Galvanic vestibular stimulation for Mal de Debarquement syndrome: a pilot study on therapeutic potential

Mal de Debarquement Syndrome (MdDS) is a debilitating neuro-otological disorder causing a persistent sensation of self-motion, often triggered by passive motion like being on a boat (MT-MdDS) or non-motion triggered (non-MT MdDS). Due to the unknown pathophysiological mechanism, available treatment options for managing symptoms are limited. Within the framework of a pilot study, our objective was to investigate the effect, safety, and feasibility of galvanic vestibular stimulation (GVS) as a potential alternative treatment option for MdDS. The trial included 12 MdDS patients and 12 controls. In Part 1, the perceptual threshold for movement perception was determined using both sine and noisy (white noise) GVS for both patients and controls. In Part 2, patients received up to eight four-minute GVS at varying intensities, determined by their individual threshold, during both sine and noisy GVS (i.e., at their threshold, 120%, 70%, and 20%). The effectiveness was evaluated using visual analogue scale (VAS) scores and static posturography. Five patients reported improvement with noisy GVS at 70%, two at noisy threshold, one at noise 20%, one at 120%, one at sine 20%, and one at sine 120%. Our findings show statistically significant positive trends in both subjective and objective outcome measures following specific GVS sessions. Particularly, notable improvements were observed with noisy GVS at intensities 70% and 20% below perceptual threshold levels. All patients found GVS to be safe and manageable, with no worsening of their symptoms. GVS demonstrated positive trends in posturographic stability, particularly with 70% currents and noisy GVS. While further research is necessary, the potential benefits, safety, and feasibility of GVS for MdDS patients have been demonstrated as promising.