1
|
Wheeler C, Smith LJ, Sakel M, Wilkinson D. A systematic review of vestibular stimulation in post-stroke visual neglect. Neuropsychol Rehabil 2024:1-33. [PMID: 38605647 DOI: 10.1080/09602011.2024.2338603] [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: 10/26/2022] [Accepted: 03/27/2024] [Indexed: 04/13/2024]
Abstract
Unilateral visual neglect is a condition that negatively impacts the lives of many stroke survivors. Studies have investigated different forms of vestibular stimulation as a potential therapy, but evidence is yet to be systematically reviewed. We therefore reviewed the effects of vestibular stimulation on outcomes of neglect and activities of daily living (ADL) for people with visual neglect. We searched relevant databases up until September 2022. Eligible articles included any form of vestibular stimulation, study design, or control condition. Included participants were 18 years or older, presenting with neglect following a haemorrhagic or ischaemic stroke. Relevant outcomes were clinically validated measures of neglect and ADL. Cochrane risk of bias tools were used to assess study quality. Meta-analyses and narrative methods were used to synthesize the data. Our search returned 17 relevant studies comprising 180 participants. Meta-analyses showed no difference between galvanic vestibular stimulation and sham conditions on outcomes, whereas caloric vestibular stimulation led to improvement compared to pre-stimulation scores. Narrative syntheses showed mixed results. Clinical and methodological heterogeneity was found both within and between studies. Overall, results were inconsistent regarding the effects of vestibular stimulation as a treatment for neglect. Further trials are warranted but require more careful methodological planning.
Collapse
Affiliation(s)
- Charlotte Wheeler
- School of Psychology, Keynes College, University of Kent, Kent, UK
- Norfolk and Suffolk NHS Foundation Trust, Norfolk, UK
| | - Laura J Smith
- School of Psychology, Keynes College, University of Kent, Kent, UK
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Mohamed Sakel
- East Kent Neuro-Rehabilitation Service, East Kent Hospitals University NHS Foundation Trust, Kent, UK
| | - David Wilkinson
- School of Psychology, Keynes College, University of Kent, Kent, UK
| |
Collapse
|
2
|
Effect of Grading Rehabilitation Nursing Mode on Limb Function, Speech Rehabilitation, and Quality of Life of Stroke Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6956406. [PMID: 35958919 PMCID: PMC9363166 DOI: 10.1155/2022/6956406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/22/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022]
Abstract
Objective. The aim of this study is to investigate the influence of grading rehabilitation nursing mode on limb function, speech function, and QOL of stroke patients. Methods. From January 2018 to April 2019, the stroke patients who received treatment in our hospital were selected as the study participants. Based on the random number table, they were assigned to CG (n = 60) and OG (n = 60). The routine rehabilitation nursing mode was used in the CG, and the grading rehabilitation nursing mode was used in the OG. The limb function, speech function, QOL, and nursing satisfaction were evaluated in both the groups, and the survival curve was analyzed after 12 months of follow-up. Results. The motor function of upper and lower limbs in OG was significantly higher than that in CG, and the total effective rate of speech function recovery in OG was 95.00%, which was obviously higher than 81.67% in CG (
); the total QOL score in OG was (80.72 ± 7.15), which was significantly higher than (69.53 ± 6.42) in CG. The nursing satisfaction of the OG was higher (
). The Kaplan–Meier curve analysis revealed that the difference of 12-month survival rate between CG and OG was statistically significant (χ2 = 4.710,
). Conclusion. The application of grading rehabilitation nursing mode in stroke patients can effectively facilitate the recovery of extremity function and speech function, ameliorate the QOL and nursing satisfaction of patients, reduce the death and disability of patients, and prolong the survival time of patients.
