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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.
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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
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2
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Tarnutzer AA, Ward BK, Shaikh AG. Novel ways to modulate the vestibular system: Magnetic vestibular stimulation, deep brain stimulation and transcranial magnetic stimulation / transcranial direct current stimulation. J Neurol Sci 2023; 445:120544. [PMID: 36621040 DOI: 10.1016/j.jns.2023.120544] [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: 06/29/2022] [Revised: 12/07/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
BACKGROUND Advances in neurotechnologies are revolutionizing our understanding of complex neural circuits and enabling new treatments for disorders of the human brain. In the vestibular system, electromagnetic stimuli can now modulate vestibular reflexes and sensations of self-motion by artificially stimulating the labyrinth, cerebellum, cerebral cortex, and their connections. OBJECTIVE In this narrative review, we describe evolving neuromodulatory techniques including magnetic vestibular stimulation (MVS), deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), and transcranial direct-current stimulation (tDCS) and discuss current and potential future application in the field of neuro-otology. RESULTS MVS triggers both vestibular nystagmic (persistent) and perceptual (lasting ∼1 min) responses that may serve as a model to study central adaptational mechanisms and pathomechanisms of hemispatial neglect. By systematically mapping DBS electrodes, targeted stimulation of central vestibular pathways allowed modulating eye movements, vestibular heading perception, spatial attention and graviception, resulting in reduced anti-saccade error rates and hypometria, improved heading discrimination, shifts in verticality perception and transiently decreased spatial attention. For TMS/tDCS treatment trials have demonstrated amelioration of vestibular symptoms in various neuro-otological conditions, including chronic vestibular insufficiency, Mal-de-Debarquement and cerebellar ataxia. CONCLUSION Neuromodulation has a bright future as a potential treatment of vestibular dysfunction. MVS, DBS and TMS may provide new and sophisticated, customizable, and specific treatment options of vestibular symptoms in humans. While promising treatment responses have been reported for TMS/tDCS, treatment trials for vestibular disorders using MVS or DBS have yet to be defined and performed.
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Affiliation(s)
- A A Tarnutzer
- Neurology, Cantonal Hospital of Baden, Baden, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland.
| | - B K Ward
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A G Shaikh
- Department of Neurology, University Hospitals and Cleveland VA Medical Center, Case Western Reserve University, Cleveland, OH, USA
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3
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Nguyen TT, Nam GS, Kang JJ, Han GC, Kim JS, Dieterich M, Oh SY. Galvanic Vestibular Stimulation Improves Spatial Cognition After Unilateral Labyrinthectomy in Mice. Front Neurol 2021; 12:716795. [PMID: 34393985 PMCID: PMC8358680 DOI: 10.3389/fneur.2021.716795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 06/29/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives: To investigate the deficits of spatial memory and navigation from unilateral vestibular deafferentation (UVD) and to determine the efficacy of galvanic vestibular stimulation (GVS) for recovery from these deficits using a mouse model of unilateral labyrinthectomy (UL). Methods: Thirty-six male C57BL/6 mice were allocated into three groups that comprise a control group and two experimental groups, UVD with (GVS group) and without GVS intervention (non-GVS group). In the experimental groups, we assessed the locomotor and cognitive behavioral function before (baseline) and 3, 7, and 14 days after surgical UL, using the open field (OF), Y maze, and Morris water maze (MWM) tests. In the GVS group, the stimulations were applied for 30 min daily from postoperative day (POD) 0–4 via the electrodes inserted subcutaneously close to both bony labyrinths. Results: Locomotion and spatial cognition were significantly impaired in the mice with UVD non-GVS group compared to the control group. GVS significantly accelerated recovery of locomotion compared to the control and non-GVS groups on PODs 3 (p < 0.001) and 7 (p < 0.05, Kruskal–Wallis and Mann–Whitney U tests) in the OF and Y maze tests. The mice in the GVS group were better in spatial working memory assessed with spontaneous alternation performance and spatial reference memory assessed with place recognition during the Y maze test than those in the non-GVS group on POD 3 (p < 0.001). In addition, the recovery of long-term spatial navigation deficits during the MWM, as indicated by the escape latency and the probe trial, was significantly better in the GVS group than in the non-GVS group 2 weeks after UVD (p < 0.01). Conclusions: UVD impairs spatial memory, navigation, and motor coordination. GVS accelerated recoveries in short- and long-term spatial memory and navigation, as well as locomotor function in mice with UVD, and may be applied to the patients with acute unilateral vestibular failure.
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Affiliation(s)
- Thanh Tin Nguyen
- Jeonbuk National University College of Medicine, Jeonju, South Korea.,Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Department of Pharmacology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Gi-Sung Nam
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Kwangju, South Korea
| | - Jin-Ju Kang
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South Korea
| | - Gyu Cheol Han
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Gachon University of Medicine and Science, Incheon, South Korea
| | - Ji-Soo Kim
- Department of Neurology, Seoul National University Hospital & School of Medicine, Seoul, South Korea
| | - Marianne Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Sun-Young Oh
- Jeonbuk National University College of Medicine, Jeonju, South Korea.,Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South Korea
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4
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De Maio G, Bottini G, Ferré ER. Galvanic Vestibular Stimulation influences risk-taking behaviour. Neuropsychologia 2021; 160:107965. [PMID: 34303719 DOI: 10.1016/j.neuropsychologia.2021.107965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
Risk-taking behaviour is an essential aspect of our interactions with the environment. Here we investigated whether vestibular inputs influence behavioural measurement of risk-taking propensity. We have combined bipolar Galvanic Vestibular Stimulation (GVS) with a well-known and established risk-taking behaviour task, namely the Balloon Analogue Risk Task (BART). A sham stimulation was used to control for non-specific effects. Left-anodal and right-cathodal GVS (L-GVS), which preferentially activates the vestibular projections in the right hemisphere, decreased the willingness to take risk during the BART compared with right-anodal and left-cathodal GVS (R-GVS), which activates the left hemisphere. This proved a specific vestibular effect which depends on GVS polarity. Conversely, no generic vestibular effect, defined as the adjusted average of L-GVS and R-GVS conditions compared to sham, emerged, excluding non-specific vestibular effects. Our results confirmed recent findings of a vestibular contribution to decision-making and strategy control behaviour. We suggest that the vestibular-mediated balancing of risk seeking behaviour is an important element of the brain's capacity to adapt to the environment.
