Stimulation Of Vestibular Nerve Research Articles

Repeated electrical vestibular nerve stimulation (VeNS) reduces severity in moderate to severe insomnia; a randomized, sham-controlled trial; The Modius Sleep Study

Insomnia is a prevalent health concern in the general population associated with a range of adverse health effects. New, effective, safe and low-cost treatments, suitable for long-term use, are urgently required. Previous studies have shown the potential of electrical vestibular nerve stimulation (VeNS) in improving insomnia symptoms, however only one sham-controlled trial has been conducted on people with chronic insomnia. /Hypothesis: Repeated VeNS delivered by the Modius Sleep device prior to sleep onset will show superior improvement in Insomnia Severity Index (ISI) scores over a 4-week period compared to sham stimulation. In this double-blinded, multi-site, randomised, sham-controlled study, 147 participants with moderate to severe insomnia (ISI≥15) were recruited and allocated a VeNS or a sham device (1:1 ratio) which they were asked to use at home for 30 minutes daily (minimum 5 days per week) for 4 weeks. After 4 weeks, mean ISI score reduction was 2.26 greater in the VeNS treatment group than the sham group (p=0.002). In the per protocol analysis, the treatment group had a mean ISI score decrease of 5.8 (95% CI [-6.8, -4.81], approaching the clinically meaningful threshold of a 6-point reduction, with over half achieving a clinically significant decrease. Furthermore, the treatment group showed superior improvement to the sham group in the SF-36 (Quality of Life) energy/fatigue component (PP p=0.004, effect size 0.26; ITT p=0.006, effect size 0.22). Modius sleep has the potential to provide a viable, non-invasive and safe clinically meaningful alternative treatment option for insomnia.

0394 Effect of electrical vestibular nerve stimulation on sleep quality in young adults with insomnia: a randomized controlled trial

Abstract Introduction Insomnia is a common sleep disorder among all age groups which adversely affects physical and mental health. Young adults are considered a high-risk population group due to increased use of electronic media at bedtime, stress associated with balancing educational demands and unhealthy sleep practices. Previous research suggests that electrical vestibular nerve stimulation (VeNS) may improve sleep outcomes by influencing the hypothalamus and brainstem nuclei involved in regulating the circadian rhythm and wakefulness. The present study is a randomised, double blinded, sham-controlled trial with the aim of assessing the efficacy of VeNS on the sleep quality of young adults suffering from insomnia. Methods Eighty adults aged 18-24 years who scored 15 or higher on the Insomnia Severity Index (ISI) were recruited. Participants assigned to the intervention group (n=40) received 30 minutes per day of VeNS with 5 sessions per week for 4 weeks, while the control group (n=40) received sham stimulation for the same period. ISI scores were recorded at baseline and repeated weekly. The primary outcome was between-group change in ISI from baseline to day 28. Secondary outcomes included between-group change in the emotional states of depression, anxiety and stress measured by the DASS-21 questionnaire, and quality of life (QoL) measured by the WHOQoL-BREF. Results A group-by-time interaction effect on change in ISI score from day 0 to day 28 (F3, 248 = 295.56; P< 0.001) was observed. The intervention group had a higher reduction in mean ISI score relative to the control group at day 28 (mean change [95% CI]: 7.23 [6.78, 7.67] vs. 0.98 [0.89, 1.06], P< 0.001; respectively). Furthermore, the intervention group showed improvements in depression, anxiety, and stress scores (P< 0.001) and QoL outcomes (P< 0.001) compared with the control group. Conclusion Regular VeNS usage over 4 weeks lead to a clinically meaningful decrease in ISI scores and improved general well-being in young adults with insomnia. VeNS may have potential as a drug-free and non-invasive therapy to improve sleep outcomes. Support (if any)

