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Wuehr M, Peto D, Fietzek UM, Katzdobler S, Nübling G, Zaganjori M, Brendel M, Levin J, Höglinger GU, Zwergal A. Low-intensity vestibular noise stimulation improves postural symptoms in progressive supranuclear palsy. J Neurol 2024; 271:4577-4586. [PMID: 38722328 PMCID: PMC11233287 DOI: 10.1007/s00415-024-12419-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/01/2024] [Accepted: 04/29/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Postural imbalance and falls are an early disabling symptom in patients with progressive supranuclear palsy (PSP) of multifactorial origin that may involve abnormal vestibulospinal reflexes. Low-intensity noisy galvanic vestibular stimulation (nGVS) is a non-invasive treatment to normalize deficient vestibular function and attenuate imbalance in Parkinson's disease. The presumed therapeutic mode of nGVS is stochastic resonance (SR), a mechanism by which weak sensory noise stimulation can enhance sensory information processing. OBJECTIVE To examine potential treatment effects of nGVS on postural instability in 16 patients with PSP with a clinically probable and [18F]PI-2620 tau-PET-positive PSP. METHODS Effects of nGVS of varying intensity (0-0.7 mA) on body sway were examined, while patients were standing with eyes closed on a posturographic force plate. We assumed a bell-shaped response curve with maximal sway reductions at intermediate nGVS intensities to be indicative of SR. An established SR-curve model was fitted on individual patient outcomes and three experienced human raters had to judge whether responses to nGVS were consistent with the exhibition of SR. RESULTS We found nGVS-induced reductions of body sway compatible with SR in 9 patients (56%) with optimal improvements of 31 ± 10%. In eight patients (50%), nGVS-induced sway reductions exceeded the minimal clinically important difference (improvement: 34 ± 5%), indicative of strong SR. CONCLUSION nGVS yielded clinically relevant reductions in body sway compatible with the exhibition of SR in vestibular sensorimotor pathways in at least half of the assessed patients. Non-invasive vestibular noise stimulation may be thus a well-tolerated treatment strategy to ameliorate postural symptoms in PSP.
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Affiliation(s)
- Max Wuehr
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
| | - Daniela Peto
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Urban M Fietzek
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Schön Klinik München Schwabing, Munich, Germany
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE) E.V., Munich, Germany
| | - Sabrina Katzdobler
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE) E.V., Munich, Germany
- Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Georg Nübling
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE) E.V., Munich, Germany
| | - Mirlind Zaganjori
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Matthias Brendel
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE) E.V., Munich, Germany
- Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Johannes Levin
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE) E.V., Munich, Germany
- Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Günter U Höglinger
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE) E.V., Munich, Germany
- Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Andreas Zwergal
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
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Morales-Rubio R, Bernal-Ramírez J, Rubio-Infante N, Luévano-Martínez LA, Ríos A, Escalante BA, García-Rivas G, Rodríguez González J. Cellular shortening and calcium dynamics are improved by noisy stimulus in a model of cardiomyopathy. Sci Rep 2023; 13:14898. [PMID: 37689752 PMCID: PMC10492796 DOI: 10.1038/s41598-023-41611-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/29/2023] [Indexed: 09/11/2023] Open
Abstract
Noise is present in cell biology. The capability of cells to respond to noisy environment have become essential. This study aimed to investigate whether noise can enhance the contractile response and Ca2+ handling in cardiomyocytes from a cardiomyopathy model. Experiments were conducted in an experimental setup with Gaussian white noise, frequency, and amplitude control to stimulate myocytes. Cell shortening, maximal shortening velocity, time to peak shortening, and time to half relaxation variables were recorded to cell shortening. Ca2+ transient amplitude and raise rate variables were registered to measure Ca2+ transients. Our results for cell shortening, Ca2+ transient amplitude, and raise rate suggest that cell response improve when myocytes are noise stimulated. Also, cell shortening, maximal shortening velocity, Ca2+ transient amplitude, and raise improves in control cells. Altogether, these findings suggest novel characteristics in how cells improve their response in a noisy environment.
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Affiliation(s)
- Russell Morales-Rubio
- Centro de Investigación y de Estudios Avanzados del I.P.N-Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, 66600, Apodaca, NL, México
| | - Judith Bernal-Ramírez
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Cátedra de Cardiología, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, México
- The Institute for Obesity Research, Tecnologico de Monterrey, Monterrey, Mexico
| | - Nestor Rubio-Infante
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Cátedra de Cardiología, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, México
- The Institute for Obesity Research, Tecnologico de Monterrey, Monterrey, Mexico
| | - Luis A Luévano-Martínez
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Cátedra de Cardiología, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, México
- The Institute for Obesity Research, Tecnologico de Monterrey, Monterrey, Mexico
| | - Amelia Ríos
- Centro de Investigación y de Estudios Avanzados del I.P.N-Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, 66600, Apodaca, NL, México
| | - Bruno A Escalante
- Centro de Investigación y de Estudios Avanzados del I.P.N-Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, 66600, Apodaca, NL, México
| | - Gerardo García-Rivas
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Cátedra de Cardiología, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, México
- The Institute for Obesity Research, Tecnologico de Monterrey, Monterrey, Mexico
| | - Jesús Rodríguez González
- Centro de Investigación y de Estudios Avanzados del I.P.N-Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, 66600, Apodaca, NL, México.
