Vestibular Implants: 8 Years of Experience with Electrical Stimulation of the Vestibular Nerve in 11 Patients with Bilateral Vestibular Loss

ORL ◽  
2015 ◽  
Vol 77 (4) ◽  
pp. 227-240 ◽  
Author(s):  
Nils Guinand ◽  
Raymond van de Berg ◽  
Samuel Cavuscens ◽  
Robert J. Stokroos ◽  
Maurizio Ranieri ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Vestibular Nerve ◽  
Years Of Experience ◽  
Vestibular Loss ◽  
Bilateral Vestibular Loss ◽  
Stimulation Of

scholarly journals Chronic Electrical Stimulation of the Otolith Organ: Preliminary Results in Humans with Bilateral Vestibulopathy and Sensorineural Hearing Loss

2019 ◽  
Vol 25 (Suppl. 1-2) ◽  
pp. 79-90 ◽  
Author(s):  
Angel Ramos Macias ◽  
Angel Ramos de Miguel ◽  
Isaura Rodriguez Montesdeoca ◽  
Silvia Borkoski Barreiro ◽  
Juan Carlos Falcón González
Keyword(s):  
Electrical Stimulation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Clinical Test ◽  
Otolith Organ ◽  
Bilateral Vestibulopathy ◽  
Vestibular Loss ◽  
Bilateral Vestibular Loss ◽  
Chronic Electrical Stimulation ◽  
Stimulation Of

Introduction: Bilateral vestibulopathy is an important cause of imbalance that is misdiagnosed. The clinical management of patients with bilateral vestibular loss remains difficult as there is no clear evidence for an effective treatment. In this paper, we try to analyze the effect of chronic electrical stimulation and adaptation to electrical stimulation of the vestibular system in humans when stimulating the otolith organ with a constant pulse train to mitigate imbalance due to bilateral vestibular dysfunction (BVD). Methods: We included 2 patients in our study with BVD according to Criteria Consensus of the Classification Committee of the Bárány Society. Both cases were implanted by using a full-band straight electrode to stimulate the otoliths organs and simultaneously for the cochlear stimulation we use a perimodiolar electrode. Results: In both cases Vestibular and clinical test (video head impulse test, videonistagmography cervical vestibular evoked myogenic potentials, cVEMP and oVEMP), subjective visual vertical test, computerized dynamic posturography, dynamic gait index, Time UP and Go test and dizziness handicap index) were performed. Posture and gait metrics reveal important improvement if compare with preoperartive situation. Oscillopsia, unsteadiness, independence and quality of life improved to almost normal situation. Discussion/Conclusion: Prosthetic implantation of the otolith organ in humans is technically feasible. Electrical stimulation might have potential effects on balance and this is stable after 1 year follow-up. This research provides new possibilities for the development of vestibular implants to improve gravito-inertial acceleration sensation, in this case by the otoliths stimulation.

scholarly journals Vestibular implantation and longitudinal electrical stimulation of the semicircular canal afferents in human subjects

2015 ◽  
Vol 113 (10) ◽  
pp. 3866-3892 ◽  
Author(s):  
James O. Phillips ◽  
Leo Ling ◽  
Kaibao Nie ◽  
Elyse Jameyson ◽  
Christopher M. Phillips ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Eye Movements ◽  
Human Subjects ◽  
Vestibular Function ◽  
Slow Phase ◽  
Vestibular Loss ◽  
Stimulation Current ◽  
Eye Velocity ◽  
Over Time ◽  
Stimulation Of

Animal experiments and limited data in humans suggest that electrical stimulation of the vestibular end organs could be used to treat loss of vestibular function. In this paper we demonstrate that canal-specific two-dimensionally (2D) measured eye velocities are elicited from intermittent brief 2 s biphasic pulse electrical stimulation in four human subjects implanted with a vestibular prosthesis. The 2D measured direction of the slow phase eye movements changed with the canal stimulated. Increasing pulse current over a 0–400 μA range typically produced a monotonic increase in slow phase eye velocity. The responses decremented or in some cases fluctuated over time in most implanted canals but could be partially restored by changing the return path of the stimulation current. Implantation of the device in Meniere's patients produced hearing and vestibular loss in the implanted ear. Electrical stimulation was well tolerated, producing no sensation of pain, nausea, or auditory percept with stimulation that elicited robust eye movements. There were changes in slow phase eye velocity with current and over time, and changes in electrically evoked compound action potentials produced by stimulation and recorded with the implanted device. Perceived rotation in subjects was consistent with the slow phase eye movements in direction and scaled with stimulation current in magnitude. These results suggest that electrical stimulation of the vestibular end organ in human subjects provided controlled vestibular inputs over time, but in Meniere's patients this apparently came at the cost of hearing and vestibular function in the implanted ear.

Activation of the thalamic parafascicular nucleus by electrical stimulation of the peripheral vestibular nerve in rats

2017 ◽  
Vol 235 (5) ◽  
pp. 1617-1625 ◽  
Author(s):  
Nari Kim ◽  
Myoung Ae Choi ◽  
Ho Koo ◽  
Byung Rim Park ◽  
Sang Who Han ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Vestibular Nerve ◽  
Parafascicular Nucleus ◽  
Stimulation Of

Excitatory and Inhibitory Vestibular Pathways to the Extraocular Motor Nuclei in Goldfish

1997 ◽  
Vol 77 (5) ◽  
pp. 2765-2779 ◽  
Author(s):  
Werner Graf ◽  
Robert Spencer ◽  
Harriet Baker ◽  
Robert Baker
Keyword(s):  
Electrical Stimulation ◽  
Gap Junctions ◽  
Synaptic Vesicles ◽  
Postsynaptic Membrane ◽  
Chloride Ions ◽  
Vestibular Nerve ◽  
Postsynaptic Potentials ◽  
Motor Nuclei ◽  
Vestibular Pathways ◽  
Stimulation Of