0396 Efficacy of electrical vestibular nerve stimulation for the management of insomnia: a randomized controlled trial

Abstract Introduction Insomnia is one of the most prevalent health concerns in the general population. Cognitive behavioural therapy (CBT) and pharmacological interventions are recommended for the treatment of insomnia. However, CBT can be expensive and difficult to access, while the use of pharmacotherapy can be limited by reports of adverse events. Due to these limitations, there is a strong need for alternative measures to manage insomnia. Preliminary research indicates the potential that electrical vestibular nerve stimulation (VeNS) has as a non-invasive method for managing insomnia. The aim of this study is to evaluate the efficacy of VeNS as a method of managing sleep quantity and quality in individuals with insomnia, as compared to a sham control. Methods The study was a two-armed, double-blind randomized controlled trial that was conducted across two research sites in the United Kingdom (UK) and Hong Kong (HK). Participants aged over 18 years with an Insomnia Severity Index (ISI) score of 15 or higher were randomly assigned to intervention and control groups. The intervention group was instructed to use the VeNS device at home for 30 minutes daily for 4 weeks, while the control group was instructed to use the sham device for the same period. ISI values were captured at baseline, at 2 weeks and at 4 weeks. Sleep quality and quality of life (QoL) were assessed at baseline and at 4 weeks using the Pittsburgh Sleep Quality Index (PSQI) and the 36-item Short Form Health Survey (SF-36), respectively. Results A total of 146 participants were recruited from the HK (n=94) and UK (n=52) research sites. The study has recently been completed with the statistical analysis ongoing. The between-group change in ISI values (primary outcome), sleep quality and QoL from baseline to week 4 will be examined. Conclusion The results of this study will help determine whether the relatively inexpensive, and non-invasive technique of VeNS is effective in the management of insomnia. The data collected will be used to support regulatory submissions, primarily to the US Food and Drug Administration. Support (if any)

A randomized controlled trial to evaluate the efficacy of electrical vestibular nerve stimulation (VeNS), compared to a sham control for the management of sleep in young adults.

Preliminary research suggests that electrical vestibular nerve stimulation (VeNS) may improve sleep outcomes by influencing the hypothalamus and brainstem nuclei involved in regulating the circadian rhythm and wakefulness. This randomised, sham-controlled trial aimed to assess the effectiveness of VeNS on insomnia in young adults. Eighty adults aged 18-24 years were randomly allocated to the intervention (n=40) and control groups (n=40). The intervention group was provided with 30min per day of VeNS with five sessions weekly for four weeks, while the control group received sham stimulation for the same period. Baseline Insomnia Sleep Index (ISI) scores were recorded weekly. At baseline and at day 28, questionnaires to evaluate emotional states of depression, anxiety and stress, and quality of life (QoL) were completed. The primary outcome was change in ISI with comparison between baseline and day 28. The VeNS group significantly reduced their mean ISI score after 7days usage (p<0.001). At day 28 it was found that mean ISI scores had reduced from 19 to 11 in the VeNS group, and from 19 to 18 in the sham group, and the difference between the groups was significant (p<0.001). Moreover, application of VeNS appeared to significantly improve emotional state and QoL outcomes. This trial demonstrates that regular VeNS usage over four weeks leads to a clinically meaningful decrease in ISI scores in young adults with insomnia. VeNS may have potential as a drug-free and non-invasive therapy to improve sleep outcomes by positively influencing the hypothalamic and brainstem nuclei.

A randomized controlled clinical trial to evaluate the efficacy of electrical vestibular stimulation, compared to a sham control for the modulation of neurotransmitters in patients with Parkinson’s disease

Background: The existing treatments for PD were associated with side effects and does not offer complete cure. Hence there is a need of alternative therapy which can prevent or delay the onset of PD with less or no side effects. Aim and objective: The overall objective of the present study was to assess the effectiveness of electrical vestibular nerve stimulation in the management of Parkinson’s disease. Materials and methods: 60 cases with PD, including both males and females, were recruited in the study by convenient sampling after obtaining written and informed consent. They were randomly grouped with 30 participants in each group. Control group received sham stimulation and the intervention group received electrical vestibular nerve stimulation for 12 weeks. After recording the baseline biochemical parameters, post intervention assessment was performed after 6 weeks and 12 weeks of intervention and compared. Results: Demographic variables were not statistically significant among the control and intervention groups. There was a significant increase in the dopamine and GABA levels followed by the intervention. Conclusion: The present study results support the positive impact of non-invasive electrical vestibular nerve stimulation in modulating neurotransmitters in patients with Parkinson’s disease. A further detailed translational study is required in this area with a larger sample size to generalize the results.