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Lacquaniti F, La Scaleia B, Zago M. Noise and vestibular perception of passive self-motion. Front Neurol 2023; 14:1159242. [PMID: 37181550 PMCID: PMC10169592 DOI: 10.3389/fneur.2023.1159242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/29/2023] [Indexed: 05/16/2023] Open
Abstract
Noise defined as random disturbances is ubiquitous in both the external environment and the nervous system. Depending on the context, noise can degrade or improve information processing and performance. In all cases, it contributes to neural systems dynamics. We review some effects of various sources of noise on the neural processing of self-motion signals at different stages of the vestibular pathways and the resulting perceptual responses. Hair cells in the inner ear reduce the impact of noise by means of mechanical and neural filtering. Hair cells synapse on regular and irregular afferents. Variability of discharge (noise) is low in regular afferents and high in irregular units. The high variability of irregular units provides information about the envelope of naturalistic head motion stimuli. A subset of neurons in the vestibular nuclei and thalamus are optimally tuned to noisy motion stimuli that reproduce the statistics of naturalistic head movements. In the thalamus, variability of neural discharge increases with increasing motion amplitude but saturates at high amplitudes, accounting for behavioral violation of Weber's law. In general, the precision of individual vestibular neurons in encoding head motion is worse than the perceptual precision measured behaviorally. However, the global precision predicted by neural population codes matches the high behavioral precision. The latter is estimated by means of psychometric functions for detection or discrimination of whole-body displacements. Vestibular motion thresholds (inverse of precision) reflect the contribution of intrinsic and extrinsic noise to perception. Vestibular motion thresholds tend to deteriorate progressively after the age of 40 years, possibly due to oxidative stress resulting from high discharge rates and metabolic loads of vestibular afferents. In the elderly, vestibular thresholds correlate with postural stability: the higher the threshold, the greater is the postural imbalance and risk of falling. Experimental application of optimal levels of either galvanic noise or whole-body oscillations can ameliorate vestibular function with a mechanism reminiscent of stochastic resonance. Assessment of vestibular thresholds is diagnostic in several types of vestibulopathies, and vestibular stimulation might be useful in vestibular rehabilitation.
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Affiliation(s)
- Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Systems Medicine, Centre of Space Bio-medicine, University of Rome Tor Vergata, Rome, Italy
| | - Barbara La Scaleia
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Myrka Zago
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Civil Engineering and Computer Science Engineering, Centre of Space Bio-medicine, University of Rome Tor Vergata, Rome, Italy
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La Scaleia B, Lacquaniti F, Zago M. Enhancement of Vestibular Motion Discrimination by Small Stochastic Whole-body Perturbations in Young Healthy Humans. Neuroscience 2023; 510:32-48. [PMID: 36535577 DOI: 10.1016/j.neuroscience.2022.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/05/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Noisy galvanic vestibular stimulation has been shown to improve vestibular perception in healthy subjects. Here, we sought to obtain similar results using more natural stimuli consisting of small-amplitude motion perturbations of the whole body. Thirty participants were asked to report the perceived direction of antero-posterior sinusoidal motion on a MOOG platform. We compared the baseline perceptual thresholds with those obtained by applying small, stochastic perturbations at different power levels along the antero-posterior axis, symmetrically distributed around a zero-mean. At the population level, we found that the thresholds for all but the highest level of noise were significantly lower than the baseline threshold. At the individual level, the threshold was lower with at least one noise level than the threshold without noise in 87% of participants. Thus, small, stochastic oscillations of the whole body can increase the probability of recognizing the direction of motion from low, normally subthreshold vestibular signals, possibly due to stochastic resonance mechanisms. We suggest that, just as the external noise of the present experiments, also the spontaneous random oscillations of the head and body associated with standing posture are beneficial by enhancing vestibular thresholds with a mechanism similar to stochastic resonance.
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Affiliation(s)
- Barbara La Scaleia
- Laboratory of Visuomotor Control and Gravitational Physiology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy.
| | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Myrka Zago
- Laboratory of Visuomotor Control and Gravitational Physiology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; Department of Civil Engineering and Computer Science Engineering and Center of Space Biomedicine, University of Rome Tor Vergata, 00133 Rome, Italy.
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McLaren R, Smith PF, Taylor RL, Niazi IK, Taylor D. Scoping out noisy galvanic vestibular stimulation: a review of the parameters used to improve postural control. Front Neurosci 2023; 17:1156796. [PMID: 37205050 PMCID: PMC10187481 DOI: 10.3389/fnins.2023.1156796] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/04/2023] [Indexed: 05/21/2023] Open
Abstract
Objective Noisy galvanic vestibular stimulation (nGVS) has been used to facilitate vestibular function and improve gait and balance in people with poor postural control. The aim of this scoping review is to collate, summarize and report on the nGVS parameters that have been used to augment postural control. Method A systematic scoping review was conducted up to December 2022. Data were extracted and synthesized from 31 eligible studies. Key nGVS parameters were identified, and the importance of these parameters and their influence on postural control evaluated. Results A range of nGVS parameters have been used to augment postural control, including; noise waveform, amplitude, frequency band, duration of stimulation, method of amplitude optimization, size and composition of electrodes and the electrode skin interface. Conclusion Systematic evaluation of the individual parameters that can be manipulated in the nGVS waveform identified that a broad array of settings have been utilized in each parameter across the studies. Choices made around the electrode and electrode-skin interface, as well as the amplitude, frequency band, duration and timing of the waveform are likely to influence the efficacy of nGVS. The ability to draw robust conclusions about the selection of optimal nGVS parameters to improve postural control, is hindered by a lack of studies that directly compare parameter settings or consider the variability in individuals' response to nGVS. We propose a guideline for the accurate reporting of nGVS parameters, as a first step toward establishing standardized stimulation protocols.