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Affiliation(s)
- Gabriele De Maio
- Department of Psychology, Royal Holloway University of London, Egham, UK; Brain and Behavioural Sciences Department, University of Pavia, Pavia, Italy
| | - Gabriella Bottini
- Brain and Behavioural Sciences Department, University of Pavia, Pavia, Italy; Centre of Cognitive Neuropsychology, ASST Grande Ospedale Metropolitano, Niguarda Hospital, Milan, Italy
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Longley V, Hazelton C, Heal C, Pollock A, Woodward-Nutt K, Mitchell C, Pobric G, Vail A, Bowen A. Non-pharmacological interventions for spatial neglect or inattention following stroke and other non-progressive brain injury. Cochrane Database Syst Rev 2021; 7:CD003586. [PMID: 34196963 PMCID: PMC8247630 DOI: 10.1002/14651858.cd003586.pub4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND People with spatial neglect after stroke or other brain injury have difficulty attending to one side of space. Various rehabilitation interventions have been used, but evidence of their benefit is unclear. OBJECTIVES The main objective was to determine the effects of non-pharmacological interventions for people with spatial neglect after stroke and other adult-acquired non-progressive brain injury. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (last searched October 2020), the Cochrane Central Register of Controlled Trials (CENTRAL; last searched October 2020), MEDLINE (1966 to October 2020), Embase (1980 to October 2020), the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1983 to October 2020), and PsycINFO (1974 to October 2020). We also searched ongoing trials registers and screened reference lists. SELECTION CRITERIA We included randomised controlled trials (RCTs) of any non-pharmacological intervention specifically aimed at spatial neglect. We excluded studies of general rehabilitation and studies with mixed participant groups, unless separate neglect data were available. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Review authors categorised the interventions into eight broad types deemed to be applicable to clinical practice through iterative discussion: visual interventions, prism adaptation, body awareness interventions, mental function interventions, movement interventions, non-invasive brain stimulation, electrical stimulation, and acupuncture. We assessed the quality of evidence for each outcome using the GRADE approach. MAIN RESULTS We included 65 RCTs with 1951 participants, all of which included people with spatial neglect following stroke. Most studies measured outcomes using standardised neglect assessments. Fifty-one studies measured effects on ADL immediately after completion of the intervention period; only 16 reported persisting effects on ADL (our primary outcome). One study (30 participants) reported discharge destination, and one (24 participants) reported depression. No studies reported falls, balance, or quality of life. Only two studies were judged to be entirely at low risk of bias, and all were small, with fewer than 50 participants per group. We found no definitive (phase 3) clinical trials. None of the studies reported any patient or public involvement. Visual interventions versus any control: evidence is very uncertain about the effects of visual interventions for spatial neglect based on measures of persisting functional ability in ADL (2 studies, 55 participants) (standardised mean difference (SMD) -0.04, 95% confidence interval (CI) -0.57 to 0.49); measures of immediate functional ability in ADL; persisting standardised neglect assessments; and immediate neglect assessments. Prism adaptation versus any control: evidence is very uncertain about the effects of prism adaptation for spatial neglect based on measures of persisting functional ability in ADL (2 studies, 39 participants) (SMD -0.29, 95% CI -0.93 to 0.35); measures of immediate functional ability in ADL; persisting standardised neglect assessments; and immediate neglect assessments. Body awareness interventions versus any control: evidence is very uncertain about the effects of body awareness interventions for spatial neglect based on measures of persisting functional ability in ADL (5 studies, 125 participants) (SMD 0.61, 95% CI 0.24 to 0.97); measures of immediate functional ability in ADL; persisting standardised neglect assessments; immediate neglect assessments; and adverse events. Mental function interventions versus any control: we found no trials of mental function interventions for spatial neglect reporting on measures of persisting functional ability in ADL. Evidence is very uncertain about the effects of mental function interventions on spatial neglect based on measures of immediate functional ability in ADL and immediate neglect assessments. Movement interventions versus any control: we found no trials of movement interventions for spatial neglect reporting on measures of persisting functional ability in ADL. Evidence is very uncertain about the effects of body awareness interventions on spatial neglect based on measures of immediate functional ability in ADL and immediate neglect assessments. Non-invasive brain stimulation (NIBS) versus any control: evidence is very uncertain about the effects of NIBS on spatial neglect based on measures of persisting functional ability in ADL (3 studies, 92 participants) (SMD 0.35, 95% CI -0.08 to 0.77); measures of immediate functional ability in ADL; persisting standardised neglect assessments; immediate neglect assessments; and adverse events. Electrical stimulation versus any control: we found no trials of electrical stimulation for spatial neglect reporting on measures of persisting functional ability in ADL. Evidence is very uncertain about the effects of electrical stimulation on spatial neglect based on immediate neglect assessments. Acupuncture versus any control: we found no trials of acupuncture for spatial neglect reporting on measures of persisting functional ability in ADL. Evidence is very uncertain about the effects of acupuncture on spatial neglect based on measures of immediate functional ability in ADL and immediate neglect assessments. AUTHORS' CONCLUSIONS The effectiveness of non-pharmacological interventions for spatial neglect in improving functional ability in ADL and increasing independence remains unproven. Many strategies have been proposed to aid rehabilitation of spatial neglect, but none has yet been sufficiently researched through high-quality fully powered randomised trials to establish potential or adverse effects. As a consequence, no rehabilitation approach can be supported or refuted based on current evidence from RCTs. As recommended by a number of national clinical guidelines, clinicians should continue to provide rehabilitation for neglect that enables people to meet their rehabilitation goals. Clinicians and stroke survivors should have the opportunity, and are strongly encouraged, to participate in research. Future studies need to have appropriate high-quality methodological design, delivery, and reporting to enable appraisal and interpretation of results. Future studies also must evaluate outcomes of importance to patients, such as persisting functional ability in ADL. One way to improve the quality of research is to involve people with experience with the condition in designing and running trials.
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Affiliation(s)
- Verity Longley
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Christine Hazelton
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Calvin Heal
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Alex Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | | | - Claire Mitchell
- Division of Human Communication, Development & Hearing, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Gorana Pobric
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Andy Vail
- Centre For Biostatistics, Manchester Academic Health Science Centre, Manchester, UK, University of Manchester, Manchester, UK
| | - Audrey Bowen
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
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6
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Wilkinson D. Caloric and galvanic vestibular stimulation for the treatment of Parkinson's disease: rationale and prospects. Expert Rev Med Devices 2021; 18:649-655. [PMID: 34047226 DOI: 10.1080/17434440.2021.1935874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Deeply embedded within the inner ear, the sensory organs of the vestibular system are exquisitely sensitive to the orientation and movement of the head. This information constrains aspects of autonomic reflex control as well as higher-level processes involved in cognition and affect. The anatomical pathways that underline these functional interactions project to many cortical and sub-cortical brain areas, and the question arises as to whether they can be therapeutically harnessed.Areas covered: The body of work reviewed here indicates that the controlled application of galvanic or thermal current to the vestibular end-organs can modulate activity throughout the ascending vestibular network and, under appropriate conditions, reduce motor and non-motor symptoms associated with Parkinson's disease, a disease of growing prevalence and continued unmet clinical need.Expert opinion: The appeal of vestibular stimulation in Parkinson's disease is underpinned by its noninvasive nature, favorable safety profile, and capacity for home-based administration. Clinical adoption now rests on the demonstration of cost-effectiveness and on the commercial availability of suitable devices, many of which are only permitted for research use or lack functionality. Dose optimization and mechanisms-of-action studies are also needed, along with a broader awareness amongst physicians of its therapeutic potential.
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7
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Lotfi Y, Farahani A, Azimiyan M, Moossavi A, Bakhshi E. Comparison of efficacy of vestibular rehabilitation and noisy galvanic vestibular stimulation to improve dizziness and balance in patients with multiple sclerosis. J Vestib Res 2021; 31:541-551. [PMID: 33967075 DOI: 10.3233/ves-201609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dizziness and imbalance are common symptoms in patients with multiple sclerosis (PwMS), and rehabilitation interventions varying greatly in effectiveness. OBJECTIVE To compare the effectiveness of vestibular rehabilitation therapy (VRT) and noisy galvanic vestibular stimulation (nGVS) on dizziness and balance in PwMS. METHODS This was a single-blind, randomized controlled trial. Twenty-four PwMS were randomly divided into groups of VRT, nGVS, and Control. The VRT and the nGVS groups underwent the intervention program. The patients were assessed with the composite score in anteroposterior and lateral directions (CS AP and LAT) obtained by sensory organization test (SOT), Dizziness Handicap Inventory (DHI), and Activities-Specific Balance Confidence Scale (ABC). RESULTS The VRT group showed greater improvements in CS AP and LAT, DHI total score, and ABC total score compared with the nGVS group and the control group. No significant difference was found between the nGVS group and the control group. These results were approximately stable at the 4-week follow-up. CONCLUSIONS These findings provided evidence for effectiveness of the VRT in improvement of dizziness and balance in PwMS. These improvements were not associated with the nGVS. Further studies are needed to assess the effectiveness of the nGVS on dizziness and balance in PwMS.
