At-home taVNS for Neurorehabilitation in Parkinson's Disease

Exclusion Criteria

• •A history of taVNS in the last 6 months
• •A history of brain surgery, traumatic brain injury or stroke
• •Diagnosis of a nervous system disorder besides PD, alcohol or substance use disorder, or unstable cardiovascular conditions
• •History of myocardial infarction or arrhythmia, bradycardia
• •A history of other significant gait impairment unrelated to PD (e.g. orthopedic deformities)
• •Inability to complete gait/ motor assessments (without assistance or assistance devices)
• •Ear trauma, facial pain, anatomical abnormalities or other barriers preventing earpiece fit
• •Failure to meet all criteria on a standardized MRI/taVNS safety screening: This includes, but is not limited to, the presence of claustrophobia, implanted electronic devices that are not 3T MRI compatible (e.g., pacemakers), metallic objects or fragments (e.g., bullets), and non-removable hair clips or piercings.
• •Individuals with a diagnosis of cognitive impairment (MoCA \< 24) that would make them unable to understand and follow study instructions or to consent for themselves.
• •Pregnancy
• •Visual hallucinations or other psychotic symptoms, other than mild visual hallucinations secondary to PD medications, not requiring treatment, or well controlled on stable doses of quetiapine or pimavenserin.
• •Individuals with a history of seizure(s)
• •Inability to perform at-home taVNS procedures safely and properly (either alone or with the aid of a caregiver)
• •Uncorrected visual or hearing impairments that would impact performance on cognitive tests or ability to follow study procedures
• •Use of B-Blockers, dopamine blocking agent (other than quetiapine or pimavenserin in stable doses), antiarrhythmic medication, acetylcholine esterase inhibitor (study doctor will consider if on stable doses), midodrine, fludrocortisone, droxidopa, or anticholinergic drugs