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Affiliation(s)
- Ruth McLaren
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
- *Correspondence: Ruth McLaren,
| | - Paul F. Smith
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, The Brain Health Research Centre, University of Otago, Dunedin, New Zealand
| | - Rachael L. Taylor
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
- Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Imran Khan Niazi
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
- Centre of Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
- Centre for Sensory-Motor Interactions, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Denise Taylor
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
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Ren P, Zhang Q, Han P, Xu S, Xu C, Li Z, Yang J. [The working principle and prototype construction of the Chinese vestibular prosthesis]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:690-697. [PMID: 36036070 PMCID: PMC10127630 DOI: 10.13201/j.issn.2096-7993.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Indexed: 04/30/2023]
Abstract
Objective:To complete the working principle design and prototype construction of the Chinese multichannel vestibular prosthesis (CMVP) with independent intellectual property rights, and verify its working performance, so as to lay the foundation for the clinical promotion and application of CMVP. Methods:On the basis of previous research, the working principle of CMVP was constructed based on the information encoding principle of vestibular nervous system, and the circuit was designed according to the principle. Then, appropriate electronic components and software systems were selected to construct a CMVP prototype according to the design. Finally, the input and output characteristics of the CMVP prototype were verified through the performance test. Results:In the present study, a block diagram of the working principle of the CMVP was successfully designed and drawn, and the working principle was explained in detail according to the block diagram. Further, the circuit diagram of the CMVP was designed and drawn based on the working principle, then the selected electronic components and software systems were combined one by one to complete the construction of a prototype. Finally, the performance test for the prototype was completed, which showed that all stimulus electrodes of the prototype could output biphasic pulse current, and the frequency of biphasic pulse current was modulated by the spatial rotation data input sensed by a motion sensor. Conclusion:The working principle and circuit design of the CMVP are reasonable; the CMVP prototype in China has been successfully constructed; the spatial rotation motion sensing input and the modulated pulse current output are stable and reliable.
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Affiliation(s)
- Pengyu Ren
- Institute of Medical Artificial Intelligence,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710061,China
- Department of Neurosurgery,the Second Affiliated Hospital of Xi'an Jiaotong University
| | - Qing Zhang
- Department of Otorhinolaryngology-Head & Neck Surgery,Xinhua Hospital,Shanghai Jiaotong University School of Medicine
| | - Peng Han
- Department of Otolaryngology-Head & Neck Surgery,the First Affiliated Hospital of Xi'an Jiaotong University
| | - Songhua Xu
- Institute of Medical Artificial Intelligence,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710061,China
| | - Chuangxin Xu
- Institute of Medical Artificial Intelligence,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710061,China
| | - Zongfang Li
- Institute of Medical Artificial Intelligence,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710061,China
| | - Jun Yang
- Department of Otorhinolaryngology-Head & Neck Surgery,Xinhua Hospital,Shanghai Jiaotong University School of Medicine
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Suh MW, Tran P, Richardson M, Sun S, Xu Y, Djalilian HR, Lin HW, Zeng FG. Electric hearing and tinnitus suppression by noninvasive ear stimulation. Hear Res 2022; 415:108431. [PMID: 35016022 DOI: 10.1016/j.heares.2022.108431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/22/2021] [Accepted: 01/04/2022] [Indexed: 11/04/2022]
Abstract
While noninvasive brain stimulation is convenient and cost effective, its utility is limited by the substantial distance between scalp electrodes and their intended neural targets in the head. The tympanic membrane, or eardrum, is a thin flap of skin deep in an orifice of the head that may serve as a port for improved efficiency of noninvasive stimulation. Here we chose the cochlea as a target because it resides in the densest bone of the skull and is adjacent to many deep-brain-stimulation structures. We also tested the hypothesis that noninvasive electric stimulation of the cochlea may restore neural activities that are missing in acoustic stimulation. We placed an electrode in the ear canal or on the tympanic membrane in 25 human adults (10 females) and compared their stimulation efficiency by characterizing the electrically-evoked auditory sensation. Relative to ear canal stimulation, tympanic membrane stimulation was four times more likely to produce an auditory percept, required eight times lower electric current to reach the threshold and produced two-to-four times more linear suprathreshold responses. We further measured tinnitus suppression in 14 of the 25 subjects who had chronic tinnitus. Compared with ear canal stimulation, tympanic membrane stimulation doubled both the probability (22% vs. 55%) and the amount (-15% vs. -34%) of tinnitus suppression. These findings extended previous work comparing evoked perception and tinnitus suppression between electrodes placed in the ear canal and on the scalp. Together, the previous and present results suggest that the efficiency of conventional scalp-based noninvasive electric stimulation can be improved by at least one order of magnitude via tympanic membrane stimulation. This increased efficiency is most likely due to the shortened distance between the electrode placed on the tympanic membrane and the targeted cochlea. The present findings have implications for the management of tinnitus by offering a potential alternative to interventions using invasive electrical stimulation such as cochlear implantation, or other non-invasive transcranial electrical stimulation methods.
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Affiliation(s)
- Myung-Whan Suh
- Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, CA 92697, United States; Department of Otorhinolaryngology - Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Phillip Tran
- Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, CA 92697, United States
| | - Matthew Richardson
- Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, CA 92697, United States
| | - Shuping Sun
- Department of Otolaryngology - Head and Neck Surgery, The First Affiliated Hospital, Zhengzhou University, Henan 450052, China
| | - Yuchen Xu
- Department of Bioengineering, University of California San Diego, San Diego, California 92092, United States
| | - Hamid R Djalilian
- Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, CA 92697, United States
| | - Harrison W Lin
- Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, CA 92697, United States
| | - Fan-Gang Zeng
- Center for Hearing Research, Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology - Head and Neck Surgery, University of California Irvine, Irvine, CA 92697, United States.