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Affiliation(s)
- Yones Lotfi
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Akram Farahani
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mojtaba Azimiyan
- Department of Clinical Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Abdollah Moossavi
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Enayatollah Bakhshi
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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8
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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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Baier B, Cuvenhaus HS, Müller N, Birklein F, Dieterich M. The importance of the insular cortex for vestibular and spatial syndromes. Eur J Neurol 2020; 28:1774-1778. [PMID: 33270346 DOI: 10.1111/ene.14660] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/21/2020] [Accepted: 11/25/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE The aim of the study was to identify the neuroanatomical correlates and associations of neuropsychological syndromes after acute unilateral right-hemisphere brain lesions. The neuropsychological syndromes considered were orientation in three-dimensional space such as tilts of the subjective visual vertical or of the subjective haptic vertical, pusher syndrome, visual neglect and unawareness of paresis (anosognosia for hemiparesis). These neuropsychological phenomena have been found to occur separately or in different combinations after lesions to the right insular cortex. METHOD Magnetic resonance imaging scans were obtained from 82 patients with acute right-hemispheric stroke. A lesion-behavior mapping analysis was conducted to specify the neuroanatomical correlates of the above-mentioned neuropsychological syndromes. RESULTS In all analyses of the individual neuropsychological syndromes the insular cortex was affected. CONCLUSIONS Thus, the insular cortex is involved in (self-)perception and orientation within a three-dimensional space. Since isolated lesions of the insular cortex did not induce the above neuropsychological phenomena, there have to be other regions involved.
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Affiliation(s)
- Bernhard Baier
- Edith-Stein-Fachklinik, Bad Bergzabern, Germany.,Department of Neurology, University of Mainz, Mainz, Germany
| | | | - Notger Müller
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
| | - Frank Birklein
- Department of Neurology, University of Mainz, Mainz, Germany
| | - Marianne Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany.,German Center for Vertigo and Balance Disorders-DSGZ, University Hospital, Ludwig-Maximilians-University, Munich, Germany.,SyNergy-Cluster for Systems Neurology, Munich, Germany
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10
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Miller SM. Fluctuations of consciousness, mood, and science: The interhemispheric switch and sticky switch models two decades on. J Comp Neurol 2020; 528:3171-3197. [DOI: 10.1002/cne.24943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Steven M. Miller
- Perceptual and Clinical Neuroscience Laboratory, Department of Physiology Monash Biomedicine Discovery Institute, School of Biomedical Sciences, Monash University Melbourne Victoria Australia
- Monash Alfred Psychiatry Research Centre Central Clinical School, Monash University and Alfred Health Melbourne Victoria Australia
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Abstract
We describe a model of neurological disease based on dysfunctional brain oscillators. This is not a new model, but it is not one that is widely appreciated by clinicians. The value of this model lies in the predictions it makes and the utility it provides in translational applications, in particular for neuromodulation devices. Specifically, we provide a perspective on devices that provide input to sensory receptors and thus stimulate endogenous sensory networks. Current forms of clinically applied neuromodulation, including devices such as (implanted) deep brain stimulators (DBS) and various, noninvasive methods such as transcranial magnetic stimulation (TMS) and transcranial current methods (tACS, tDCS), have been studied extensively. The potential strength of neuromodulation of a sensory organ is access to the same pathways that natural environmental stimuli use and, importantly, the modulatory signal will be transformed as it travels through the brain, allowing the modulation input to be consistent with regional neuronal dynamics. We present specific examples of devices that rely on sensory neuromodulation and evaluate the translational potential of these approaches. We argue that sensory neuromodulation is well suited to, ideally, repair dysfunctional brain oscillators, thus providing a broad therapeutic approach for neurological diseases.
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12
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Keywan A, Badarna H, Jahn K, Wuehr M. No evidence for after-effects of noisy galvanic vestibular stimulation on motion perception. Sci Rep 2020; 10:2545. [PMID: 32054910 PMCID: PMC7018946 DOI: 10.1038/s41598-020-59374-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 01/27/2020] [Indexed: 11/09/2022] Open
Abstract
Noisy galvanic vestibular stimulation (nGVS) delivered at imperceptible intensities can improve vestibular function in health and disease. Here we evaluated whether nGVS effects on vestibular function are only present during active stimulation or may exhibit relevant post-stimulation after-effects. Initially, nGVS amplitudes that optimally improve posture were determined in 13 healthy subjects. Subsequently, effects of optimal nGVS amplitudes on vestibular roll-tilt direction recognition thresholds (DRT) were examined during active and sham nGVS. Ten of 13 subjects exhibited reduced DRTs during active nGVS compared to sham stimulation (p < 0.001). These 10 participants were then administered to 30 mins of active nGVS treatment while being allowed to move freely. Immediately post-treatment , DRTs were increased again (p = 0.044), reverting to baseline threshold levels (i.e. were comparable to the sham nGVS thresholds), and remained stable in a follow-up assessment after 30 min. After three weeks, participants returned for a follow-up experiment to control for learning effects, in which DRTs were measured during and immediately after 30 min application of sham nGVS. DRTs during both assessments did not differ from baseline level. These findings indicate that nGVS does not induce distinct post-stimulation effects on vestibular motion perception and favor the development of a wearable technology that continuously delivers nGVS to patients in order to enhance vestibular function.
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Affiliation(s)
- Aram Keywan
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University of Munich, University Hospital Grosshadern, Munich, Germany.
| | - Hiba Badarna
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University of Munich, University Hospital Grosshadern, Munich, Germany
| | - Klaus Jahn
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University of Munich, University Hospital Grosshadern, Munich, Germany.,Schoen Clinic Bad Aibling, Department of Neurology, Bad Aibling, Germany
| | - Max Wuehr
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University of Munich, University Hospital Grosshadern, Munich, Germany
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13
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Smith L, Gkioka A, Wilkinson D. Vestibular-guided visual search. Exp Brain Res 2020; 238:689-698. [PMID: 32036414 PMCID: PMC7080682 DOI: 10.1007/s00221-020-05741-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/23/2020] [Indexed: 02/05/2023]
Abstract
The amnesic symptoms that accompany vestibular dysfunction point to a functional relationship between the vestibular and visual memory systems. However, little is known about the underpinning cognitive processes. As a starting point, we sought evidence for a type of cross-modal interaction commonly observed between other sensory modalities in which the identification of a target (in this case, visual) is facilitated if earlier coupled to a unique, temporally coincident stimulus from another sensory domain (in this case, vestibular). Participants first performed a visual detection task in which stimuli appeared at random locations within a computerised grid. Unknown to participants, the onset of one particular stimulus was accompanied by a brief, sub-sensory pulse of galvanic vestibular stimulation (GVS). Across two visual search experiments, both old and new targets were identified faster when presented in the grid location at which the GVS-paired visual stimulus had appeared in the earlier detection task. This location advantage appeared to be based on relative rather than absolute spatial co-ordinates since the effect held when the search grid was rotated 90°. Together these findings indicate that when individuals return to a familiar visual scene (here, a 2D grid), visual judgements are facilitated when targets appear at a location previously associated with a unique, task-irrelevant vestibular cue. This novel case of multisensory interplay has broader implications for understanding how vestibular signals inform cognitive processes and helps constrain the growing therapeutic application of GVS.
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Affiliation(s)
- Laura Smith
- School of Psychology, University of Kent, Canterbury, CT2 7NP, UK
| | - Annita Gkioka
- School of Psychology, University of Kent, Canterbury, CT2 7NP, UK
| | - David Wilkinson
- School of Psychology, University of Kent, Canterbury, CT2 7NP, UK.
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14
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Gammeri R, Iacono C, Ricci R, Salatino A. Unilateral Spatial Neglect After Stroke: Current Insights. Neuropsychiatr Dis Treat 2020; 16:131-152. [PMID: 32021206 PMCID: PMC6959493 DOI: 10.2147/ndt.s171461] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 12/24/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Unilateral spatial neglect (USN) is a disorder of contralesional space awareness which often follows unilateral brain lesion. Since USN impairs awareness of contralesional space/body and often of concomitant motor disorders, its presence represents a negative prognostic factor of functional recovery. Thus, the disorder needs to be carefully diagnosed and treated. Here, we attempted to present a clear and concise picture of current insights in the comprehension and rehabilitation of USN. METHODS We first provided an updated overview of USN clinical and neuroanatomical features and then highlighted recent progresses in the diagnosis and rehabilitation of the disease. In relation to USN rehabilitation, we conducted a MEDLINE literature research on three of the most promising interventions for USN rehabilitation: prismatic adaptation (PA), non-invasive brain stimulation (NIBS), and virtual reality (VR). The identified studies were classified according to the strength of their methods. RESULTS The last years have witnessed a relative decrement of interest in the study of neuropsychological disorders of spatial awareness in USN, but a relative increase in the study of potential interventions for its rehabilitation. Although optimal protocols still need to be defined, high-quality studies have demonstrated the efficacy of PA, TMS and tDCS interventions for the treatment of USN. In addition, preliminary investigations are suggesting the potentials of GVS and VR approaches for USN rehabilitation. CONCLUSION Advancing neuropsychological and neuroscience tools to investigate USN pathophysiology is a necessary step to identify effective rehabilitation treatments and to foster our understanding of neurofunctional bases of spatial cognition in the healthy brain.