Effectiveness of 12 weeks of electrical vestibular nerve stimulation in the management of obesity: A pilot study

Background: It was hypothesized that electrical vestibular nerve stimulation (VeNs) was an effective therapy in the management of obesity. Aims and Objectives: The present pilot study was undertaken to observe the efficacy of 12-week electrical VeNs in the management of obesity. Materials and Methods: As this is a pilot study, a total of ten obese male and female participants were recruited after obtaining written, informed consent. After recording the baseline values, electrical VeNs was administered as an intervention for 12 weeks. The post-interventional assessment was done after 12 weeks. Results: There was a significant decrease in the serum cholesterol, VLDL, and HbA1C followed by the vestibular stimulation for 12 weeks. Although the body weight was decreased, it was not statistically significant. Conclusion: The present pilot study results support the positive impact of electrical VeNs in the management of obesity. Further, detailed studies with higher sample size were recommended to provide adequate scientific evidence to adopt electrical VeNs as an alternative therapy for the management of obesity.

A randomized, controlled, and clinical trial to evaluate the efficacy of electrical vestibular stimulation, compared to a sham control for the management of sleep and autonomic parameters in patients with Parkinson’s disease

Background: Electrical vestibular nerve stimulation (VeNs) was simple, non-invasive, and can administer the stimulus in a controlled manner. The studies related to the application of electrical VeNs in the management of sleep and autonomic parameters were sparse in the Indian population. Aims and Objectives: The present study was undertaken to observe the effectiveness of electrical VeNs in the management of sleep and autonomic parameters in patients with Parkinson’s disease (PD). Materials and Methods: Thirty cases of PD, both the genders, were recruited in the study by convenient sampling after obtaining written informed consent. After recording baseline parameters of Insomnia Severity Index (ISI), systolic and diastolic blood pressure (DBP), and pulse rate, electrical VeNs was administered to the intervention group and placebo stimulation was administered to the control group for 12 weeks. Post-intervention parameters were recorded after 6 weeks and after 12 weeks after the intervention in both control and intervention groups. Results: There was a significant decrease in the ISI scores, pulse rate, and systolic blood pressure after the intervention in the participants of the intervention group. DBP was decreased but was not statistically significant. There was no significant difference in the ISI scores, pulse rate, and systolic and DBP before and after the intervention in the participants of the control group. Conclusion: The present study results support the improvement of sleep followed by electrical VeNs. The study recommends detailed studies in this area to support the incorporation of electrical VeNs in the management strategy of PD.

Effectiveness of electrical vestibular nerve stimulation as adjunctive therapy to improve the cognitive functions in patients with Parkinson's disease.

The present study was undertaken to observe the effectiveness of electrical vestibular stimulation in improving cognitive functions in patients with Parkinson's disease. Randomized controlled trial (ClinicalTrials.gov Identifier: NCT04450550). 30 cases of PD, including both males and females were recruited in the study by convenient sampling after obtaining written informed consent. After recruiting, the participants were randomly assigned into two groups. The control group (n=15) received placebo stimulation whereas the intervention group (n=15) received electrical vestibular stimulation administered for 12weeks. Auditory, visual reaction time and spatial and verbal memory were recorded before and after 6weeks and after 12weeks of intervention and compared. There was a significant improvement in both auditory and visual reaction time of right and left-hand responses. Also, significant improvement was observed in both the spatial and verbal memory of the patients. There was a significant improvement in the auditory and visual reaction time and spatial and verbal memory in the participants after the electrical vestibular nerve stimulation administration. No side effects were reported by the study participants and they have expressed willingness to continue the intervention after the study period also. The study recommends further detailed studies with a higher sample size to adopt electrical vestibular nerve stimulation as adjunctive therapy in the management of Parkinson's disease.

