been interested in developing vibration technologies for Parkinson’s disease. One recent example is David Putrino’s work on a device developed by Not Impossible. He recently published his work in Frontiers and concluded that ‘short durations of vibrotactile stimulation delivered via wearable devices were safe and well tolerated and may attenuate resting tremor severity in individuals with Parkinson’s.’ The study was small and all of these ‘new devices’ will require control or sham groups to understand the possibility of a placebo effect (described by experts as beneficial effects driven by a patient’s beliefs or by another factor; the manifested benefits are not actually from the treatment).
The device used in the recent Putrino study.
What about the new Parkinson’s gloves developed by Peter Tass at Stanford?
Peter Tass is a well known and accomplished neuroscientist at Stanford University who has developed gloves for Parkinson’s that are designed to be worn a few hours a day. The gloves provide some sort of vibro-tactile stimulation to the fingertips and hands. We have read that Tass and his laboratory have been working on techniques to ‘reset’ the brain oscillations in Parkinson’s disease. The Tass laboratory previously published work in the field of deep brain stimulation and a technique called ‘coordinated reset,’ which also aims to change the oscillatory patterns in the brains of Parkinson’s patients. To date, the Tass laboratory has not produced a well powered peer-reviewed publication with control subjects on the use of the gloves; thus we cannot comment on how his new method may work and how it may differs from other attempts at vibration therapy for Parkinson’s disease.
Look carefully at Jonny Acheson’s picture of Parkinson’s tremor. I believe there gloves on a few of the letters?
Are the Parkinson’s gloves hope, hype or both?
It is too early to answer this question without data and without a peer reviewed paper. I am reminded of many recent examples of Parkinson’s therapies that were touted by video evidence only to ‘flame out’ once tested with a control group. Most recently was Nilotinib, the leukemia drug which was repurposed for Parkinson’s. The initial videos of patients led to a run of patients seeking access to the cancer drug; two clinical trials followed the video evidence, and we were humbled by the ‘negative’ results.
Our group uses the technology hype cycle each year at the DBS Think Tank; we use it to classify new technologies. Where are the gloves on the ‘hype cycle?’ My guess is that they are at now at the ‘peak of inflated expectations.’ There may be symptomatic benefits from application of the Tass gloves, however once we clarify the acute vs. chronic benefits there will likely be a trough of disillusionment and ‘hopefully’ it will reach a slope of enlightenment. The ‘enlightenment’ will be the moment when we understand enough about the technology to reasonably apply it to humans— while offering realistic expectations.
The technology hype cycle.
What are the key questions we need to answer about the Parkinson’s gloves?
Does the effect persist both acutely (days) vs. chronically (months).
Which symptoms improve in what Parkinson’s group (subtype) of patients? Patient selection will be a key consideration for success or failure.
Are there placebo or nocebo effects?
How does the technology change or effect ‘brain networks’ involved in Parkinson’s? e.g. will it be a similar story to the effects of DBS and changes in brain beta oscillations?
Does the effect hold up in an adequately sized sample of patients vs. controls?
This blog post was written by Dr. Michael Okun.
The blog artist is Jonny Acheson