Electrical Vestibular Stimulation in Humans: A Narrative Review.
Electrical stimulation
Galvanic vestibular stimulation
Humans
Vestibular co-stimulation
Vestibular implant
Journal
Audiology & neuro-otology
ISSN: 1421-9700
Titre abrégé: Audiol Neurootol
Pays: Switzerland
ID NLM: 9606930
Informations de publication
Date de publication:
2020
2020
Historique:
received:
31
05
2019
accepted:
29
07
2019
pubmed:
19
9
2019
medline:
9
9
2020
entrez:
19
9
2019
Statut:
ppublish
Résumé
In patients with bilateral vestibulopathy, the regular treatment options, such as medication, surgery, and/or vestibular rehabilitation, do not always suffice. Therefore, the focus in this field of vestibular research shifted to electrical vestibular stimulation (EVS) and the development of a system capable of artificially restoring the vestibular function. Key Message: Currently, three approaches are being investigated: vestibular co-stimulation with a cochlear implant (CI), EVS with a vestibular implant (VI), and galvanic vestibular stimulation (GVS). All three applications show promising results but due to conceptual differences and the experimental state, a consensus on which application is the most ideal for which type of patient is still missing. Vestibular co-stimulation with a CI is based on "spread of excitation," which is a phenomenon that occurs when the currents from the CI spread to the surrounding structures and stimulate them. It has been shown that CI activation can indeed result in stimulation of the vestibular structures. Therefore, the question was raised whether vestibular co-stimulation can be functionally used in patients with bilateral vestibulopathy. A more direct vestibular stimulation method can be accomplished by implantation and activation of a VI. The concept of the VI is based on the technology and principles of the CI. Different VI prototypes are currently being evaluated regarding feasibility and functionality. So far, all of them were capable of activating different types of vestibular reflexes. A third stimulation method is GVS, which requires the use of surface electrodes instead of an implanted electrode array. However, as the currents are sent through the skull from one mastoid to the other, GVS is rather unspecific. It should be mentioned though, that the reported spread of excitation in both CI and VI use also seems to induce a more unspecific stimulation. Although all three applications of EVS were shown to be effective, it has yet to be defined which option is more desirable based on applicability and efficiency. It is possible and even likely that there is a place for all three approaches, given the diversity of the patient population who serves to gain from such technologies.
Sections du résumé
BACKGROUND
In patients with bilateral vestibulopathy, the regular treatment options, such as medication, surgery, and/or vestibular rehabilitation, do not always suffice. Therefore, the focus in this field of vestibular research shifted to electrical vestibular stimulation (EVS) and the development of a system capable of artificially restoring the vestibular function. Key Message: Currently, three approaches are being investigated: vestibular co-stimulation with a cochlear implant (CI), EVS with a vestibular implant (VI), and galvanic vestibular stimulation (GVS). All three applications show promising results but due to conceptual differences and the experimental state, a consensus on which application is the most ideal for which type of patient is still missing.
SUMMARY
Vestibular co-stimulation with a CI is based on "spread of excitation," which is a phenomenon that occurs when the currents from the CI spread to the surrounding structures and stimulate them. It has been shown that CI activation can indeed result in stimulation of the vestibular structures. Therefore, the question was raised whether vestibular co-stimulation can be functionally used in patients with bilateral vestibulopathy. A more direct vestibular stimulation method can be accomplished by implantation and activation of a VI. The concept of the VI is based on the technology and principles of the CI. Different VI prototypes are currently being evaluated regarding feasibility and functionality. So far, all of them were capable of activating different types of vestibular reflexes. A third stimulation method is GVS, which requires the use of surface electrodes instead of an implanted electrode array. However, as the currents are sent through the skull from one mastoid to the other, GVS is rather unspecific. It should be mentioned though, that the reported spread of excitation in both CI and VI use also seems to induce a more unspecific stimulation. Although all three applications of EVS were shown to be effective, it has yet to be defined which option is more desirable based on applicability and efficiency. It is possible and even likely that there is a place for all three approaches, given the diversity of the patient population who serves to gain from such technologies.
Identifiants
pubmed: 31533097
pii: 000502407
doi: 10.1159/000502407
pmc: PMC7050666
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
6-24Informations de copyright
© 2019 The Author(s) Published by S. Karger AG, Basel.