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Affiliation(s)
- Roberto Gammeri
- Department of Psychology, SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, University of Turin, Turin, Italy
| | - Claudio Iacono
- Department of Psychology, SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, University of Turin, Turin, Italy
| | - Raffaella Ricci
- Department of Psychology, SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, University of Turin, Turin, Italy
- Neuroscience Institute of Turin (NIT), University of Turin, Turin, Italy
| | - Adriana Salatino
- Department of Psychology, SAMBA (SpAtial, Motor and Bodily Awareness) Research Group, University of Turin, Turin, Italy
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15
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Chen A, Khosravi-Hashemi N, Kuo C, Kramer JK, Blouin JS. Development of a conversion model between mechanical and electrical vestibular stimuli. J Neurophysiol 2019; 123:548-559. [PMID: 31851563 DOI: 10.1152/jn.00276.2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The vestibular end-organs encode for linear and angular head accelerations in space contributing to our internal representation of self-motion. Activation of the vestibular system with transmastoid electrical current has recently grown in popularity; however, a direct relationship between electrically evoked and mechanically evoked vestibular responses remains elusive in humans. We have developed and tested a mechanical-to-electrical vestibular stimulus conversion model incorporating physiological activation of primary vestibular afferents identified in nonhuman primates. We compared ocular torsional responses between mechanical (chair rotation) and model-derived electrical (binaural-bipolar) stimuli in separate experiments for an angular velocity step change (±10 deg/s over 1 s, ±4-mA peak amplitude; n = 10) and multisine angular velocities (±10 deg/s, 9.7 mA peak to peak, 0.05-1 Hz; n = 5), respectively. Perception of whole body rotation (n = 18) to our step-change stimuli was also evaluated. Ocular torsional slow-phase velocity responses between stimulation types were similar (paired two one-sided tests of equivalence: multiple P < 0.002; one-sample t test: P = 0.178) and correlated (Pearson's coefficient: multiple P < 0.001). Bootstrap analysis of perceived angular velocity likewise showed similarity in perceptual decay dynamics. These data suggest that central processing between stimuli was similar, and our vestibular stimulus conversion model with a conversion factor of ∼0.4 mA per deg/s for an angular velocity step change can generate electrical stimuli that replicates dynamic vestibular activation elicited by mechanical whole body rotations. This proposed vestibular conversion model represents an initial framework for using electrical stimuli to generate mechanically equivalent activation of primary vestibular afferents for use in biomedical applications and immersive reality technologies.NEW & NOTEWORTHY With the growing popularity of electrical vestibular stimulation in biomedical and immersive reality applications, a direct conversion model between electrical and mechanical vestibular stimuli is needed. We developed a model to generate electrical stimuli mimicking the physiological activation of vestibular afferents evoked by mechanical rotations. Ocular and perceptual responses evoked by mechanical and model-derived electrical stimuli were similar, thus providing a critical first step toward generation of electrically induced vestibular responses that have a realistic mechanical equivalent.
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Affiliation(s)
- A Chen
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - N Khosravi-Hashemi
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
| | - C Kuo
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.,Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | - J K Kramer
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
| | - J-S Blouin
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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16
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Khosravi‐Hashemi N, Forbes PA, Dakin CJ, Blouin J. Virtual signals of head rotation induce gravity‐dependent inferences of linear acceleration. J Physiol 2019; 597:5231-5246. [DOI: 10.1113/jp278642] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
| | - Patrick A. Forbes
- Department of NeuroscienceErasmus MCUniversity Medical Center Rotterdam Rotterdam The Netherlands
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17
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Sukumaran S, Sivadasan S, Sakunthala PT, Tandon V, Sarma SP. "Sequential multimodality stimulation" for post-stroke-hemineglect: Feasibility and outcome in a pilot randomized controlled trial. J Clin Neurosci 2019; 71:108-112. [PMID: 31495658 DOI: 10.1016/j.jocn.2019.08.112] [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: 07/18/2019] [Accepted: 08/25/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To test the feasibility and efficacy of multimodality stimulation combined with motor tasking as a corrective strategy for hemineglect following right hemispheric ischemic strokes. MATERIAL AND METHODS A prospective randomized controlled single blinded clinical trial was conducted over eighteen months from January 2017. All patients with right hemispheric ischemic strokes were screened for hemineglect and those fulfilling criteria were recruited and randomized. Patients under the therapy group (TG) received the intervention based on a structured protocol in addition to standard physiotherapy. The control group (CG) received standard physiotherapy alone. NIHSS, mRS and Neuropsychological test scores were recorded at different time points. The primary outcome measures (neuropsychological test scores) were compared between the two groups (Student's t-test to find out the difference in outcome measures) at one and three months post-stroke. RESULTS Of the 14 patients recruited, data from 12 were available for analysis, 5 patients in TG and 7 in CG. There was a trend for better hemineglect and functional outcomes in TG. CONCLUSION Multimodality stimulation, in addition to standard physiotherapy, is feasible and potentially results in better neurocognitive and functional recovery following right hemispheric ischemic strokes. However, larger studies are warranted to prove these preliminary observations beyond doubt.
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Affiliation(s)
- Sajith Sukumaran
- Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
| | - Sesh Sivadasan
- Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Parthan T Sakunthala
- Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Vaibhav Tandon
- Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Sankara P Sarma
- Department of Biostatistics, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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18
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Paschke K, Bähr M, Wüstenberg T, Wilke M. Trunk rotation and handedness modulate cortical activation in neglect-associated regions during temporal order judgments. NEUROIMAGE-CLINICAL 2019; 23:101898. [PMID: 31491819 PMCID: PMC6627032 DOI: 10.1016/j.nicl.2019.101898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 05/13/2019] [Accepted: 06/13/2019] [Indexed: 12/02/2022]
Abstract
The rotation of the trunk around its vertical midline could be shown to bias visuospatial temporal judgments towards targets in the hemifield ipsilateral to the trunk orientation and to improve visuospatial performance in patients with visual neglect. However, the underlying brain mechanisms are not well understood. Therefore, the goal of the present study was to investigate the neural effects associated with egocentric midplane shifts under consideration of individual handedness. We employed a visuospatial temporal order judgment (TOJ) task in healthy right- and left-handed subjects while their trunk rotation was varied. Participants responded by a saccade towards the stimulus perceived first out of two stimuli presented with different stimulus onset asynchronies (SOA). Apart from gaze behavior, BOLD-fMRI responses were measured using functional magnetic resonance imaging (fMRI). Based on findings from spatial neglect research, analyses of fMRI-BOLD responses were focused on a bilateral fronto-temporo-parietal network comprising Brodmann areas 22, 39, 40, and 44, as well as the basal ganglia core nuclei (caudate, putamen, pallidum). We observed an acceleration of saccadic speed towards stimuli ipsilateral to the trunk orientation modulated by individual handedness. Left-handed participants showed the strongest behavioral and neural effects, suggesting greater susceptibility to manipulations of trunk orientation. With respect to the dominant hand, a rotation around the vertical trunk midline modulated the activation of an ipsilateral network comprising fronto-temporo-parietal regions and the putamen with the strongest effects for saccades towards the hemifield opposite to the dominant hand. Within the investigated network, the temporo-parietal junction (TPJ) appears to serve as a region integrating sensory, motor, and trunk position information. Our results are discussed in the context of gain modulatory and laterality effects. We examined the effect of trunk rotation on brain responses in neglect-associated areas.Trunk-related BOLD-fMRI activation patterns depend on handedness. They were modulated most during trunk rotation contralateral to the dominant hand. Trunk rotation and saccade direction show interaction effects at TPJ. TPJ serves as a region integrating sensory, motor, and trunk position information.