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Stefani SP, Pastras CJ, Serrador JM, Breen PP, Camp AJ. Stochastic and sinusoidal electrical stimuli increase the irregularity and gain of Type A and B medial vestibular nucleus neurons, in vitro. J Neurosci Res 2021; 99:3066-3083. [PMID: 34510506 DOI: 10.1002/jnr.24957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/30/2021] [Accepted: 08/23/2021] [Indexed: 11/05/2022]
Abstract
Galvanic vestibular stimulation (GVS) has been shown to improve vestibular function potentially via stochastic resonance, however, it remains unknown how central vestibular nuclei process these signals. In vivo work applying electrical stimuli to the vestibular apparatus of animals has shown changes in neuronal discharge at the level of the primary vestibular afferents and hair cells. This study aimed to determine the cellular impacts of stochastic, sinusoidal, and stochastic + sinusoidal stimuli on individual medial vestibular nucleus (MVN) neurons of male and female C57BL/6 mice. All stimuli increased the irregularity of MVN neuronal discharge, while differentially affecting neuronal gain. This suggests that the heterogeneous MVN neuronal population (marked by differential expression of ion channels), may influence the impact of electrical stimuli on neuronal discharge. Neuronal subtypes showed increased variability of neuronal firing, where Type A and B neurons experienced the largest gain changes in response to stochastic and sinusoidal stimuli. Type C neurons were the least affected regarding neuronal firing variability and gain changes. The membrane potential (MP) of neurons was altered by sinusoidal and stochastic + sinusoidal stimuli, with Type B and C neuronal MP significantly affected. These results indicate that GVS-like electrical stimuli impact MVN neuronal discharge differentially, likely as a result of heterogeneous ion channel expression.
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Affiliation(s)
- Sebastian P Stefani
- Department of Physiology, The University of Sydney, Camperdown, New South Wales, Australia
| | - Christopher J Pastras
- Department of Physiology, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jorge M Serrador
- Department of Pharmacology, Physiology & Neuroscience, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
| | - Paul P Breen
- The MARCS Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Aaron J Camp
- Department of Physiology, The University of Sydney, Camperdown, New South Wales, Australia
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9
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Valdés BA, Lajoie K, Marigold DS, Menon C. Cortical Effects of Noisy Galvanic Vestibular Stimulation Using Functional Near-Infrared Spectroscopy. SENSORS 2021; 21:s21041476. [PMID: 33672519 PMCID: PMC7923808 DOI: 10.3390/s21041476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 11/25/2022]
Abstract
Noisy galvanic vestibular stimulation (nGVS) can improve different motor, sensory, and cognitive behaviors. However, it is unclear how this stimulation affects brain activity to facilitate these improvements. Functional near-infrared spectroscopy (fNIRS) is inexpensive, portable, and less prone to motion artifacts than other neuroimaging technology. Thus, fNIRS has the potential to provide insight into how nGVS affects cortical activity during a variety of natural behaviors. Here we sought to: (1) determine if fNIRS can detect cortical changes in oxygenated (HbO) and deoxygenated (HbR) hemoglobin with application of subthreshold nGVS, and (2) determine how subthreshold nGVS affects this fNIRS-derived hemodynamic response. A total of twelve healthy participants received nGVS and sham stimulation during a seated, resting-state paradigm. To determine whether nGVS altered activity in select cortical regions of interest (BA40, BA39), we compared differences between nGVS and sham HbO and HbR concentrations. We found a greater HbR response during nGVS compared to sham stimulation in left BA40, a region previously associated with vestibular processing, and with all left hemisphere channels combined (p < 0.05). We did not detect differences in HbO responses for any region during nGVS (p > 0.05). Our results suggest that fNIRS may be suitable for understanding the cortical effects of nGVS.
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Affiliation(s)
- Bulmaro A. Valdés
- Menrva Research Group, Schools of Mechatronic Systems and Engineering Science, Simon Fraser University, 250-13450 102nd Avenue, Surrey, BC V5A 1S6, Canada; (B.A.V.); (K.L.)
| | - Kim Lajoie
- Menrva Research Group, Schools of Mechatronic Systems and Engineering Science, Simon Fraser University, 250-13450 102nd Avenue, Surrey, BC V5A 1S6, Canada; (B.A.V.); (K.L.)
| | - Daniel S. Marigold
- Sensorimotor Neuroscience Lab, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada;
| | - Carlo Menon
- Menrva Research Group, Schools of Mechatronic Systems and Engineering Science, Simon Fraser University, 250-13450 102nd Avenue, Surrey, BC V5A 1S6, Canada; (B.A.V.); (K.L.)
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, ETH Zurich, 8008 Zurich, Switzerland
- Correspondence:
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Chen PY, Jheng YC, Wang CC, Huang SE, Yang TH, Hsu PC, Kuo CH, Lin YY, Lai WY, Kao CL. Effect of noisy galvanic vestibular stimulation on dynamic posture sway under visual deprivation in patients with bilateral vestibular hypofunction. Sci Rep 2021; 11:4229. [PMID: 33608568 PMCID: PMC7896086 DOI: 10.1038/s41598-021-83206-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/27/2021] [Indexed: 01/31/2023] Open
Abstract
A single-blind study to investigate the effects of noisy galvanic vestibular stimulation (nGVS) in straight walking and 2 Hz head yaw walking for healthy and bilateral vestibular hypofunction (BVH) participants in light and dark conditions. The optimal stimulation intensity for each participant was determined by calculating standing stability on a force plate while randomly applying six graded nGVS intensities (0-1000 µA). The chest-pelvic (C/P) ratio and lateral deviation of the center of mass (COM) were measured by motion capture during straight and 2 Hz head yaw walking in light and dark conditions. Participants were blinded to nGVS served randomly and imperceivably. Ten BVH patients and 16 healthy participants completed all trials. In the light condition, the COM lateral deviation significantly decreased only in straight walking (p = 0.037) with nGVS for the BVH. In the dark condition, both healthy (p = 0.026) and BVH (p = 0.017) exhibited decreased lateral deviation during nGVS. The C/P ratio decreased significantly in BVH for 2 Hz head yaw walking with nGVS (p = 0.005) in light conditions. This study demonstrated that nGVS effectively reduced walking deviations, especially in visual deprived condition for the BVH. Applying nGVS with different head rotation frequencies and light exposure levels may accelerate the rehabilitation process for patients with BVH.Clinical Trial Registration This clinical trial was prospectively registered at www.clinicaltrials.gov with the Unique identifier: NCT03554941. Date of registration: (13/06/2018).