Collapse
|
3
|
Zhang K, Xu G, Du C, Liang R, Han C, Zheng X, Zhang S, Wang J, Tian P, Jia Y. Enhancement of capability for motor imagery using vestibular imbalance stimulation during brain computer interface. J Neural Eng 2021; 18. [PMID: 34571497 DOI: 10.1088/1741-2552/ac2a6f] [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] [Received: 05/18/2021] [Accepted: 09/27/2021] [Indexed: 01/07/2023]
Abstract
Objective.Motor imagery (MI), based on the theory of mirror neurons and neuroplasticity, can promote motor cortical activation in neurorehabilitation. The strategy of MI based on brain-computer interface (BCI) has been used in rehabilitation training and daily assistance for patients with hemiplegia in recent years. However, it is difficult to maintain the consistency and timeliness of receiving external stimulation to neural activation in most subjects owing to the high variability of electroencephalogram (EEG) representation across trials/subjects. Moreover, in practical application, MI-BCI cannot highly activate the motor cortex and provide stable interaction owing to the weakness of the EEG feature and lack of an effective mode of activation.Approach.In this study, a novel hybrid BCI paradigm based on MI and vestibular stimulation motor imagery (VSMI) was proposed to enhance the capability of feature response for MI. Twelve subjects participated in a group of controlled experiments containing VSMI and MI. Three indicators, namely, activation degree, timeliness, and classification accuracy, were adopted to evaluate the performance of the task.Main results.Vestibular stimulation could significantly strengthen the suppression ofαandβbands of contralateral brain regions during MI, that is, enhance the activation degree of the motor cortex (p< 0.01). Compared with MI, the timeliness of EEG feature-response achieved obvious improvements in VSMI experiments. Moreover, the averaged classification accuracy of VSMI and MI was 80.56% and 69.38%, respectively.Significance.The experimental results indicate that specific vestibular activity contributes to the oscillations of the motor cortex and has a positive effect on spontaneous imagery, which provides a novel MI paradigm and enables the preliminary exploration of sensorimotor integration of MI.
Collapse
Affiliation(s)
- Kai Zhang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Guanghua Xu
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China.,State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Chenghang Du
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Renghao Liang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Chenchen Han
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xiaowei Zheng
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Sicong Zhang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Jiahuan Wang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Peiyuan Tian
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yaguang Jia
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, People's Republic of China
| |
Collapse
|
4
|
Embrechts E, Van Criekinge T, Schröder J, Nijboer T, Lafosse C, Truijen S, Saeys W. The association between visuospatial neglect and balance and mobility post-stroke onset: A systematic review. Ann Phys Rehabil Med 2020; 64:101449. [PMID: 33152521 DOI: 10.1016/j.rehab.2020.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although previous narrative reviews have highlighted a potential association between visuospatial neglect (VSN) and balance disorders, to what extent different areas of balance and mobility could be affected is still unclear. OBJECTIVES This systematic review updates previous literature findings and systematically reviews sitting balance, standing balance and mobility outcomes. METHODS PubMed, Web of Science, ScienceDirect, Naric-Rehabdata, PEDro and the Cochrane Trials Library were systematically searched. Methodological quality was assessed by the National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The association between VSN and sitting balance, standing balance and mobility (walking, stair climbing/descending and transfers) was investigated. RESULTS In total, 48 studies were included (4595 stroke survivors): at least 1319 (29%) showed symptoms of VSN. VSN was associated with less independence during sitting, with an asymmetric posture toward the affected body side. For standing balance, we revealed a significant negative association between VSN and mediolateral stability and weight shifting, whereas only activities of daily living-related VSN was associated with weight-bearing asymmetry during static stance. While walking, patients with VSN laterally deviated from their path. Results were inconclusive regarding other aspects of mobility. The association between VSN and balance/mobility seemed to decrease over time. CONCLUSIONS Despite great heterogeneity in results, this study suggests that stroke survivors with VSN show specific deviations in posture and movement in the mediolateral direction. Although the association between VSN and balance/mobility has been extensively investigated, explanatory studies evaluating underlying mechanisms of the frequently present association are lacking. Future studies should address this by combining clinical and instrumented assessment of balance and gait performance, preferably longitudinally to investigate the associations over time.