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Affiliation(s)
- Kerstin Paschke
- Department of Cognitive Neurology, University Medicine Göttingen, Robert-Koch-Str. 40, Göttingen 37075, Germany; German Center for Addiction Research in Childhood and Adolescence, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany; Department of Neurology, University Medicine Göttingen, Robert-Koch-Str. 40, Goettingen 37075, Germany.
| | - Mathias Bähr
- Department of Neurology, University Medicine Göttingen, Robert-Koch-Str. 40, Goettingen 37075, Germany; DFG Center for Nanoscale Microscopy & Molecular Physiology of the Brain (CNMPB), Germany
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Charité Campus Mitte, Charitéplatz 1, Berlin 10117, Germany; Systems Neuroscience in Psychiatry (SNiP), Central Institute of Mental Health, Mannheim, J5, Mannheim 68159, Germany
| | - Melanie Wilke
- Department of Cognitive Neurology, University Medicine Göttingen, Robert-Koch-Str. 40, Göttingen 37075, Germany; DFG Center for Nanoscale Microscopy & Molecular Physiology of the Brain (CNMPB), Germany; German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Göttingen 37077, Germany; Leibniz-science campus primate cognition, Germany
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19
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Helmchen C, Rother M, Spliethoff P, Sprenger A. Increased brain responsivity to galvanic vestibular stimulation in bilateral vestibular failure. NEUROIMAGE-CLINICAL 2019; 24:101942. [PMID: 31382239 PMCID: PMC6690736 DOI: 10.1016/j.nicl.2019.101942] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 05/31/2019] [Accepted: 07/17/2019] [Indexed: 01/30/2023]
Abstract
In this event-related functional magnetic resonance imaging (fMRI) study we investigated how the brain of patients with bilateral vestibular failure (BVF) responds to vestibular stimuli. We used imperceptible noisy galvanic vestibular stimulation (GVS) and perceptible bi-mastoidal GVS intensities and related the corresponding brain activity to the evoked motion perception. In contrast to caloric irrigation, GVS stimulates the vestibular organ at its potentially intact afferent nerve site. Motion perception thresholds and cortical responses were compared between 26 BVF patients to 27 age-matched healthy control participants. To identify the specificity of vestibular cortical responses we used a parametric design with different stimulus intensities (noisy imperceptible, low perceptible, high perceptible) allowing region-specific stimulus response functions. In a 2 × 3 flexible factorial design all GVS-related brain activities were contrasted with a sham condition that did not evoke perceived motion. Patients had a higher motion perception threshold and rated the vestibular stimuli higher than the healthy participants. There was a stimulus intensity related and region-specific increase of activity with steep stimulus response functions in parietal operculum (e.g. OP2), insula, superior temporal gyrus, early visual cortices (V3) and cerebellum while activity in the hippocampus and intraparietal sulcus did not correlate with vestibular stimulus intensity. Using whole brain analysis, group comparisons revealed increased brain activity in early visual cortices (V3) and superior temporal gyrus of patients but there was no significant interaction, i.e. stimulus-response function in these regions were still similar in both groups. Brain activity in these regions during (high)GVS increased with higher dizziness-related handicap scores but was not related to the degree of vestibular impairment or disease duration. nGVS did not evoke cortical responses in any group. Our data indicate that perceptible GVS-related cortical responsivity is not diminished but increased in multisensory (visual-vestibular) cortical regions despite bilateral failure of the peripheral vestibular organ. The increased activity in early visual cortices (V3) and superior temporal gyrus of BVF patients has several potential implications: (i) their cortical reciprocal inhibitory visuo-vestibular interaction is dysfunctional, (ii) it may contribute to the visual dependency of BVF patients, and (iii) it needs to be considered when BVF patients receive peripheral vestibular stimulation devices, e.g. vestibular implants or portable GVS devices. Imperceptible nGVS did not elicit cortical brain responses making it unlikely that the reported balance improvement of BVF by nGVS is mediated by cortical mechanisms. Responsivity to galvanic vestibular stimuli is increased in the visual and superior temporal Cortex of patients with bilateral vestibulopathy. Group differences correlated with clinical scores of disability. Dysfunctional visual-vestibular interaction is proposed.
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Affiliation(s)
- Christoph Helmchen
- Department of Neurology, University of Lübeck, University Hospitals Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
| | - Matthias Rother
- Department of Neurology, University of Lübeck, University Hospitals Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Peer Spliethoff
- Department of Neurology, University of Lübeck, University Hospitals Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Andreas Sprenger
- Department of Neurology, University of Lübeck, University Hospitals Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; Institute of Psychology II, University of Luebeck, Germany
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20
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Noisy galvanic vestibular stimulation modulates spatial memory in young healthy adults. Sci Rep 2019; 9:9310. [PMID: 31249334 PMCID: PMC6597709 DOI: 10.1038/s41598-019-45757-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/14/2019] [Indexed: 02/07/2023] Open
Abstract
Hippocampal and striatal circuits play important roles in spatial navigation. These regions integrate environmental information and receive intrinsic afferent inputs from the vestibular system. Past research indicates that galvanic vestibular stimulation (GVS) is a non-invasive technique that modulates hippocampal and striatal activities. There are also evidences for enhanced motor and cognitive functions through GVS. This study extends previous research to investigate whether noisy GVS may improve hippocampal- and striatal-associated aspects of spatial navigation performance. Using a virtual navigation task, we examined effects of noisy GVS on spatial learning and memory. To probe the participants’ sensitivity to hippocampal- or striatal-associated spatial information, we either enlarged the virtual environment’s boundary or replaced an intra-environmental location cue, respectively. Noisy GVS or sham stimulation was applied online during the learning phase in a within-subject crossover design. The results showed that noisy GVS enhanced spatial learning and the sensitivity foremost to hippocampal-dependent spatial information both in males and females. Individual differences in spatial working memory capacity moderated the effects of GVS, with individuals with lower capacity benefitting more from the stimulation. Furthermore, sex-related differences in GVS effects on the two forms of spatial representations may reflect differences between males and females in preferred spatial strategies.
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21
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Kwan A, Forbes PA, Mitchell DE, Blouin JS, Cullen KE. Neural substrates, dynamics and thresholds of galvanic vestibular stimulation in the behaving primate. Nat Commun 2019; 10:1904. [PMID: 31015434 PMCID: PMC6478681 DOI: 10.1038/s41467-019-09738-1] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/21/2019] [Indexed: 11/09/2022] Open
Abstract
Galvanic vestibular stimulation (GVS) uses the external application of electrical current to selectively target the vestibular system in humans. Despite its recent popularity for the assessment/treatment of clinical conditions, exactly how this non-invasive tool activates the vestibular system remains an open question. Here we directly investigate single vestibular afferent responses to GVS applied to the mastoid processes of awake-behaving monkeys. Transmastoid GVS produces robust and parallel activation of both canal and otolith afferents. Notably, afferent activation increases with intrinsic neuronal variability resulting in constant GVS-evoked neuronal detection thresholds across all afferents. Additionally, afferent tuning differs for GVS versus natural self-motion stimulation. Using a stochastic model of repetitive activity in afferents, we largely explain the main features of GVS-evoked vestibular afferent dynamics. Taken together, our results reveal the neural substrate underlying transmastoid GVS-evoked perceptual, ocular and postural responses-information that is essential to advance GVS applicability for biomedical uses in humans.