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Affiliation(s)
- Po-Yin Chen
- Department of Physical Therapy and Assistive Technology, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, 11217, Taiwan
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan
| | - Ying-Chun Jheng
- Department of Physical Therapy and Assistive Technology, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, 11217, Taiwan
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan
| | - Chien-Chih Wang
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital Yuli Branch, Hualien, 98142, Taiwan
| | - Shih-En Huang
- Department of Physical Therapy and Assistive Technology, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, 11217, Taiwan
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan
| | - Ting-Hua Yang
- Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, 106216, Taiwan
| | - Po-Cheng Hsu
- Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, 10845, Taiwan
| | - Chia-Hua Kuo
- Department of Sports Sciences, University of Taipei, Taipei, 11153, Taiwan
| | - Yi-Ying Lin
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, 11217, Taiwan
| | - Wei-Yi Lai
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, 11217, Taiwan
| | - Chung-Lan Kao
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, 11217, Taiwan.
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan.
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang-Ming Chiao-Tung University, Hsinchu, 30093, Taiwan.
- Institute of Clinical Medicine, National Yang-Ming Chiao-Tung University, Taipei, 11221, Taiwan.
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Lajoie K, Marigold DS, Valdés BA, Menon C. The potential of noisy galvanic vestibular stimulation for optimizing and assisting human performance. Neuropsychologia 2021; 152:107751. [PMID: 33434573 DOI: 10.1016/j.neuropsychologia.2021.107751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/17/2022]
Abstract
Noisy galvanic vestibular stimulation (nGVS) is an emerging non-invasive brain stimulation technique. It involves applying alternating currents of different frequencies and amplitudes presented in a random, or noisy, manner through electrodes on the mastoid bones behind the ears. Because it directly activates vestibular hair cells and afferents and has an indirect effect on a variety of brain regions, it has the potential to impact many different functions. The objective of this review is twofold: (1) to review how nGVS affects motor, sensory, and cognitive performance in healthy adults; and (2) to discuss potential clinical applications of nGVS. First, we introduce the technique. We then describe the regions receiving and processing vestibular information. Next, we discuss the effects of nGVS on motor, sensory, and cognitive function in healthy adults. Subsequently, we outline its potential clinical applications. Finally, we highlight other electrical stimulation technologies and discuss why nGVS offers an alternative or complementary approach. Overall, nGVS appears promising for optimizing human performance and as an assistive technology, though further research is required.
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Affiliation(s)
- Kim Lajoie
- Menrva Research Group, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Metro Vancouver, BC, Canada
| | - Daniel S Marigold
- Sensorimotor Neuroscience Lab, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
| | - Bulmaro A Valdés
- Menrva Research Group, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Metro Vancouver, BC, Canada
| | - Carlo Menon
- Menrva Research Group, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Metro Vancouver, BC, Canada.
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Vestibular rehabilitation therapy in combination with transcranial direct current stimulation (tDCS) for treatment of chronic vestibular dysfunction in the elderly: a double-blind randomized controlled trial. Braz J Otorhinolaryngol 2020; 88:758-766. [PMID: 33339758 PMCID: PMC9483938 DOI: 10.1016/j.bjorl.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/10/2020] [Accepted: 11/02/2020] [Indexed: 01/21/2023] Open
Abstract
Introduction Dizziness and imbalance are common dysfunctions in the elderly. Vestibular rehabilitation therapy is an effective method to alleviate chronic dizziness in patients with vestibular dysfunction. Transcranial direct current stimulation has reportedly improved balance function in patients with vestibular dysfunction. Objective This study was conducted to investigate the therapeutic efficacy of vestibular rehabilitation combined with transcranial direct current stimulation in elderly patients with vestibular dysfunction. Methods In a double-blinded randomized controlled trial, 36 elderly patients with chronic vestibular dysfunction were randomly assigned to either vestibular rehabilitation and transcranial direct current stimulation (n = 18) or vestibular rehabilitation alone (n = 18) group. The transcranial stimulation protocol consisted of multisession bifrontal electrical stimulation of the dorsolateral prefrontal cortex (2 mA intensity and 20 min duration), followed by rehabilitation exercises. The vestibular rehabilitation protocol consisted of habituation and adaptation exercises combined with gait exercises during a three week period. The primary outcome of this study was the dizziness handicap inventory score, and the secondary outcomes were activities-specific balance confidence and Beck anxiety inventory scores. Results For the dizziness handicap score, the repeated-measures analysis of variance showed a significant main effect of “time”, “stimulation” and stimulation × time interaction effect. There was a significant reduction in the overall dizziness handicap score with “time” for both the groups, which was more pronounced in the vestibular rehabilitation and electrical stimulation group. In terms of activities-specific balance confidence change scores, we found a significant main effect of “time” and “stimulation” main factors, but this effect for stimulation × time interaction was not significant. For the Beck anxiety score, we observed a significant main effect of “time”, but no evidence for the main effect of the “stimulation” factor. Conclusion Bifrontal transcranial direct current stimulation in combination with vestibular rehabilitation therapy is a promising approach to improve chronic vestibular symptoms in the elderly.
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Ramírez Hurtado AL, Martínez FV, Diaz Galindo CA, Cuellar KG, Villareal Reyna SZ, Sánchez Herrera DP, Rodríguez González J. Noisy stimulation effect in calcium dynamics on cardiac cells. Exp Cell Res 2020; 396:112319. [PMID: 33039368 DOI: 10.1016/j.yexcr.2020.112319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 11/24/2022]
Abstract
Noise is present in nature, and it affects the nervous and cardiovascular system. Noise added to stimuli may change the performance of excitable cells. In this paper, we study the effect of noise on the two main heart cell types: pacemaker and myocardial cells. This study investigates whether noise can induce changes in calcium dynamics on the two main heart cell types: pacemaker and myocardial cells, when stimuli with periodic electrical signals are disturbed by Gaussian white noise. Calcium dynamic parameters were obtained using imaging signals. Our results show that low intensities of noise favor amplitude and raise rate calcium dynamics, although our results show that the pacemaker cells are not affected by a noisy stimulus. Altogether, these findings suggest that noise plays a key role in calcium dynamics.
