Noisy galvanic vestibular stimulation improves vestibular perception in bilateral vestibulopathy

Max Wuehr, Josefine Eder, Aram Keywan, Klaus Jahn

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with bilateral vestibulopathy (BVP) suffer from impaired vestibular motion perception that is linked to deficits in spatial memory and navigation. Objective: To examine the potential therapeutic effect of imperceptible noisy galvanic vestibular stimulation (nGVS) on impaired vestibular perceptual performance in BVP. Methods: In 11 patients with BVP (mean age: 54.0 ± 8.3 years, 7 females), we initially determined the nGVS intensity that optimally stabilizes balance during a static posturographic assessment. Subsequently, effects of optimal nGVS vs. sham stimulation on vestibular motion perception were examined in randomized order. Vestibular perceptual performance was determined as direction recognition thresholds for head-centered roll tilt motion on a 6DOF motion platform in the absence of any visual or auditory motion cues. Results: For each patient, an nGVS intensity that optimally stabilized static balance compared to sham stimulation could be identified (mean 0.36 ± 0.16 mA). nGVS at optimal intensity resulted in lowered vestibular perceptual thresholds (0.94 ± 0.30 deg/s) compared to sham stimulation (1.67 ± 1.11 deg/s; p = 0.040). nGVS-induced improvements in vestibular perception were observed in 8 of 11 patients (73%) and were greater in patients with poorer perceptual performance during sham stimulation (R = − 0.791; p = 0.007). Conclusions: nGVS is effective in improving impaired vestibular motion perception in patients with BVP, in particular in those patients with poor baseline perceptual performance. Imperceptible vestibular noise stimulation might thus offer a non-invasive approach to target BVP-related impairments in spatial memory, orientation, and navigation.

Original languageEnglish
Pages (from-to)938-943
Number of pages6
JournalJournal of Neurology
Volume270
Issue number2
DOIs
StatePublished - Feb 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Balance
  • Bilateral vestibulopathy
  • Galvanic vestibular stimulation
  • Stochastic resonance
  • Vestibular perception

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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