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Affiliation(s)
- Annie Kwan
- Department of Biomedical Engineering, McGill University, Montreal, QC, H3G 1Y6, Canada
| | - Patrick A Forbes
- Department of Neuroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, 3000 CA, The Netherlands.,Department of BioMechanical Engineering, Delft University of Technology, Delft, 2628 CD, The Netherlands.,School of Kinesiology, University of British Columbia, Vancouver, BC, V6T 1Z1, Canada
| | - Diana E Mitchell
- Department of Physiology, McGill University, Montreal, QC, H3G 1Y6, Canada
| | - Jean-Sébastien Blouin
- School of Kinesiology, University of British Columbia, Vancouver, BC, V6T 1Z1, Canada
| | - Kathleen E Cullen
- Department of Physiology, McGill University, Montreal, QC, H3G 1Y6, Canada. .,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, 21205, MD, USA.
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22
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Karabanov AN, Saturnino GB, Thielscher A, Siebner HR. Can Transcranial Electrical Stimulation Localize Brain Function? Front Psychol 2019; 10:213. [PMID: 30837911 PMCID: PMC6389710 DOI: 10.3389/fpsyg.2019.00213] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/22/2019] [Indexed: 11/13/2022] Open
Abstract
Transcranial electrical stimulation (TES) uses constant (TDCS) or alternating currents (TACS) to modulate brain activity. Most TES studies apply low-intensity currents through scalp electrodes (≤2 mA) using bipolar electrode arrangements, producing weak electrical fields in the brain (<1 V/m). Low-intensity TES has been employed in humans to induce changes in task performance during or after stimulation. In analogy to focal transcranial magnetic stimulation, TES-induced behavioral effects have often been taken as evidence for a causal involvement of the brain region underlying one of the two stimulation electrodes, often referred to as the active electrode. Here, we critically review the utility of bipolar low-intensity TES to localize human brain function. We summarize physiological substrates that constitute peripheral targets for TES and may mediate subliminal or overtly perceived peripheral stimulation during TES. We argue that peripheral co-stimulation may contribute to the behavioral effects of TES and should be controlled for by "sham" TES. We discuss biophysical properties of TES, which need to be considered, if one wishes to make realistic assumptions about which brain regions were preferentially targeted by TES. Using results from electric field calculations, we evaluate the validity of different strategies that have been used for selective spatial targeting. Finally, we comment on the challenge of adjusting the dose of TES considering dose-response relationships between the weak tissue currents and the physiological effects in targeted cortical areas. These considerations call for caution when attributing behavioral effects during or after low-intensity TES studies to a specific brain region and may facilitate the selection of best practices for future TES studies.
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Affiliation(s)
- Anke Ninija Karabanov
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Guilherme Bicalho Saturnino
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Electrical Engineering, Technical University of Denmark, Copenhagen, Denmark
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Electrical Engineering, Technical University of Denmark, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
- Institute for Clinical Medicine, Faculty of Health Sciences and Medicine, University of Copenhagen, Copenhagen, Denmark
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23
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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.
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24
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Balancing body ownership: Visual capture of proprioception and affectivity during vestibular stimulation. Neuropsychologia 2018; 117:311-321. [PMID: 29940194 PMCID: PMC6092558 DOI: 10.1016/j.neuropsychologia.2018.06.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/01/2018] [Accepted: 06/21/2018] [Indexed: 11/23/2022]
Abstract
The experience of our body as our own (i.e. body ownership) involves integrating different sensory signals according to their contextual relevance (i.e. multisensory integration). Until recently, most studies of multisensory integration and body ownership concerned only vision, touch and proprioception; the role of other modalities, such as the vestibular system and interoception, has been neglected and remains poorly understood. In particular, no study to date has directly explored the combined effect of vestibular and interoceptive signals on body ownership. Here, we investigated for the first time how Galvanic Vestibular Stimulation (left, right, sham), tactile affectivity (a reclassified interoceptive modality manipulated by applying touch at C-tactile optimal versus non-optimal velocities), and their combination, influence proprioceptive and subjective measures of body ownership during a rubber hand illusion paradigm with healthy participants (N = 26). Our results show that vestibular stimulation (left GVS) significantly increased proprioceptive drift towards the rubber hand during mere visual exposure to the rubber hand. Moreover, it also enhanced participants’ proprioceptive drift towards the rubber hand during manipulations of synchronicity and affective touch. These findings suggest that the vestibular system influences multisensory integration, possibly by re-weighting both the two-way relationship between proprioception and vision, as well as the three-way relationship between proprioception, vision and affective touch. We discuss these findings in relation to current predictive coding models of multisensory integration and body ownership. We studied vestibular and affective contributions to body ownership. We stimulated the vestibular system in a Rubber Hand paradigm with affective touch. Right-hemisphere stimulation increased proprioceptive drift during vision of a RH. Applying affective touch further increased proprioceptive drift. Affective and vestibular signals may favour vision in multisensory integration.
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25
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Kwon JS. Therapeutic Intervention for Visuo-Spatial Neglect after Stroke: A Meta-Analysis of Randomized Controlled Trials. Osong Public Health Res Perspect 2018; 9:59-65. [PMID: 29740529 PMCID: PMC5935145 DOI: 10.24171/j.phrp.2018.9.2.04] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives The aims of this meta-analysis were to examine intervention methods of qualitatively, well-designed studies from the past 10 years for treating visuo-spatial neglect (VSN) in patients who had suffered a stroke, and to evaluate the combined effects of intervention. Methods Studies published between 2008 and 2017 on the theme of VSN were collected from PubMed, CINAHL, and MEDLINE, representative academic databases and search engines. The PEDro scale was used for evaluating the quality of methodology. The sample size, mean, and standard deviation of identified studies were used for meta-analysis. Results Eight studies were selected for analysis. The PEDro scores of the selected studies were ≥ 7, with 237 subjects analyzed. The results of intervention were classified into “mental function” and “activity and participation” based on the International Classification of Functioning, Disability and Health. The analyzed effect sizes for combined outcomes, mental function and, activity and participation, were 0.728 (medium effect size), 0.850 (large effect size), and 0.536 (medium effect size), respectively. Conclusion Intervention methods for treating VSN had a short-term effect on cognitive function (visual perception). In particular, non-invasive brain stimulation therapy showed a large effect size for VSN treatment.
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Affiliation(s)
- Jae-Sung Kwon
- Department of Occupational Therapy, Cheongju University, Cheongju, Korea
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26
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Non-associative learning processes in vestibular nucleus. Med Biol Eng Comput 2018; 56:1841-1851. [DOI: 10.1007/s11517-018-1817-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 03/13/2018] [Indexed: 11/25/2022]
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Pavlidou A, Ferrè ER, Lopez C. Vestibular stimulation makes people more egocentric. Cortex 2017; 101:302-305. [PMID: 29329639 DOI: 10.1016/j.cortex.2017.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/18/2017] [Accepted: 10/08/2017] [Indexed: 11/18/2022]
Affiliation(s)
| | - Elisa Raffaella Ferrè
- Department of Psychology, Royal Holloway University of London, Egham, United Kingdom
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Single-session transcranial direct current stimulation induces enduring enhancement of visual processing speed in patients with major depression. Eur Arch Psychiatry Clin Neurosci 2017; 267:671-686. [PMID: 28039551 DOI: 10.1007/s00406-016-0761-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 12/13/2016] [Indexed: 01/17/2023]
Abstract
Attentional deficits are considered key cognitive symptoms in major depressive disorder (MDD) arising from abnormal activation patterns within dorsolateral prefrontal cortex (dlPFC) alertness networks. Altering these activity patterns with transcranial direct current stimulation (tDCS) might thus ameliorate alertness-dependent cognitive deficits in MDD patients. In a double-blind, randomized, sham-controlled study, we investigated the effect of a single session of anodal tDCS (2 mA) applied to the left dlPFC on different parameters of visual attention based on Bundesen's theory of visual attention (Psychol Rev 97(4):523-547, 1990) in a group of 20 patients with MDD and a control group of 20 healthy participants. The parametric attention assessment took place before, immediately after and 24 h after tDCS intervention. It revealed a selective impairment in visual processing speed as a primary functional deficit in MDD at baseline assessment. Furthermore, a significant stimulation condition × time point interaction showed that verum tDCS over the left dlPFC resulted in a processing speed enhancement 24 h post-stimulation in MDD patients. In healthy control participants, we did not find similar tDCS-induced effects. Our results suggest that even a single session of tDCS over the dlPFC can induce enduring neurocognitive benefits that indicate an amelioration of cortical under-arousal in MDD patients in a time frame beyond that of immediate, excitability increases that are directly induced by the current.
