Abstract

Patients with bilateral vestibular hypofunction (BVH) often suffer from imbalance, gait problems, and oscillopsia. Noisy galvanic vestibular stimulation (GVS), a technique that non-invasively stimulates the vestibular afferents, has been shown to enhance postural and walking stability. However, no study has investigated how it affects stability and neural activities while standing and walking with a 2 Hz head yaw turning. Herein, we investigated this issue by comparing differences in neural activities during standing and walking with a 2 Hz head turning, before and after noisy GVS. We applied zero-mean gaussian white noise signal stimulations in the mastoid processes of 10 healthy individuals and seven patients with BVH, and simultaneously recorded electroencephalography (EEG) signals with 32 channels. We analyzed the root mean square (RMS) of the center of pressure (COP) sway during 30 s of standing, utilizing AMTI force plates (Advanced Mechanical Technology Inc., Watertown, MA, USA). Head rotation quality when walking with a 2 Hz head yaw, with and without GVS, was analyzed using a VICON system (Vicon Motion Systems Ltd., Oxford, UK) to evaluate GVS effects on static and dynamic postural control. The RMS of COP sway was significantly reduced during GVS while standing, for both patients and healthy subjects. During walking, 2 Hz head yaw movements was significantly improved by noisy GVS in both groups. Accordingly, the EEG power of theta, alpha, beta, and gamma bands significantly increased in the left parietal lobe after noisy GVS during walking and standing in both groups. GVS post-stimulation effect changed EEG activities in the left and right precentral gyrus, and the right parietal lobe. After stimulation, EEG activity changes were greater in healthy subjects than in patients. Our findings reveal noisy GVS as a non-invasive therapeutic alternative to improve postural stability in patients with BVH. This novel approach provides insight to clinicians and researchers on brain activities during noisy GVS in standing and walking conditions in both healthy and BVH patients.

Highlights

  • Vestibular systems sense linear and angular movements of the head, keeping the body in an upright position to maintain gaze and postural control

  • A plot can be seen of typical center of pressure (COP) displacements over the course of a trial for two individual subjects

  • When walking with a 2 Hz head yaw, both groups showed a closer approximation to the 2 Hz head yaw with noisy galvanic vestibular stimulation (GVS) than without

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Summary

Introduction

Vestibular systems sense linear and angular movements of the head, keeping the body in an upright position to maintain gaze and postural control. There is no primary cortical area responsible for vestibular functions, the parieto-insular-vestibular-cortex is known to be the most robust area modulating the vestibular system [5,6]. By applying galvanic vestibular stimulation (GVS), the firing activity of the eighth cranial nerve is enhanced on the side with the cathode electrode and decreased on the side with the anode electrode [7,8]. This current input is a non-invasive method that has long been applied in the investigation of vestibular functions

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