1
|
Gökçe E, Milot E, Langeard A, Quarck G. Impact of repetitive home-based galvanic vestibular stimulation on cognitive skills in healthy older adults. Exp Gerontol 2024; 194:112504. [PMID: 38936440 DOI: 10.1016/j.exger.2024.112504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/12/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024]
Abstract
The human vestibular system is adversely affected by the aging process. Recent evidence indicates that vestibular information and cognitive functions are related, suggesting that age-related vestibular loss may contribute to cognitive impairment. In this study, we aimed to investigate the effects of repetitive, home-based galvanic vestibular stimulation (GVS) on cognitive functions in healthy older adults. Twenty-one participants (age = 64.66 ± 2.97 years, 12 females) were randomly allocated to either a home-based GVS or an active control group. The GVS intervention lasted 20 min per session, five times a week, for two weeks (10 sessions). Cognitive functions were assessed before and after the intervention using the Stroop Test, Trail Making Test A&B, and Dual-Task (digit recall and paper-pencil tracking test). Our findings revealed a significant group-by-time interaction effect for the tracking accuracy (F(1,18) = 7.713, p = 0.012, η p2 = 0.30), with only the home-based GVS group showing significant improvement (t = -2.544, p = 0.029). The proposed home-based GVS protocol offers a promising non-pharmacological avenue for enhancing visuospatial ability in healthy older adults. Further research is needed to investigate the effects of different GVS protocols on various cognitive functions, particularly in older individuals with different health conditions.
Collapse
Affiliation(s)
- Evrim Gökçe
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France.
| | - Emma Milot
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Antoine Langeard
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Gaëlle Quarck
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| |
Collapse
|
2
|
Abstract
PURPOSE OF REVIEW The aim of this study was to illuminate the extent of the bilateral central vestibular network from brainstem and cerebellum to subcortical and cortical areas and its interrelation to higher cortical functions such as spatial cognition and anxiety. RECENT FINDINGS The conventional view that the main function of the vestibular system is the perception of self-motion and body orientation in space and the sensorimotor control of gaze and posture had to be developed further by a hierarchical organisation with bottom-up and top-down interconnections. Even the vestibulo-ocular and vestibulo-spinal reflexes are modified by perceptual cortical processes, assigned to higher vestibulo-cortical functions. A first comparative fMRI meta-analysis of vestibular stimulation and fear-conditioning studies in healthy participants disclosed widely distributed clusters of concordance, including the prefrontal cortex, anterior insula, temporal and inferior parietal lobe, thalamus, brainstem and cerebellum. In contrast, the cortical vestibular core region around the posterior insula was activated during vestibular stimulation but deactivated during fear conditioning. In recent years, there has been increasing evidence from studies in animals and humans that the central vestibular system has numerous connections related to spatial sensorimotor performance, memory, and emotion. The clinical implication of the complex interaction within various networks makes it difficult to assign some higher multisensory disorders to one particular modality, for example in spatial hemineglect or room-tilt illusion. SUMMARY Our understanding of higher cortical vestibular functions is still in its infancy. Different brain imaging techniques in animals and humans are one of the most promising methodological approaches for further structural and functional decoding of the vestibular and other intimately interconnected networks. The multisensory networking including cognition and emotion determines human behaviour in space.
Collapse
Affiliation(s)
- Marianne Dieterich
- German Center for Vertigo and Balance Disorders
- Department of Neurology, Ludwig-Maximilians University
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | | |
Collapse
|
3
|
Zwergal A, Grabova D, Schöberl F. Vestibular contribution to spatial orientation and navigation. Curr Opin Neurol 2024; 37:52-58. [PMID: 38010039 PMCID: PMC10779452 DOI: 10.1097/wco.0000000000001230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
PURPOSE OF REVIEW The vestibular system provides three-dimensional idiothetic cues for updating of one's position in space during head and body movement. Ascending vestibular signals reach entorhinal and hippocampal networks via head-direction pathways, where they converge with multisensory information to tune the place and grid cell code. RECENT FINDINGS Animal models have provided insight to neurobiological consequences of vestibular lesions for cerebral networks controlling spatial cognition. Multimodal cerebral imaging combined with behavioural testing of spatial orientation and navigation performance as well as strategy in the last years helped to decipher vestibular-cognitive interactions also in humans. SUMMARY This review will update the current knowledge on the anatomical and cellular basis of vestibular contributions to spatial orientation and navigation from a translational perspective (animal and human studies), delineate the behavioural and functional consequences of different vestibular pathologies on these cognitive domains, and will lastly speculate on a potential role of vestibular dysfunction for cognitive aging and impeding cognitive impairment in analogy to the well known effects of hearing loss.
