Abstract
SummaryIn contrast to the conventional pulsatile neuromodulation that excites neurons, galvanic or direct current stimulation can excite, inhibit, or sensitize neurons. The vestibular system presents an excellent system for studying galvanic neural interface due to the spontaneously firing afferent activity that needs to be either suppressed or excited to convey head motion sensation. We determine the cellular mechanisms underlying the beneficial properties of galvanic vestibular stimulation (GVS) by creating a computational model of the vestibular end organ that elicits all experimentally observed response characteristics to GVS simultaneously. When GVS was modeled to affect the axon alone, the complete experimental data could not be replicated. We found that if GVS affects hair cell vesicle release and axonal excitability simultaneously, our modeling results matched all experimental observations. We conclude that contrary to the conventional belief that GVS affects only axons, the hair cells are likely also affected by this stimulation paradigm.
Highlights
In contrast to conventional pulsatile neural prostheses used to excite neural targets (Loeb, 2018), direct current (DC) neuromodulation emerged as having potential for use in a variety of new medical treatments due to its unique ability to evoke a broad range of beneficial clinical effects on target neurons (Aplin and Fridman, 2019)
Recent innovations with DC stimulation technology have led to the development of safe direct current stimulation (SDCS) (Fridman and Della Santina, 2013; Cheng et al, 2017; Fridman, 2017; Ou and Fridman, 2017; Aplin and Fridman, 2019), which makes it possible to chronically deliver localized direct ionic current from an implantable device
Preliminary behavioral testing of the SDCS for vestibular balance disorders as well as for the treatment of pain suppression revealed that DC neuromodulation has multiple beneficial effects on targeted neural populations that cannot be produced with pulsatile stimulation, including inhibiting, exciting, and sensitizing neural targets in a natural, desynchronized manner (Yang et al, 2018; Aplin and Fridman, 2019; Aplin et al, 2019a, 2019b)
Summary
In contrast to conventional pulsatile neural prostheses used to excite neural targets (Loeb, 2018), direct current (DC) neuromodulation emerged as having potential for use in a variety of new medical treatments due to its unique ability to evoke a broad range of beneficial clinical effects on target neurons (Aplin and Fridman, 2019). These have been shown in its ability to achieve peripheral nerve block for pain suppression (Bhadra and Kilgore, 2004; Yang et al, 2018), modulate cortical activity and synaptic connectivity for psychiatric treatments (Bikson et al, 2004; Radman et al, 2007; Brunoni et al, 2012), and excite and inhibit vestibular afferent activity to treat balance disorders (Manca et al, 2019; Aplin et al, 2020). To be consistent with the terminology used in the field of vestibular neuromodulation that is addressed here we refer to this non-pulsatile current delivery as ‘‘galvanic vestibular stimulus’’ or GVS
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