Graf, Werner, Robert Spencer, Harriet Baker, and Robert Baker. Excitatory and inhibitory vestibular pathways to the extraocular motor nuclei in goldfish. J. Neurophysiol. 77: 2765–2779, 1997. Electrophysiological, ultrastructural, and immunohistochemical techniques were utilized to describe the excitatory and inhibitory vestibular innervation of extraocular motor nuclei in the goldfish. In antidromically activated oculomotor motoneurons, electrical stimulation of the intact contralateral vestibular nerve produced short-latency, variable amplitude electrotonic excitatory postsynaptic potentials (EPSPs) at 0.5–0.7 ms followed by chemical EPSPs at 1.0–1.3 ms. Stimulation of the ipsilateral vestibular nerve produced small amplitude membrane hyperpolarizations at a latency of 1.3–1.7 ms in which equilibrium potentials were slightly more negative than resting potentials. The inhibitory postsynaptic potentials (IPSPs) reversed with large amplitudes after the injection of chloride ions suggesting a proximal soma-dendritic location of terminals exhibiting high efficacy inhibitory synaptic conductances. In antidromically identified abducens motoneurons and putative internuclear neurons, electrical stimulation of the contralateral vestibular nerve produced large-amplitude, short-latency electrotonic EPSPs at 0.5 ms followed by chemical depolarizations at 1.2–1.3 ms. Stimulation of the ipsilateral vestibular nerve evoked IPSPs at 1.4 ms that were reversed after injection of current and/or chloride ions. γ-Aminobutyric acid (GABA) antibodies labeled inhibitory neurons in vestibular subdivisions with axons projecting into the ipsilateral medial longitudinal fasciculus (MLF). Putative GABAergic terminals surrounded oculomotor, but not abducens, motoneurons retrogradely labeled with horseradish peroxidase. Hence the spatial distribution of GABAergic neurons and terminals appears highly similar in the vestibuloocular system of goldfish and mammals. Electron microscopy of motoneurons in the oculomotor and abducens nucleus showed axosomatic and axodendritic synaptic endings containing spheroidal synaptic vesicles establishing chemical, presumed excitatory, synaptic contacts with asymmetric pre- and/or postsynaptic membrane specializations. The majority of contacts with spheroidal vesicles displayed gap junctions in which the chemical and electrotonic synapses were either en face to dissimilar or adjacent to one another on the same soma/dendritic profiles. Another separate set of axosomatic synaptic endings, presumed to be inhibitory, contained pleiomorphic synaptic vesicles with symmetric pre- and/or postsynaptic membrane specializations that never included gap junctions. Excitatory and inhibitory synaptic contacts appeared equal in number but were more sparsely distributed along the soma-dendritic profiles of oculomotor as compared with abducens motoneurons. Collectively these data provide evidence for both disynaptic vestibular inhibition and excitation in all subdivisions of the extraocular motor nuclei suggesting the basic vestibulooculomotor blueprint to be conserved among vertebrates. We propose that unique vestibular neurons, transmitters, pathways, and synaptic arborizations are homologous structural traits that have been essentially preserved throughout vertebrate phylogeny by a shared developmental plan.

scholarly journals Responses of vestibular nucleus neurons to inputs from the hindlimb are enhanced following a bilateral labyrinthectomy

2013 ◽  
Vol 114 (6) ◽  
pp. 742-751 ◽  
Author(s):  
Andrew A. McCall ◽  
Jennifer D. Moy ◽  
Sonya R. Puterbaugh ◽  
William M. DeMayo ◽  
Bill J. Yates
Keyword(s):  
Nerve Stimulation ◽  
Vestibular Nucleus ◽  
Muscle Spindles ◽  
Vestibular Nuclei ◽  
Vestibular Loss ◽  
Median Response ◽  
Golgi Tendon Organs ◽  
Bilateral Vestibular Loss ◽  
Median Response Latency ◽  
Stimulation Of

Vestibular nucleus neurons have been shown to respond to stimulation of afferents innervating the limbs. However, a limitation in the potential translation of these findings is that they were obtained from decerebrate or anesthetized animals. The goal of the present study was to determine whether stimulation of hindlimb nerves similarly affects vestibular nucleus neuronal activity in conscious cats, and whether the responsiveness of neurons to the stimuli is altered following a bilateral labyrinthectomy. In labyrinth-intact animals, the firing rate of 24/59 (41%) of the neurons in the caudal vestibular nucleus complex was affected by hindlimb nerve stimulation. Most responses were excitatory; the median response latency was 20 ms, but some units had response latencies as short as 10 ms. In the first week after a bilateral labyrinthectomy, the proportion of vestibular nucleus neurons that responded to hindlimb nerve stimulation increased slightly (to 24/55 or 44% of units). However, during the subsequent postlabyrinthectomy survival period, the proportion of vestibular nucleus neurons with hindlimb inputs increased significantly (to 30/49 or 61% of units). Stimuli to hindlimb nerves needed to elicit neuronal responses was consistently over three times the threshold for eliciting an afferent volley. These data show that inputs from hindlimb afferents smaller than those innervating muscle spindles and Golgi tendon organs affect the processing of information in the vestibular nuclei, and that these inputs are enhanced following a bilateral labyrinthectomy. These findings have implications for the development of a limb neuroprosthetics device for the management of bilateral vestibular loss.

Sign in / Sign up

Export Citation Format

Share Document