Références
Otol Neurotol. 2009 Aug;30(5):586-91
pubmed: 19574943
Acta Otolaryngol. 1972 Sep;74(3):155-62
pubmed: 5080248
Exp Brain Res. 2005 Jul;164(3):271-85
pubmed: 15991028
Front Bioeng Biotechnol. 2016 Apr 20;4:34
pubmed: 27148528
Front Syst Neurosci. 2015 Aug 24;9:117
pubmed: 26347619
IEEE Trans Biomed Eng. 2001 Oct;48(10):1153-61
pubmed: 11585039
Exp Brain Res. 2000 Apr;131(4):406-15
pubmed: 10803410
Laryngoscope. 2005 Jan;115(1 Pt 2 Suppl 106):1-26
pubmed: 15626926
J Neurosci Methods. 2018 Jan 15;294:116-121
pubmed: 29170018
IEEE Trans Biomed Eng. 2012 Jul;59(7):1978-84
pubmed: 22531740
J Neurosci. 2016 Aug 31;36(35):9097-110
pubmed: 27581452
Audiol Neurootol. 2008;13(3):187-92
pubmed: 18212494
Front Neurol. 2017 Aug 17;8:404
pubmed: 28861034
Auris Nasus Larynx. 2014 Oct;41(5):432-5
pubmed: 24882586
Front Neurol. 2012 Feb 20;3:18
pubmed: 22363317
Physiol Res. 1994;43(3):187-92
pubmed: 7993887
Exp Brain Res. 2013 Aug;229(2):181-95
pubmed: 23771587
Exp Brain Res. 2002 Dec;147(3):407-17
pubmed: 12428148
Arch Intern Med. 2009 May 25;169(10):938-44
pubmed: 19468085
Auris Nasus Larynx. 2019 Feb;46(1):50-57
pubmed: 29935892
Front Neurol. 2014 Apr 29;5:66
pubmed: 24808890
Otol Neurotol. 2004 Sep;25(5):746-51
pubmed: 15354006
Acta Otolaryngol. 1994 May;114(3):225-30
pubmed: 8073855
J Neurophysiol. 2002 Apr;87(4):2064-73
pubmed: 11929924
Auris Nasus Larynx. 2004 Sep;31(3):220-5
pubmed: 15364355
Brain Inj. 2009 Sep;23(10):841-5
pubmed: 19697173
J Neurosci. 1994 Mar;14(3 Pt 1):1290-308
pubmed: 8120625
Exp Brain Res. 2012 May;218(3):389-400
pubmed: 22349559
J Neurophysiol. 1971 Jul;34(4):661-75
pubmed: 5000363
Ann N Y Acad Sci. 2009 May;1164:505-8
pubmed: 19645958
Physiother Res Int. 2012 Mar;17(1):4-11
pubmed: 21207506
Hear Res. 2005 Jun;204(1-2):111-4
pubmed: 15925196
Ann Otol Rhinol Laryngol. 2011 Feb;120(2):81-7
pubmed: 21391418
J Otolaryngol Head Neck Surg. 2016 Jun 14;45(1):38
pubmed: 27301263
J Assoc Res Otolaryngol. 2010 Sep;11(3):367-81
pubmed: 20177732
Am J Otol. 1997 May;18(3):336-41
pubmed: 9149828
J Neurophysiol. 2015 Jun 1;113(10):3866-92
pubmed: 25652917
Pract Otorhinolaryngol (Basel). 1963;25:345-8
pubmed: 14059772
Acta Otolaryngol. 1971 Apr;71(4):313-8
pubmed: 5574307
Laryngoscope. 2006 Oct;116(10):1787-91
pubmed: 17003731
Clin Neurophysiol. 2015 Aug;126(8):1624-31
pubmed: 25511635
Ann Otol Rhinol Laryngol. 1964 Mar;73:153-69
pubmed: 14128701
J Neurol. 2016 Apr;263 Suppl 1:S30-5
pubmed: 27083882
J Neurol Neurosurg Psychiatry. 2008 Mar;79(3):284-8
pubmed: 17635972
Brain Res. 1971 Dec 24;35(2):469-90
pubmed: 5135545
Brain Stimul. 2018 Jul - Aug;11(4):709-715
pubmed: 29563049
Front Neurosci. 2016 Dec 22;10:577
