Vibrotactile Coordinated Reset Stimulation for the Treatment of Neurological Diseases: Concepts and Device Specifications

Coordinated reset stimulation (CRS) consists of spatiotemporal sequences of stimuli delivered to different sites in the brain. Computationally, it was shown that by achieving an unlearning of abnormal synaptic connectivity, CRS can cause a long-lasting reduction of pathological synchronization, a hallmark feature of Parkinson's disease and other brain disorders. Pre-clinical and proof of concept clinical studies in parkinsonian monkeys and patients showed that CRS applied through deep brain stimulation electrodes implanted in the subthalamic nucleus resulted in cumulative and long-lasting therapeutic effects along with a reduction of beta band oscillations. To apply CRS noninvasively by vibrotactile stimulation delivered to different fingertips, we present three different possible stimulation concepts. These different CRS approaches target different mechanoreceptors and related stimulus mechanisms. The different approaches are based on the diverse physiology of mechanoreceptors and dynamic CRS principles. Required stimulation parameters and specifications provide a guideline for technically implementing vibrotactile CRS during clinical tests.