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Affiliation(s)
- Alberto Luis Ramírez Hurtado
- Centro de Investigación y de Estudios Avanzados del I.P.N - Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, C.P.: 66600, Apodaca, Nuevo León, Mexico
| | - Fernando Villafranca Martínez
- Centro de Investigación y de Estudios Avanzados del I.P.N - Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, C.P.: 66600, Apodaca, Nuevo León, Mexico
| | - Carlos Alberto Diaz Galindo
- Centro de Investigación y de Estudios Avanzados del I.P.N - Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, C.P.: 66600, Apodaca, Nuevo León, Mexico
| | - Karen Garza Cuellar
- Centro de Investigación y de Estudios Avanzados del I.P.N - Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, C.P.: 66600, Apodaca, Nuevo León, Mexico
| | - Sandra Zue Villareal Reyna
- Centro de Investigación y de Estudios Avanzados del I.P.N - Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, C.P.: 66600, Apodaca, Nuevo León, Mexico
| | - Daniel Paulo Sánchez Herrera
- Centro de Investigación y de Estudios Avanzados del I.P.N - Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, C.P.: 66600, Apodaca, Nuevo León, Mexico.
| | - Jesús Rodríguez González
- Centro de Investigación y de Estudios Avanzados del I.P.N - Unidad Monterrey, Vía del Conocimiento 201, Parque de Investigación e Innovación Tecnológica, C.P.: 66600, Apodaca, Nuevo León, Mexico.
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Hope J, RaviChandran N, Vanholsbeeck F, McDaid A. Augmentation of neural activity in peripheral nerve of sheep using 6 kHz subthreshold currents. Physiol Meas 2020; 41:10NT01. [PMID: 33045694 DOI: 10.1088/1361-6579/abc01f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine how increased excitability from subthreshold currents would alter neural activity as it propagates through the subthreshold currents. APPROACH Experiments were performed on two Romney cross-breed sheep in vivo, by applying subthreshold currents either at the stimulus site or between the stimulus and recording sites. Neural recordings were obtained from nerve cuff implanted on the peroneal or sciatic nerve branches, while stimulus was applied to either the peroneal nerve or pins placed through the lower hindshank. MAIN RESULTS Showed that subthreshold currents applied to the same site as stimulus increased excitation of underlying nerve fibres (p < 0.005). With stimulus and subthreshold currents applied to different sites on the peroneal nerve, the primary compound action potential (CAP) in the sciatic displayed a temporal shift of -2.5 to -3 µs which agreed with changes observed in the CAP waveform (p > 0.05). SIGNIFICANCE These findings contribute to the understanding of mechanisms in myelinated fibres of subthreshold current neuromodulation therapies.
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Affiliation(s)
- James Hope
- The Department of Mechanical Engineering, The University of Auckland, Auckland 1010, New Zealand. The Dodd Walls Centre for Photonic and Quantum Technologies, Auckland 1010, New Zealand
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15
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Ooka T, Bay J, Takeda T, Honda K, Ikeda T, Tsutsumi T. Clinical application of 3D-VOG analysis for quantitative evaluation of Otolith-Ocular reflex in the roll and pitch planes. Acta Otolaryngol 2020; 140:925-929. [PMID: 33026898 DOI: 10.1080/00016489.2020.1816657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Management of vestibular falls requires precise evaluation of otolithic function and gravity recognition. Tilt of the head in the roll plane causes ocular counter rolling (OCR) with a gain of 5-10%, which can be a quantitative parameter related to the otolith-ocular reflex (OOR) in that plane. However, the OOR in the pitch plane is indiscernible because of our ability to voluntarily gaze and pursue. 3 D eye movements and its Listing's plane description can provide novel parameters with which to evaluate OOR, even in the pitch plane. OBJECTIVES To evaluate the utility of 3 D eye movement analysis in video oculography (VOG) as a quantitative parameter reflecting otolithic function during head movements associated with daily life. MATERIALS AND METHODS In healthy subjects, we analyzed the changes in 3 D eye movements and the Listing's plane that occur with static gravitational modification. RESULTS OOR during head tilt in the roll plane revealed that OCR amplitude had a saturating/peaked conformation and was not fitted by a sine curve. OOR in the pitch plane revealed anteroposterior leaning of the Listing's plane. CONCLUSIONS These novel tools for minimally invasive evaluation of OOR in a clinical setting could potentially enable us to quantitatively evaluate peripheral static disequilibrium.
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Affiliation(s)
- Tomoki Ooka
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jing Bay
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takamori Takeda
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiji Honda
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takuo Ikeda
- Department of Otolaryngology, Tsudumigaura Medical Center for Children with Disabilities, Yamaguchi, Japan
| | - Takeshi Tsutsumi
- Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan
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Mitsutake T, Imura T, Tanaka R. The Effects of Vestibular Rehabilitation on Gait Performance in Patients with Stroke: A Systematic Review of Randomized Controlled Trials. J Stroke Cerebrovasc Dis 2020; 29:105214. [PMID: 33066892 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patients with post-stroke hemiparesis have poor postural stability; nevertheless, it is unclear whether vestibular rehabilitation affects gait performance after a stroke or not. We performed a systematic review of randomized controlled trials to investigate the effects of vestibular rehabilitation on gait performance in patients with post stroke. METHODS The Medline, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, and Cumulative Index to Nursing and Allied Health Literature databases were comprehensively searched. All literature published from each source's earliest date to June 2019 was included. Study selection and data extraction were performed independently by paired reviewers. Outcomes of gait performance were the 10-Meter Walking Test, Timed Up and Go Test, and Dynamic Gait Index. We applied the Physiotherapy Evidence Database scale to evaluate the risk of bias and the Grading of Recommendations Assessment, Development and Evaluation system to evaluate the quality of a body of evidence. RESULTS Three studies were included, and two out of three trials showed beneficial effects of vestibular rehabilitation in post-stroke patients. Quality assessment using the Grading of Recommendations Assessment, Development and Evaluation criteria found very low-quality evidence of all included studies due to inadequate allocation concealment, low participant numbers, and lack of blinding. CONCLUSION This review found beneficial effects of vestibular rehabilitation on gait performance in patients with stroke. However, due to the very low-quality evidence of previous randomized controlled trials as assessed by the Grading of Recommendations Assessment, Development and Evaluation criteria, definitive conclusions on the effectiveness of vestibular rehabilitation cannot be made. Hence, more high-quality and large-scale randomized controlled trials of vestibular rehabilitation after stroke are needed.