pubmed: 28066163
IEEE Trans Biomed Circuits Syst. 2014 Aug;8(4):474-84
pubmed: 25073124
J Physiol. 2007 Sep 15;583(Pt 3):1117-27
pubmed: 17640935
Front Neurosci. 2017 Nov 21;11:645
pubmed: 29209162
Front Neurol. 2016 Mar 04;7:26
pubmed: 26973594
J Vestib Res. 2015;25(3-4):185-94
pubmed: 26756134
Clin Neurophysiol. 2004 Feb;115(2):267-81
pubmed: 14744566
Ann Otol Rhinol Laryngol. 1968 Oct;77(5):959-70
pubmed: 5693022
Arch Otolaryngol Head Neck Surg. 2006 Apr;132(4):398-404
pubmed: 16618909
Front Neurol. 2011 Aug 11;2:47
pubmed: 21991260
Front Integr Neurosci. 2016 Sep 13;10:32
pubmed: 27679562
J Vestib Res. 2017;27(4):177-189
pubmed: 29081426
Neurosci Res. 2011 Dec;71(4):315-27
pubmed: 21968226
Int J Pediatr Otorhinolaryngol. 2017 Sep;100:18-22
pubmed: 28802368
Acta Otolaryngol. 1985 Jan-Feb;99(1-2):107-12
pubmed: 3872005
Otol Neurotol. 2015 Jul;36(6):1029-34
pubmed: 25853610
Arch Otolaryngol Head Neck Surg. 2003 Aug;129(8):819-24
pubmed: 12925338
Hear Res. 2012 May;287(1-2):51-6
pubmed: 22504025
Int J Pediatr Otorhinolaryngol. 2016 Sep;88:30-3
pubmed: 27497382
Brain Stimul. 2018 Mar - Apr;11(2):261-263
pubmed: 29100928
Otolaryngol Head Neck Surg. 1998 Jun;118(6):900-2
pubmed: 9627263
Laryngoscope. 2001 Oct;111(10):1812-7
pubmed: 11801950
Sci Rep. 2016 Nov 21;6:37575
pubmed: 27869225
Front Neurosci. 2018 May 15;12:88
pubmed: 29867306
Acta Otorhinolaryngol Ital. 2011 Feb;31(1):11-6
pubmed: 21808458
Ann Otol Rhinol Laryngol. 2011 Mar;120(3):143-9
pubmed: 21510138
J Neurophysiol. 1984 Jun;51(6):1236-56
pubmed: 6737029
J Int Adv Otol. 2017 Aug;13(2):154-161
pubmed: 28816686
Laryngoscope. 2005 Jun;115(6):977-82
pubmed: 15933504
Brain Stimul. 2016 Jan-Feb;9(1):109-16
pubmed: 26422129
IEEE Trans Biomed Eng. 2002 Feb;49(2):175-81
pubmed: 12066886
ORL J Otorhinolaryngol Relat Spec. 2015 Sep 15;77(4):227-240
pubmed: 26367113
Sci Rep. 2018 Jan 10;8(1):336
pubmed: 29321511
Gait Posture. 2003 Oct;18(2):64-72
pubmed: 14654209
Scand J Rehabil Med. 1995 Jun;27(2):99-104
pubmed: 7569827
J Neurophysiol. 1966 Nov;29(6):996-1010
pubmed: 5971666
Exp Neurol. 1964 Feb;9:137-60
pubmed: 14126123
Cochlear Implants Int. 2010 Sep;11 Suppl 2:2-11
pubmed: 21756683
PLoS One. 2015 Aug 21;10(8):e0136335
pubmed: 26295807
Conf Proc IEEE Eng Med Biol Soc. 2015;2015:7192-5
pubmed: 26737951
Front Neurol. 2018 Mar 01;9:83
pubmed: 29545766
J Physiol. 1994 Jul 15;478 ( Pt 2):363-72
pubmed: 7965852
Am J Otol. 2000 Nov;21(6):847-51
pubmed: 11078074
Exp Brain Res. 2001 Sep;140(1):1-11
pubmed: 11500792
Front Neurol. 2017 Mar 30;8:117
pubmed: 28424655
J Assoc Res Otolaryngol. 2013 Dec;14(6):863-77
pubmed: 24013822
Am J Otol. 1998 Mar;19(2):163-9