Collapse
Affiliation(s)
- Andreas Zwergal
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Denis Grabova
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich
| | - Florian Schöberl
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
4
|
Wuehr M, Eilles E, Lindner M, Grosch M, Beck R, Ziegler S, Zwergal A. Repetitive Low-Intensity Vestibular Noise Stimulation Partly Reverses Behavioral and Brain Activity Changes following Bilateral Vestibular Loss in Rats. Biomolecules 2023; 13:1580. [PMID: 38002261 PMCID: PMC10669117 DOI: 10.3390/biom13111580] [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: 08/30/2023] [Revised: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 11/26/2023] Open
Abstract
Low-intensity noisy galvanic vestibular stimulation (nGVS) can improve static and dynamic postural deficits in patients with bilateral vestibular loss (BVL). In this study, we aimed to explore the neurophysiological and neuroanatomical substrates underlying nGVS treatment effects in a rat model of BVL. Regional brain activation patterns and behavioral responses to a repeated 30 min nGVS treatment in comparison to sham stimulation were investigated by serial whole-brain 18F-FDG-PET measurements and quantitative locomotor assessments before and at nine consecutive time points up to 60 days after the chemical bilateral labyrinthectomy (BL). The 18F-FDG-PET revealed a broad nGVS-induced modulation on regional brain activation patterns encompassing biologically plausible brain networks in the brainstem, cerebellum, multisensory cortex, and basal ganglia during the entire observation period post-BL. nGVS broadly reversed brain activity adaptions occurring in the natural course post-BL. The parallel behavioral locomotor assessment demonstrated a beneficial treatment effect of nGVS on sensory-ataxic gait alterations, particularly in the early stage of post-BL recovery. Stimulation-induced locomotor improvements were finally linked to nGVS brain activity responses in the brainstem, hemispheric motor, and limbic networks. In conclusion, combined 18F-FDG-PET and locomotor analysis discloses the potential neurophysiological and neuroanatomical substrates that mediate previously observed therapeutic nGVS effects on postural deficits in patients with BVL.
Collapse
Affiliation(s)
- Max Wuehr
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, 81377 Munich, Germany; (M.W.); (E.E.); (M.L.); (M.G.); (R.B.)
| | - Eva Eilles
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, 81377 Munich, Germany; (M.W.); (E.E.); (M.L.); (M.G.); (R.B.)
| | - Magdalena Lindner
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, 81377 Munich, Germany; (M.W.); (E.E.); (M.L.); (M.G.); (R.B.)
| | - Maximilian Grosch
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, 81377 Munich, Germany; (M.W.); (E.E.); (M.L.); (M.G.); (R.B.)
| | - Roswitha Beck
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, 81377 Munich, Germany; (M.W.); (E.E.); (M.L.); (M.G.); (R.B.)
- Pharmaceutical Radiochemistry, TUM School of Natural Sciences, TU Munich, 85748 Garching, Germany
| | - Sibylle Ziegler
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, 81377 Munich, Germany;
| | - Andreas Zwergal
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, 81377 Munich, Germany; (M.W.); (E.E.); (M.L.); (M.G.); (R.B.)
- Department of Neurology, LMU University Hospital, LMU Munich, 81377 Munich, Germany
| |
Collapse
|
5
|
Schöne CG, Mast FW. High-current galvanic vestibular stimulation impairs working memory span, but not other executive functions. Neuropsychologia 2023; 188:108617. [PMID: 37302752 DOI: 10.1016/j.neuropsychologia.2023.108617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 06/13/2023]
Abstract
Patients with peripheral vestibular dysfunction (PVD) suffer not only from physical problems such as imbalance or vertigo but also from neuropsychological difficulties, including executive deficits. However, it is unclear whether the PVD directly causes executive problems. To examine the causal vestibular influence on executive functions, we induced either high-current (2 mA), low-current (0.8 mA), or sham current (0 mA) galvanic vestibular stimulation (GVS) in 79 healthy participants. Participants solved three tasks, measuring the core executive components (working memory, inhibition, cognitive flexibility) before and during GVS. High-current GVS impaired working memory span, but not inhibition and cognitive flexibility performance. Low-current GVS did not influence executive performance. Results indicate a causal vestibular influence on working memory span. Joint cortical areas of vestibular and working memory processing are discussed. Since high-current GVS in healthy participants serves as a model for an artificial vestibular dysfunction, our results could improve the diagnostics and therapy of patients with PVD.
Collapse
Affiliation(s)
- Corina G Schöne
- Department of Psychology, University of Bern, Bern, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland; Doctoral Program for Brain and Behavioral Sciences, University of Bern, Bern, Switzerland.
| | - Fred W Mast
- Department of Psychology, University of Bern, Bern, Switzerland
| |
Collapse
|
6
|
Smith PF. Recent developments in the understanding of the interactions between the vestibular system, memory, the hippocampus, and the striatum. Front Neurol 2022; 13:986302. [PMID: 36119673 PMCID: PMC9479733 DOI: 10.3389/fneur.2022.986302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/08/2022] [Indexed: 12/05/2022] Open
Abstract
Over the last two decades, evidence has accumulated to demonstrate that the vestibular system has extensive connections with areas of the brain related to spatial memory, such as the hippocampus, and also that it has significant interactions with areas associated with voluntary motor control, such as the striatum in the basal ganglia. In fact, these functions are far from separate and it is believed that interactions between the striatum and hippocampus are important for memory processing. The data relating to vestibular-hippocampal-striatal interactions have considerable implications for the understanding and treatment of Alzheimer's Disease and Parkinson's Disease, in addition to other neurological disorders. However, evidence is accumulating rapidly, and it is difficult to keep up with the latest developments in these and related areas. The aim of this review is to summarize and critically evaluate the relevant evidence that has been published over the last 2 years (i.e., since 2021), in order to identify emerging themes in this research area.
Collapse
Affiliation(s)
- Paul F. Smith
- Department of Pharmacology and Toxicology, School of Biomedical Sciences and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
- *Correspondence: Paul F. Smith
| |
Collapse
|