Collapse
Affiliation(s)
- Elissa Embrechts
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium.
| | - Tamaya Van Criekinge
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Jonas Schröder
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Tanja Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Steven Truijen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium; Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| |
Collapse
|
5
|
Impairments of Visuospatial Attention in Children with Unilateral Spastic Cerebral Palsy. Neural Plast 2018; 2018:1435808. [PMID: 30647728 PMCID: PMC6311787 DOI: 10.1155/2018/1435808] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/10/2018] [Accepted: 09/17/2018] [Indexed: 12/20/2022] Open
Abstract
Aim This observational study aimed at assessing the prevalence of visuospatial attention deficits in children with unilateral spastic cerebral palsy (USCP), taking into consideration the affected hemibody and the localization of the brain lesion. Method Seventy-five children with USCP were assessed with four visuospatial attention tests: star cancellation, Ogden figure copy, line bisection, and proprioceptive pointing. Results A majority (64%) of children with USCP presented a deficit in at least one test compared to the reference values. The alterations observed in children with left or right USCP were related to egocentric or allocentric neglect, respectively. Children with cortico/subcortical lesion presented more often visuospatial attention deficits than children with periventricular lesion. Visuospatial attention deficits were not associated with brain lesion locations. Interpretation Visuospatial attention deficits are prevalent in children with USCP and should be taken into account during their rehabilitation process. The present results shed new light on the interpretation of motor impairments in children with USCP as they may be influenced by the frequent presence of visuospatial deficits.
Collapse
|
6
|
Ohmura Y, Yano S, Katsuhira J, Migita M, Yozu A, Kondo T. Inclination of standing posture due to the presentation of tilted view through an immersive head-mounted display. J Phys Ther Sci 2017; 29:228-231. [PMID: 28265145 PMCID: PMC5332976 DOI: 10.1589/jpts.29.228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/02/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of the present study is to clarify whether tilted scenery presented
through an immersive head-mounted display (HMD) causes the inclination of standing
posture. [Subjects and Methods] Eleven healthy young adult males who provided informed
consent participated in the experiment. An immersive HMD and a stereo camera were employed
to develop a visual inclination system. The subjects maintained a standing posture twice
for 5s each while wearing the visual inclination system. They performed this task under
two conditions: normal view and 20° leftward tilted view. A three-dimensional motion
analysis system was used to measure the subjects’ postures, and two force plates were used
to measure the vertical component of the floor reaction force of each leg. [Results] In
the 20° leftward tilted view, the head and trunk angles in the frontal plane were
similarly inclined toward the left, and the vertical component of the floor reaction force
increased in the left leg, whereas it decreased in the right leg. [Conclusion] When the
view in the immersive HMD was tilted, the participants’ trunk side bent toward the same
side as that of the view. This visual inclination system seems to be a simple intervention
for changing standing posture.
Collapse
Affiliation(s)
- Yuji Ohmura
- Department of Physical Therapy, School of Nursing and Rehabilitation Sciences at Odawara, International University of Health and Welfare, Japan; Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, Japan
| | - Shiro Yano
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, Japan
| | - Junji Katsuhira
- Department of Prosthetics & Orthotics and Assistive Technology, Faculty of Medical Technology, Niigata University of Health and Welfare, Japan; Department of Medical Research and Management for Musculoskeletal Pain 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo Hospital, Japan
| | - Masato Migita
- Department of Physical Therapy, School of Nursing and Rehabilitation Sciences at Odawara, International University of Health and Welfare, Japan
| | - Arito Yozu
- Department of Rehabilitation Medicine, The University of Tokyo Hospital, Japan
| | - Toshiyuki Kondo
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, Japan
| |
Collapse
|
7
|
Volkening K, Kerkhoff G, Keller I. Effects of repetitive galvanic vestibular stimulation on spatial neglect and verticality perception-a randomised sham-controlled trial. Neuropsychol Rehabil 2016; 28:1179-1196. [PMID: 27820972 DOI: 10.1080/09602011.2016.1248446] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Recent evidence shows that bipolar galvanic vestibular stimulation (GVS) with the cathode on the left (CL) or right (CR) mastoid ameliorates spatial neglect, extinction and verticality perception transiently and partly permanently. However, no randomised controlled trial evaluated the long-term effects of repetitive GVS in comparison to sham-GVS on exploration and verticality perception. To compare the effects of CL-GVS, CR-GVS and Sham-GVS on spatial exploration and verticality perception in right-hemispheric stroke patients with left neglect we conducted a randomised controlled trial with minimisation. Twenty-four patients completed 10-12 training sessions on a daily basis, 5 days/week. The CL-and CR-GVS group received 20 min of stimulation at 1.5 mA, the Sham-GVS group only 30 s of CL-GVS. Simultaneously, all patients performed a standard therapy of smooth pursuit eye movement training (SPT) followed by visual scanning training (VST). Outcome measures (Neglect test, visuo-tactile search task, subjective visual and tactile vertical) were assessed before and immediately after the intervention and at 2- and 4-week follow-ups. Our results show that neither our standard therapy nor the combination of standard therapy and GVS improved neglect symptoms significantly. The reasons for our non-significant results are discussed.