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Affiliation(s)
- Tsubasa Mitsutake
- Department of Physical Therapy, Fukuoka International University of Health and Welfare, Fukuoka 814-0001, Japan.
| | - Takeshi Imura
- Department of Rehabilitation, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Ryo Tanaka
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima, Japan
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Thomas C, Truong D, Clark TK, Datta A. Understanding current flow in Galvanic Vestibular Stimulation: A Computational Study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:2442-2446. [PMID: 33018500 DOI: 10.1109/embc44109.2020.9176716] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Galvanic vestibular stimulation (GVS) involves the application of electrical current through electrodes placed exclusively at the mastoids or in combination with electrodes placed on other regions. It is a simple, safe modality to modulate and probe vestibular function. Despite a long history of use, it continues to be primarily used as a research tool with no fully developed therapeutic use. This is partly due to the fact that to further advance this technique, a better understanding of what structures are stimulated and by how much is needed. While models have been proposed to explain response, cellular and structural substrates confirmed empirically, the exact current flow pattern has not been investigated.The goal of this study is to therefore determine current flow patterns in GVS. In order to do so, we developed the first ultrahigh-resolution finite element model of GVS incorporating the tiny structures of interest in the inner ear. We simulated the Bilateral-Bipolar, Bilateral-Monopolar, and the Unilateral-Monopolar configurations. Specifically, we generated surface electric field magnitude plots for the brain and for structures considered most relevant to GVS mechanism of action- the semi-circular canals (SCC) and the otolith.Findings show that the Bilateral-Bipolar configuration results in the most spatially restricted flow while the Unilateral-Monopolar configuration results in the most diffuse. With respect to SCC and the otolith, both Bilateral-Bipolar and Bilateral-Monopolar configurations led to similar flow in both the left and right pairs. For the Unilateral-Monopolar configuration, we observed increased flow in the left pair.We expect via this first model developed for GVS, researchers investigating this technique to have a better understanding of the effects of different configurations. Anatomically detailed models like these may also help understand the mechanism of action and may guide the rational design of future GVS administration.
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Impact of galvanic vestibular stimulation-induced stochastic resonance on the output of the vestibular system: A systematic review. Brain Stimul 2020; 13:533-535. [DOI: 10.1016/j.brs.2020.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 11/21/2022] Open
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Sluydts M, Curthoys I, Vanspauwen R, Papsin BC, Cushing SL, Ramos A, Ramos de Miguel A, Borkoski Barreiro S, Barbara M, Manrique M, Zarowski A. Electrical Vestibular Stimulation in Humans: A Narrative Review. Audiol Neurootol 2019; 25:6-24. [PMID: 31533097 DOI: 10.1159/000502407] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/29/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In patients with bilateral vestibulopathy, the regular treatment options, such as medication, surgery, and/or vestibular rehabilitation, do not always suffice. Therefore, the focus in this field of vestibular research shifted to electrical vestibular stimulation (EVS) and the development of a system capable of artificially restoring the vestibular function. Key Message: Currently, three approaches are being investigated: vestibular co-stimulation with a cochlear implant (CI), EVS with a vestibular implant (VI), and galvanic vestibular stimulation (GVS). All three applications show promising results but due to conceptual differences and the experimental state, a consensus on which application is the most ideal for which type of patient is still missing. SUMMARY Vestibular co-stimulation with a CI is based on "spread of excitation," which is a phenomenon that occurs when the currents from the CI spread to the surrounding structures and stimulate them. It has been shown that CI activation can indeed result in stimulation of the vestibular structures. Therefore, the question was raised whether vestibular co-stimulation can be functionally used in patients with bilateral vestibulopathy. A more direct vestibular stimulation method can be accomplished by implantation and activation of a VI. The concept of the VI is based on the technology and principles of the CI. Different VI prototypes are currently being evaluated regarding feasibility and functionality. So far, all of them were capable of activating different types of vestibular reflexes. A third stimulation method is GVS, which requires the use of surface electrodes instead of an implanted electrode array. However, as the currents are sent through the skull from one mastoid to the other, GVS is rather unspecific. It should be mentioned though, that the reported spread of excitation in both CI and VI use also seems to induce a more unspecific stimulation. Although all three applications of EVS were shown to be effective, it has yet to be defined which option is more desirable based on applicability and efficiency. It is possible and even likely that there is a place for all three approaches, given the diversity of the patient population who serves to gain from such technologies.