pubmed: 9520052
Front Syst Neurosci. 2015 Jan 20;8:255
pubmed: 25653601
Neurology. 2016 Jun 7;86(23):2196-202
pubmed: 27164706
J Neural Eng. 2016 Aug;13(4):046023
pubmed: 27396631
Exp Brain Res. 2011 May;210(3-4):561-8
pubmed: 21287152
Laryngoscope. 2012 Dec;122 Suppl 4:S101-2
pubmed: 23254598
J Neurophysiol. 2006 Aug;96(2):925-30
pubmed: 16641374
J Neurophysiol. 2016 Dec 1;116(6):2777-2788
pubmed: 27760820
Auris Nasus Larynx. 2003 Dec;30(4):341-8
pubmed: 14656558
Exp Brain Res. 2011 Apr;210(2):303-12
pubmed: 21442221
Conf Proc IEEE Eng Med Biol Soc. 2010;2010:6247
pubmed: 21097347
Acta Otolaryngol. 1969 Oct;68(4):350-62
pubmed: 5309166
AJNR Am J Neuroradiol. 1996 Jun-Jul;17(6):1099-105
pubmed: 8791922
J Neurosci. 1991 Jun;11(6):1636-48
pubmed: 2045879
Laryngoscope. 2017 Feb;127(2):E75-E81
pubmed: 27291637
IEEE Trans Biomed Eng. 2013 Jun;60(6):1685-92
pubmed: 23358943
Arch Otolaryngol Head Neck Surg. 2008 Jan;134(1):34-8
pubmed: 18209133
Brain Res Bull. 2004 Sep 30;64(3):265-71
pubmed: 15464864
Ann Otol Rhinol Laryngol Suppl. 1982 Mar-Apr;91(2 Pt 3):47-54
pubmed: 6805397
J Am Acad Audiol. 2000 Feb;11(2):76-83
pubmed: 10685673
Otol Neurotol. 2011 Jan;32(1):88-97
pubmed: 21192375
Acta Otolaryngol. 2008 Mar;128(3):284-90
pubmed: 18274914
Brain Res. 1972 Aug 25;43(2):383-96
pubmed: 4340832
Laryngoscope. 2004 Oct;114(10 Pt 2 Suppl 103):1-22
pubmed: 15454752
Int J Pediatr Otorhinolaryngol. 2007 Apr;71(4):629-37
pubmed: 17275927
J Neurophysiol. 2010 Feb;103(2):1066-79
pubmed: 20018838
Front Neurol. 2017 Nov 03;8:587
pubmed: 29163348
Front Neurol. 2017 Dec 14;8:644
pubmed: 29312107
Otolaryngol Head Neck Surg. 1993 Oct;109(4):735-41
pubmed: 8233513
J Vestib Res. 2002-2003;12(2-3):87-94
pubmed: 12867667
Neurology. 2014 Mar 18;82(11):969-75
pubmed: 24532279
Cochlear Implants Int. 2014 May;15 Suppl 1:S62-4
pubmed: 24869447
Ann Otol Rhinol Laryngol. 2007 May;116(5):369-74
pubmed: 17561766
Laryngoscope. 1998 Feb;108(2):291-4
pubmed: 9473085
Otol Neurotol. 2012 Apr;33(3):335-42
pubmed: 22334157
Front Physiol. 2018 Mar 29;9:301
pubmed: 29651250
J Vestib Res. 2017;27(1):51-61
pubmed: 28387690
Hear Res. 2017 Jul;350:235-243
pubmed: 28323018
Conf Proc IEEE Eng Med Biol Soc. 2011;2011:2262-4
pubmed: 22254791
Otol Neurotol. 2012 Jul;33(5):789-96
pubmed: 22699989
Exp Brain Res. 2006 Jun;172(2):208-20
pubmed: 16432695
Ann Otol Rhinol Laryngol. 1969 Aug;78(4):815-26
pubmed: 4979119
Otol Neurotol. 2005 May;26(3):500-11
pubmed: 15891657
Otol Neurotol. 2014 Jan;35(1):136-47
pubmed: 24317220
J Neurol. 2017 Oct;264(Suppl 1):81-86
pubmed: 28391373
Otol Neurotol. 2017 Apr;38(4):484-486
pubmed: 28187057
Front Neurol. 2017 Nov 14;8:600
pubmed: 29184530