Collapse
Affiliation(s)
- Katharina Volkening
- a Department of Neuropsychology , Schoen Klinik Bad Aibling , Bad Aibling , Germany.,b German Center for Vertigo and Balance Disorders (IFB) , Ludwig-Maximilians-University , Munich , Germany
| | - Georg Kerkhoff
- c Clinical Neuropsychology & Neuropsychological University Clinic , Saar University , Saarbruecken , Germany
| | - Ingo Keller
- a Department of Neuropsychology , Schoen Klinik Bad Aibling , Bad Aibling , Germany
| |
Collapse
|
8
|
Non-Invasive Neuromodulation Using Time-Varying Caloric Vestibular Stimulation. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2016; 4:2000310. [PMID: 27777829 PMCID: PMC5074346 DOI: 10.1109/jtehm.2016.2615899] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/17/2016] [Accepted: 09/18/2016] [Indexed: 12/14/2022]
Abstract
Caloric vestibular stimulation (CVS) to elicit the vestibulo-ocular reflex has long been used in clinical settings to aid in the diagnosis of balance disorders and to confirm the absence of brainstem function. While a number of studies have hinted at the potential therapeutic applications of CVS, the limitations of existing devices have frustrated that potential. Current CVS irrigators use water or air during short-duration applications; however, this approach is not tenable for longer duration therapeutic protocols or home use. Here, we describe a solid-state CVS device we developed in order to address these limitations. This device delivers tightly controlled time-varying thermal waveforms, which can be programmed through an external control unit. It contains several safety features, which limit patients to the prescribed waveform and prevent the potential for temperature extremes. In this paper, we provide evidence that CVS treatment with time-varying, but not constant temperature waveforms, elicits changes in cerebral blood flow physiology consistent with the neuromodulation of brainstem centers, and we present results from a small pilot study, which demonstrate that the CVS can safely and feasibly be used longitudinally in the home setting to treat episodic migraine. Together, these results indicate that this solid-state CVS device may be a viable tool for non-invasive neuromodulation.
Collapse
|
9
|
Wilkinson D, Podlewska A, Sakel M. A durable gain in motor and non-motor symptoms of Parkinson’s Disease following repeated caloric vestibular stimulation: A single-case study. NeuroRehabilitation 2016; 38:179-82. [DOI: 10.3233/nre-161308] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- David Wilkinson
- School of Psychology, University of Kent, Canterbury, Kent, UK
| | | | - Mohamed Sakel
- East Kent Neuro-Rehabilitation Service, East Kent Hospitals University NHS Foundation Trust, Kent, UK
| |
Collapse
|
10
|
Conrad J, Habs M, Brandt T, Dieterich M. Acute Unilateral Vestibular Failure Does Not Cause Spatial Hemineglect. PLoS One 2015; 10:e0135147. [PMID: 26247469 PMCID: PMC4527734 DOI: 10.1371/journal.pone.0135147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 07/17/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Visuo-spatial neglect and vestibular disorders have common clinical findings and involve the same cortical areas. We questioned (1) whether visuo-spatial hemineglect is not only a disorder of spatial attention but may also reflect a disorder of higher cortical vestibular function and (2) whether a vestibular tone imbalance due to an acute peripheral dysfunction can also cause symptoms of neglect or extinction. Therefore, patients with an acute unilateral peripheral vestibular failure (VF) were tested for symptoms of hemineglect. METHODS Twenty-eight patients with acute VF were assessed for signs of vestibular deficits and spatial neglect using clinical measures and various common standardized paper-pencil tests. Neglect severity was evaluated further with the Center of Cancellation method. Pathological neglect test scores were correlated with the degree of vestibular dysfunction determined by the subjective visual vertical and caloric testing. RESULTS Three patients showed isolated pathological scores in one or the other neglect test, either ipsilesionally or contralesionally to the VF. None of the patients fulfilled the diagnostic criteria of spatial hemineglect or extinction. CONCLUSIONS A vestibular tone imbalance due to unilateral failure of the vestibular endorgan does not cause spatial hemineglect, but evidence indicates it causes mild attentional deficits in both visual hemifields.