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Affiliation(s)
- Morgana Sluydts
- European Institute for Otorhinolaryngology, GZA Hospitals Antwerp, Wilrijk, Belgium,
| | - Ian Curthoys
- Vestibular Research Laboratory, University of Sydney, Sydney, New South Wales, Australia
| | - Robby Vanspauwen
- European Institute for Otorhinolaryngology, GZA Hospitals Antwerp, Wilrijk, Belgium
| | - Blake Croll Papsin
- Department of Otolaryngology - Head and Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon Lynn Cushing
- Department of Otolaryngology - Head and Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Angel Ramos
- Hearing Loss Unit, Otorhinolaryngology, Head and Neck Department, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas of Gran Canaria, Spain
| | - Angel Ramos de Miguel
- Hearing Loss Unit, Otorhinolaryngology, Head and Neck Department, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas of Gran Canaria, Spain
| | - Silvia Borkoski Barreiro
- Hearing Loss Unit, Otorhinolaryngology, Head and Neck Department, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas of Gran Canaria, Spain
| | | | - Manuel Manrique
- Otorhinolaryngology Department, Clinica Universidad de Navarra, Pamplona, Spain
| | - Andrzej Zarowski
- European Institute for Otorhinolaryngology, GZA Hospitals Antwerp, Wilrijk, Belgium
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Dlugaiczyk J, Gensberger KD, Straka H. Galvanic vestibular stimulation: from basic concepts to clinical applications. J Neurophysiol 2019; 121:2237-2255. [DOI: 10.1152/jn.00035.2019] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Galvanic vestibular stimulation (GVS) plays an important role in the quest to understand sensory signal processing in the vestibular system under normal and pathological conditions. It has become a highly relevant tool to probe neuronal computations and to assist in the differentiation and treatment of vestibular syndromes. Following its accidental discovery, GVS became a diagnostic tool that generates eye movements in the absence of head/body motion. With the possibility to record extracellular and intracellular spikes, GVS became an indispensable method to activate or block the discharge in vestibular nerve fibers by cathodal and anodal currents, respectively. Bernie Cohen, in his attempt to decipher vestibular signal processing, has used this method in a number of hallmark studies that have added to our present knowledge, such as the link between selective electrical stimulation of semicircular canal nerves and the generation of directionally corresponding eye movements. His achievements paved the way for other major milestones including the differential recruitment order of vestibular fibers for cathodal and anodal currents, pronounced discharge adaptation of irregularly firing afferents, potential activation of hair cells, and fiber type-specific activation of central circuits. Previous disputes about the structural substrate for GVS are resolved by integrating knowledge of ion channel-related response dynamics of afferents, fiber type-specific innervation patterns, and central convergence and integration of semicircular canal and otolith signals. On the basis of solid knowledge of the methodology, specific waveforms of GVS are currently used in clinical diagnosis and patient treatment, such as vestibular implants and noisy galvanic stimulation.
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Affiliation(s)
- Julia Dlugaiczyk
- German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | | | - Hans Straka
- Department Biology II, Ludwig-Maximilians-Universität München, Planegg, Germany
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Breen PP, Serrador JM, Gargiulo GD. Arbitrary waveform constant current stimulator for long-term wearable applications. Med Eng Phys 2019; 68:108-115. [PMID: 31003910 DOI: 10.1016/j.medengphy.2019.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 01/29/2019] [Accepted: 04/03/2019] [Indexed: 11/16/2022]
Abstract
Subsensory electrical noise stimulation has been shown to improve sensory perception in humans. However, the majority of this work has been limited to the laboratory due to unavailability of portable body-worn stimulators. In this paper, we present a robust and reliable stimulator, engineered for wearable applications and designed to extend modulation of human sensory perception outside the physiology laboratory. The stimulator provides an arbitrary waveform constant current stimulation, offering continuous current stimulation up to ±5 mA with a voltage compliance of ±25 V (expandable up to 70 V). A graphical user interface allows setting of stimulus parameters within fixed ranges via a USB connected computer. The interface is very simple using a single power switch and a single multi-coloured LED for device feedback. The applied stimulus voltage and current are continually monitored and used to detect short circuit, high impedance conditions. These conditions, and other errors e.g. low battery state, put the device in a safe state with the user disconnected via a relay. All captured data, including accelerometer data, is logged to a removable SD card. Powered by an interchangeable, Li-Ion battery pack >4 h stimulation is achievable. The full circuit, system software and bench tests performed are presented.
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Affiliation(s)
- Paul P Breen
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, NSW, Australia; Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Jorge M Serrador
- Department of Pharmacology, Physiology & Neuroscience, Rutgers Biomedical and Health Sciences, Newark, NJ, USA; National University of Ireland Galway, Galway, Ireland; Department of Veteran Affairs, NJ Health Care System, War Related Illness & Injury Study Center, East Orange, NJ, USA.
| | - Gaetano D Gargiulo
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, NSW, Australia; Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
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Keywan A, Jahn K, Wuehr M. Noisy Galvanic Vestibular Stimulation Primarily Affects Otolith-Mediated Motion Perception. Neuroscience 2019; 399:161-166. [DOI: 10.1016/j.neuroscience.2018.12.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022]
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Strollo F, Gentile S, Strollo G, Mambro A, Vernikos J. Recent Progress in Space Physiology and Aging. Front Physiol 2018; 9:1551. [PMID: 30483144 PMCID: PMC6240610 DOI: 10.3389/fphys.2018.01551] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/16/2018] [Indexed: 12/17/2022] Open
Abstract
Astronauts coming back from long-term space missions present with different health problems potentially affecting mission performance, involving all functional systems and organs and closely resembling those found in the elderly. This review points out the most recent advances in the literature in areas of expertise in which specific research groups were particularly creative, and as they relate to aging and to possible benefits on Earth for disabled people. The update of new findings and approaches in space research refers especially to neuro-immuno-endocrine-metabolic interactions, optic nerve edema, motion sickness and muscle-tendon-bone interplay and aims at providing the curious - and even possibly naïve young researchers – with a source of inspiration and of creative ideas for translational research.
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Affiliation(s)
| | - Sandro Gentile
- Campania University "Luigi Vanvitelli" and Nefrocenter Research Network, Naples, Italy
| | | | - Andrea Mambro
- Anesthesiology and Resuscitation Unit, "Misercordia" Hospital, Grosseto, Italy
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