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Ward BK, Otero-Millan J, Jareonsettasin P, Schubert MC, Roberts DC, Zee DS. Magnetic Vestibular Stimulation (MVS) As a Technique for Understanding the Normal and Diseased Labyrinth. Front Neurol 2017; 8:122. [PMID: 28424657 PMCID: PMC5380677 DOI: 10.3389/fneur.2017.00122] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 03/15/2017] [Indexed: 12/03/2022] Open
Abstract
Humans often experience dizziness and vertigo around strong static magnetic fields such as those present in an MRI scanner. Recent evidence supports the idea that this effect is the result of inner ear vestibular stimulation and that the mechanism is a magnetohydrodynamic force (Lorentz force) that is generated by the interactions between normal ionic currents in the inner ear endolymph and the strong static magnetic field of MRI machines. While in the MRI, the Lorentz force displaces the cupula of the lateral and anterior semicircular canals, as if the head was rotating with a constant acceleration. If a human subject’s eye movements are recorded when they are in darkness in an MRI machine (i.e., without fixation), there is a persistent nystagmus that diminishes but does not completely disappear over time. When the person exits the magnetic field, there is a transient aftereffect (nystagmus beating in the opposite direction) that reflects adaptation that occurred in the MRI. This magnetic vestibular stimulation (MVS) is a useful technique for exploring set-point adaptation, the process by which the brain adapts to a change in its environment, which in this case is vestibular imbalance. Here, we review the mechanism of MVS, how MVS produces a unique stimulus to the labyrinth that allows us to explore set-point adaptation, and how this technique might apply to the understanding and treatment of vestibular and other neurological disorders.
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Affiliation(s)
- Bryan K Ward
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University, Baltimore, MD, USA
| | - Jorge Otero-Millan
- Department of Neurology, The Johns Hopkins University, Baltimore, MD, USA
| | - Prem Jareonsettasin
- Department of Neuroscience, Exeter College, University of Oxford, Oxford, UK
| | - Michael C Schubert
- Department of Neuroscience, Exeter College, University of Oxford, Oxford, UK.,Department of Physical Medicine and Rehabilitation, The Johns Hopkins University, Baltimore, MD, USA
| | - Dale C Roberts
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University, Baltimore, MD, USA.,Department of Neurology, The Johns Hopkins University, Baltimore, MD, USA
| | - David S Zee
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University, Baltimore, MD, USA.,Department of Neurology, The Johns Hopkins University, Baltimore, MD, USA.,Department of Neuroscience, The Johns Hopkins University, Baltimore, MD, USA.,Department of Ophthalmology, The Johns Hopkins University, Baltimore, MD, USA
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31
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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.
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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
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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.
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33
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Miller SM. Vestibular neuromodulation: stimulating the neural crossroads of psychiatric illness. Bipolar Disord 2016; 18:539-543. [PMID: 27628748 DOI: 10.1111/bdi.12427] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 08/06/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Steven M Miller
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred Hospital and School of Psychological Sciences, Monash University, Melbourne, Vic, Australia.
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34
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Jareonsettasin P, Otero-Millan J, Ward BK, Roberts DC, Schubert MC, Zee DS. Multiple Time Courses of Vestibular Set-Point Adaptation Revealed by Sustained Magnetic Field Stimulation of the Labyrinth. Curr Biol 2016; 26:1359-66. [PMID: 27185559 DOI: 10.1016/j.cub.2016.03.066] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 03/24/2016] [Accepted: 03/30/2016] [Indexed: 11/28/2022]
Abstract
A major focus in neurobiology is how the brain adapts its motor behavior to changes in its internal and external environments [1, 2]. Much is known about adaptively optimizing the amplitude and direction of eye and limb movements, for example, but little is known about another essential form of learning, "set-point" adaptation. Set-point adaptation balances tonic activity so that reciprocally acting, agonist and antagonist muscles have a stable platform from which to launch accurate movements. Here, we use the vestibulo-ocular reflex-a simple behavior that stabilizes the position of the eye while the head is moving-to investigate how tonic activity is adapted toward a new set point to prevent eye drift when the head is still [3, 4]. Set-point adaptation was elicited with magneto-hydrodynamic vestibular stimulation (MVS) by placing normal humans in a 7T MRI for 90 min. MVS is ideal for prolonged labyrinthine activation because it mimics constant head acceleration and induces a sustained nystagmus similar to natural vestibular lesions [5, 6]. The MVS-induced nystagmus diminished slowly but incompletely over multiple timescales. We propose a new adaptation hypothesis, using a cascade of imperfect mathematical integrators, that reproduces the response to MVS (and more natural chair rotations), including the gradual decrease in nystagmus as the set point changes over progressively longer time courses. MVS set-point adaptation is a biological model with applications to basic neurophysiological research into all types of movements [7], functional brain imaging [8], and treatment of vestibular and higher-level attentional disorders by introducing new biases to counteract pathological ones [9].
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Affiliation(s)
- Prem Jareonsettasin
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 1TA, UK
| | - Jorge Otero-Millan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Bryan K Ward
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Dale C Roberts
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Michael C Schubert
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - David S Zee
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Straka H, Zwergal A, Cullen KE. Vestibular animal models: contributions to understanding physiology and disease. J Neurol 2016; 263 Suppl 1:S10-23. [PMID: 27083880 PMCID: PMC4833800 DOI: 10.1007/s00415-015-7909-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/11/2015] [Accepted: 09/12/2015] [Indexed: 12/20/2022]
Abstract
Our knowledge of the vestibular sensory system, its functional significance for gaze and posture stabilization, and its capability to ensure accurate spatial orientation perception and spatial navigation has greatly benefitted from experimental approaches using a variety of vertebrate species. This review summarizes the attempts to establish the roles of semicircular canal and otolith endorgans in these functions followed by an overview of the most relevant fields of vestibular research including major findings that have advanced our understanding of how this system exerts its influence on reflexive and cognitive challenges encountered during daily life. In particular, we highlight the contributions of different animal models and the advantage of using a comparative research approach. Cross-species comparisons have established that the morpho-physiological properties underlying vestibular signal processing are evolutionarily inherent, thereby disclosing general principles. Based on the documented success of this approach, we suggest that future research employing a balanced spectrum of standard animal models such as fish/frog, mouse and primate will optimize our progress in understanding vestibular processing in health and disease. Moreover, we propose that this should be further supplemented by research employing more “exotic” species that offer unique experimental access and/or have specific vestibular adaptations due to unusual locomotor capabilities or lifestyles. Taken together this strategy will expedite our understanding of the basic principles underlying vestibular computations to reveal relevant translational aspects. Accordingly, studies employing animal models are indispensible and even mandatory for the development of new treatments, medication and technical aids (implants) for patients with vestibular pathologies.