Collapse
Affiliation(s)
- Julian Conrad
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders—IFB (DSGZ), Munich, Germany
- * E-mail:
| | - Maximilian Habs
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders—IFB (DSGZ), Munich, Germany
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders—IFB (DSGZ), Munich, Germany
- Clinical Neuroscience, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Marianne Dieterich
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders—IFB (DSGZ), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Ludwig-Maximilians-University Munich, Munich, Germany
| |
Collapse
|
11
|
Noll-Hussong M, Holzapfel S, Pokorny D, Herberger S. Caloric vestibular stimulation as a treatment for conversion disorder: a case report and medical hypothesis. Front Psychiatry 2014; 5:63. [PMID: 24917828 PMCID: PMC4040883 DOI: 10.3389/fpsyt.2014.00063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 05/19/2014] [Indexed: 12/12/2022] Open
Abstract
Conversion disorder is a medical condition in which a person has paralysis, blindness, or other neurological symptoms that cannot be clearly explained physiologically. To date, there is neither specific nor conclusive treatment. In this paper, we draw together a number of disparate pieces of knowledge to propose a novel intervention to provide transient alleviation for this condition. As caloric vestibular stimulation has been demonstrated to modulate a variety of cognitive functions associated with brain activations, especially in the temporal-parietal cortex, anterior cingulate cortex, and insular cortex, there is evidence to assume an effect in specific mental disorders. Therefore, we go on to hypothesize that lateralized cold vestibular caloric stimulation will be effective in treating conversion disorder and we present provisional evidence from one patient that supports this conclusion. If our hypothesis is correct, this will be the first time in psychiatry and neurology that a clinically well-known mental disorder, long considered difficult to understand and to treat, is relieved by a simple or common, non-invasive medical procedure.
Collapse
Affiliation(s)
- Michael Noll-Hussong
- Klinik und Poliklinik fuer Psychosomatische Medizin und Psychotherapie des Universitaetsklinikums Ulm, Ulm, Germany
| | - Sabrina Holzapfel
- Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Dan Pokorny
- Klinik und Poliklinik fuer Psychosomatische Medizin und Psychotherapie des Universitaetsklinikums Ulm, Ulm, Germany
| | - Simone Herberger
- Klinik fuer Psychosomatische Medizin und Psychotherapie des Klinikums Muenchen-Harlaching, Muenchen, Germany
| |
Collapse
|
12
|
Wilkinson D, Morris R, Milberg W, Sakel M. Caloric vestibular stimulation in aphasic syndrome. Front Integr Neurosci 2013; 7:99. [PMID: 24391559 PMCID: PMC3870329 DOI: 10.3389/fnint.2013.00099] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 12/08/2013] [Indexed: 11/13/2022] Open
Abstract
Caloric vestibular stimulation (CVS) is commonly used to diagnose brainstem disorder but its therapeutic application is much less established. Based on the finding that CVS increases blood flow to brain structures associated with language and communication, we assessed whether the procedure has potential to relieve symptoms of post-stroke aphasia. Three participants, each presenting with chronic, unilateral lesions to the left hemisphere, were administered daily CVS for four consecutive weeks. Relative to their pre-treatment baseline scores, two of the three participants showed significant improvement on both picture and responsive naming at immediate and 1-week follow-up. One of these participants also showed improved sentence repetition, and another showed improved auditory word discrimination. No adverse reactions were reported. These data provide the first, albeit tentative, evidence that CVS may relieve expressive and receptive symptoms of aphasia. A larger, sham-controlled study is now needed to further assess efficacy.
Collapse
Affiliation(s)
- David Wilkinson
- School of Psychology, University of Kent Canterbury, Kent, UK
| | - Rachael Morris
- School of Psychology, University of Kent Canterbury, Kent, UK
| | - William Milberg
- Department of Psychiatry, Harvard Medical School Boston, MA, USA
| | - Mohamed Sakel
- East Kent Neuro-Rehabilitation Service, East Kent Hospitals University NHS Foundation Trust Kent, UK
| |
Collapse
|