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Affiliation(s)
- Hans Straka
- Department Biology II, Ludwig-Maximilians-University Munich, Grosshaderner Str. 2, 82152, Planegg, Germany. .,German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University of Munich, Munich, Germany.
| | - Andreas Zwergal
- German Center for Vertigo and Balance Disorders, DSGZ, Ludwig-Maximilians-University of Munich, Munich, Germany.,Department of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Kathleen E Cullen
- Department of Physiology, McGill University, Montreal, QC, H3A 0G4, Canada
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36
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Adel Ghahraman M, Zahmatkesh M, Pourbakht A, Seifi B, Jalaie S, Adeli S, Niknami Z. Noisy galvanic vestibular stimulation enhances spatial memory in cognitive impairment-induced by intracerebroventricular-streptozotocin administration. Physiol Behav 2016; 157:217-24. [PMID: 26892259 DOI: 10.1016/j.physbeh.2016.02.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 01/30/2016] [Accepted: 02/13/2016] [Indexed: 10/22/2022]
Abstract
There are several anatomical connections between vestibular system and brain areas construct spatial memory. Since subliminal noisy galvanic vestibular stimulation (GVS) has been demonstrated to enhance some types of memory, we speculated that application of noisy GVS may improve spatial memory in a rat model of intracerebroventricular streptozotocin (ICV-STZ)-induced cognitive impairment. Moreover, we attempted to determine the effect of repeated exposure to GVS on spatial memory performance. The spatial memory was assessed using Morris water maze test. The groups received 1 (ICV-STZ/GVS-I) or 5 (ICV-STZ/GVS-II) sessions, each lasting 30 min, of low amplitude noisy GVS, or no GVS at all (Control, ICV-saline, ICV-STZ/noGVS). Hippocampal morphological changes investigated with cresyl violet staining and the immediate early gene product c-Fos, as a neuronal activity marker, was measured. Hippocampal c-Fos positive cells increased in both GVS stimulated groups. We observed significantly improved spatial performance only in ICV-STZ/GVS-II group. Histological evaluation showed normal density in ICV-STZ/GVS-II group whereas degeneration observed in ICV-STZ/GVS-I group similar to ICV-STZ/noGVS. The results showed the improvement of memory impairment after repeated exposure to GVS. This effect may be due in part to frequent activation of the vestibular neurons and the hippocampal regions connected to them. Our current study suggests the potential role of GVS as a practical method to combat cognitive decline induced by sporadic Alzheimer disease.
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Affiliation(s)
- Mansoureh Adel Ghahraman
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Zahmatkesh
- Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Akram Pourbakht
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Behjat Seifi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Jalaie
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Adeli
- Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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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
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Besnard S, Lopez C, Brandt T, Denise P, Smith PF. Editorial: The Vestibular System in Cognitive and Memory Processes in Mammalians. Front Integr Neurosci 2015; 9:55. [PMID: 26617498 PMCID: PMC4639622 DOI: 10.3389/fnint.2015.00055] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/19/2015] [Indexed: 12/16/2022] Open
Affiliation(s)
- Stéphane Besnard
- COMETE, Institut National de la Santé et de la Recherche Médicale U1075, Normandy University Caen, France
| | - Christophe Lopez
- Centre National de la Recherche Scientifique, NIA UMR 7260, Aix Marseille Université Marseille, France
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders Munich, Germany
| | - Pierre Denise
- COMETE, Institut National de la Santé et de la Recherche Médicale U1075, Normandy University Caen, France
| | - Paul F Smith
- Department of Pharmacology and Toxicology and the Brain Health Research Centre, University of Otago Medical School Dunedin, New Zealand
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40
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Paschke K, Kagan I, Wüstenberg T, Bähr M, Wilke M. Trunk rotation affects temporal order judgments with direct saccades: Influence of handedness. Neuropsychologia 2015; 79:123-37. [PMID: 26518506 DOI: 10.1016/j.neuropsychologia.2015.10.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/21/2015] [Accepted: 10/25/2015] [Indexed: 10/22/2022]
Abstract
Manipulation of the trunk midline has been shown to improve visuospatial performance in patients with unilateral visual neglect. The goal of the present study was to disentangle motor and perceptual components of egocentric midline manipulations and to investigate the contribution of individual hand preference. Two versions of visual temporal order judgment (TOJ) tasks were tested in healthy right- and left-handed subjects while trunk rotation was varied. In the congruent version, subjects were required to execute a saccade to the first of two horizontal stimuli presented with different stimulus onset asynchronies (SOA). In the incongruent version, subjects were required to perform a vertical saccade to a pre-learned color target, thereby dissociating motor response from the perceptual stimulus location. The main findings of this study are a trunk rotation and response direction specific impact on temporal judgments in form of a prior entry bias for right hemifield stimuli during rightward trunk rotation, but only in the congruent task. This trunk rotation-induced spatial bias was most pronounced in left-handed participants but had the same sign in the right-handed group. Results suggest that egocentric midline shifts in healthy subjects induce a spatially-specific motor, but not a perceptual, bias and underline the importance of taking individual differences in functional laterality such as handedness and mode of perceptual report into account when evaluating effects of trunk rotation in either healthy subjects or neurological patients.
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Affiliation(s)
- Kerstin Paschke
- Department of Cognitive Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; Department of Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany; Department of Child and Adolescent Psychiatry, University Medicine Goettingen, von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - Igor Kagan
- Department of Cognitive Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, 37077 Goettingen, Germany
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany
| | - Mathias Bähr
- Department of Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; DFG Center for Nanoscale Microscopy & Molecular Physiology of the Brain (CNMPB), Germany
| | - Melanie Wilke
- Department of Cognitive Neurology, University Medicine Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany; German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, 37077 Goettingen, Germany; DFG Center for Nanoscale Microscopy & Molecular Physiology of the Brain (CNMPB), Germany.
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Patel M, Roberts RE, Arshad Q, Ahmed M, Riyaz MU, Bronstein AM. Galvanic Vestibular Stimulation Induces a Spatial Bias in Whole-body Position Estimates. Brain Stimul 2015; 8:981-3. [PMID: 26271154 DOI: 10.1016/j.brs.2015.07.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 07/16/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mitesh Patel
- Academic Department of Neuro-otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, Fulham Palace Road, London W6 8RF, UK
| | - R Edward Roberts
- Academic Department of Neuro-otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, Fulham Palace Road, London W6 8RF, UK
| | - Qadeer Arshad
- Academic Department of Neuro-otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, Fulham Palace Road, London W6 8RF, UK.
| | - Maroof Ahmed
- Academic Department of Neuro-otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, Fulham Palace Road, London W6 8RF, UK
| | - Mohammed U Riyaz
- Academic Department of Neuro-otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, Fulham Palace Road, London W6 8RF, UK
| | - Adolfo M Bronstein
- Academic Department of Neuro-otology, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, Fulham Palace Road, London W6 8RF, UK
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42
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Subliminal galvanic-vestibular stimulation recalibrates the distorted visual and tactile subjective vertical in right-sided stroke. Neuropsychologia 2015; 74:178-83. [DOI: 10.1016/j.neuropsychologia.2015.03.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 02/28/2015] [Accepted: 03/02/2015] [Indexed: 11/20/2022]
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43
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Subliminal galvanic-vestibular stimulation influences ego- and object-centred components of visual neglect. Neuropsychologia 2015; 74:170-7. [DOI: 10.1016/j.neuropsychologia.2014.10.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/29/2014] [Accepted: 10/31/2014] [Indexed: 11/22/2022]
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44
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Clarke S, Bindschaedler C, Crottaz-Herbette S. Impact of Cognitive Neuroscience on Stroke Rehabilitation. Stroke 2015; 46:1408-13. [DOI: 10.1161/strokeaha.115.007435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/11/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Stephanie Clarke
- From the Service de Neuropsychologie et de Neuroréhabilitation, CHUV, Lausanne, Switzerland
| | - Claire Bindschaedler
- From the Service de Neuropsychologie et de Neuroréhabilitation, CHUV, Lausanne, Switzerland
| | - Sonia Crottaz-Herbette
- From the Service de Neuropsychologie et de Neuroréhabilitation, CHUV, Lausanne, Switzerland
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Does galvanic vestibular stimulation reduce spatial neglect? A negative study. Ann Phys Rehabil Med 2014; 57:570-7. [DOI: 10.1016/j.rehab.2014.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 09/21/2014] [Accepted: 09/21/2014] [Indexed: 11/22/2022]
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Volkening K, Bergmann J, Keller I, Wuehr M, Müller F, Jahn K. Verticality perception during and after galvanic vestibular stimulation. Neurosci Lett 2014; 581:75-9. [DOI: 10.1016/j.neulet.2014.08.028] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 08/11/2014] [Accepted: 08/15/2014] [Indexed: 11/28/2022]
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