Electrical vestibular nerve stimulation in the management of pain in the patients with temporomandibular disorders: A pilot study

Background: It is hypothesized that electrical vestibular stimulation may be an effective adjunctive therapy in the management of Temporomandibular disorder (TMD). Aims and Objectives: The aim of the present study is to assess the effectiveness of electrical vestibular nerve stimulation (VeNS) in the management of pain in patients with temporomandibular disorders. Materials and Methods: A total of 24 male and female participants newly diagnosed with TMD were recruited after obtaining the written informed consent. VeNS was administered for 4 weeks. Each daily session was for an hour (1 h), with three sessions being carried out each week. The pain was assessed using a numerical pain rating scale. The JFLS-8 is a short form for measuring global functional limitations of the jaw. The DASS-21 questionnaire is comprised of three self-reported scales to measure negative emotional states of depression, anxiety, and stress. Results: Age, height, weight and, BMI were not significantly different between the control and intervention groups (Table 1). There was a significant decrease in the pain score in the intervention group when compared with the control group (P&lt;0.001). Jaw function score was significantly improved followed by the intervention in the intervention group (P&lt;0.001). Depression scores were significantly decreased followed by the intervention in the intervention group (P&lt;0.001). Anxiety scores were significantly decreased followed by the intervention in the intervention group (P&lt;0.001). Stress scores were significantly decreased followed by the intervention in the intervention group (P&lt;0.001). Conclusion: The study introduced new technology that is electrical VeNS for the management of pain. Electrical vestibular stimulation is effective in the management of pain and decreases the negative emotions that are depression, anxiety, and stress, and improves sleep quality in patients with temporomandibular disorders. The study recommends further detailed studies in this area to recommend electrical vestibular stimulation as adjunctive therapy for the management of pain.

Electrical vestibular nerve stimulation (VeNS): a follow-up safety assessment of long-term usage.

This retrospective, open-label study was undertaken to assess the safety of repeated, long-term electrical vestibular nerve stimulation (VeNS). The primary outcome for this study was assessment of hearing function as reported by formal audiometry testing. Assessments were conducted on n=25 long-term users of daily 1.5mA VeNS. Skin inspection of the mastoid area, otoscope examination of the inner ear, and formal audiometry testing was conducted on n=18 users. All participants completed a survey-based assessment to determine usage of the device, adverse events, and long-term outcomes. Mean duration of use was 22months, with approximately 80% of users reporting 1h of daily, or 1h of regular (2-3 times per week) VeNS usage. No adverse events were reported. There were no significant findings during examination of the mastoid areas, ear canal, or tympanic membranes. There were no significant findings reported from the formal audiogram assessments. This appears to be the first study to provide formal assessment to show that repeated, long-term VeNS usage has not generated any significant side effects or adverse events. Results from this study further support previous literature that electrical vestibular stimulation is both safe and well-tolerated.

Assessment of the efficacy of electrical vestibular nerve stimulation as an adjunct therapy in the management of motor functions and quality of life in patients with Parkinson’s disease

Background: The existing treatments for Parkinson’s disease (PD) were associated with side effects and do not offer a complete cure. Hence, there is a need for an alternative therapy that can prevent or delay the onset of PD with less or no side effects. Our extensive review of literature has shown no studies to be existing so far in India regarding vestibular stimulation as a treatment method for PD. Aims and Objectives: The present study was undertaken to administer electrical vestibular nerve stimulation (VeNs) as an adjunct therapy in the management of motor functions and to improve the quality of life in PD patients. Materials and Methods: The present study was a randomized controlled trial. (ClinicalTrials.gov Identifier: NCT04450550). 30 cases of PD, of both genders, were part of the study by convenient sampling after obtaining written informed consent. Patients were recruited from the out-patient ward of the General Medicine department, R.D. Gardi Medical College. Motor activities were assessed using the Berg balance scale, strength procedures by hand dynamometer and hand-eye coordination by 100 pin dexterity test. Quality of life was assessed by the World Health Organization Quality of Life Brief. Results: The study results support the earlier studies as there was a significant improvement in the motor functions and quality of life of the study participants. Conclusion: The study recommends further detailed studies with higher sample size and involving many centers to recommend the use of electrical VeNs as adjunctive therapy in the management of PD.

Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution Hypothesis.

An ongoing EU Horizon 2020 Project called BionicVEST is investigating the effect of constant electrical stimulation (ES) of the inferior vestibular nerve in patients with bilateral vestibular dysfunction (BVD). The evidence is that constant ES results in improved postural stability and gait performance, and so the question of central importance concerns how constant ES of mainly saccular afferents in these BVD patients could cause this improved performance. We suggest that the constant ES substitutes for the absent saccular neural input to the vestibular nuclei and the cerebellum in these BVD patients and indirectly via these structures to other structures, which have been of great recent interest in motor control. One target area, the anterior midline cerebellum (the uvula), has recently been targeted as a location for deep-brain stimulation in human patients to improve postural stability and gait. There are projections from midline cerebellum to basal ganglia, including the striatum, which are structures involved in the initiation of gait. It may be that the effect of this activation of peripheral saccular afferent neurons is analogous to the effect of deep-brain stimulation (DBS) by electrodes in basal ganglia acting to help alleviate the symptoms of patients with Parkinson’s disease.

Acceptability and feasibility of a vestibular nerve stimulation headset protocol in children with cerebral palsy

BackgroundResearch suggests electrical Vestibular Nerve Stimulation (VeNS) may improve balance for people with neurological impairments. This study aimed to assess the feasibility and acceptability of a VeNS headset protocol in children with cerebral palsy (CP).MethodsChildren aged 5–18 years with ambulant CP, their parents, and healthcare professionals were recruited via social media. Children completed a battery of balance tests and wore a sham VeNS headset one hour per day for four weeks. Perspectives on the balance tests and headset were ascertained from children, parents and healthcare professionals using semi-structured interviews. Interview data were analysed thematically.ResultsTwo families and four healthcare professionals participated. Balance outcome measures were fully completed and deemed acceptable. Adherence with wearing the headset was 89–100% but discomfort with self-adhesive electrodes was reported. Four themes emerged from interview data: headset issues, perceptions about VeNS, the importance of balance, and modifications for future study.ConclusionsAlthough the VeNS headset had high acceptability, the volunteer sample was small, potentially suggesting limited interest in VeNS as a treatment for children with CP, or reluctance to trial a ‘non-active’ headset. Recruitment via clinicians known to the family and use of an ‘active’ headset may increase participation in future research.

Application of Multiplanar Volume Reconstruction Technique for the Assessment of Electrode Location and Analysis of the Correlation to Cochlear Programming and Performance in Common Cavity Deformity

Purpose: Owing to the characteristic anatomy, cochlear implantation (CI) for common cavity deformity (CCD) has resulted in varied outcomes and frequent facial and vestibular nerve stimulation. The current study analyzed the correlation among the distance between each electrode and cavity wall (abbreviation, D), programming parameters, and performances outcomes.Materials and Methods: The current, retrospective study included 25 patients (27 ears) with CCD underwent CI. The multiplanar volume reconstruction (MPVR) techniques were employed to reconstruct and evaluate the postoperative temporal bone CT. The D and maximum comfortable level (MCL) 6 months after CI, facial and vestibular nerve stimulation, and outcomes 1, 2, and 3 years after CI pertaining to the questionnaires were documented and analyzed.Results: The patients were divided into symptomatic (10, 37%) and asymptomatic (17, 63%) groups according to with or without facial and vestibular nerve stimulation. The MCL pertaining to the symptomatic group was significantly lower than asymptomatic group, but Categories of Auditory Performance (CAP) scores 1 year after surgery was better (p < 0.05). The subjects were divided into flat (12, 44.4%) and curved (15, 55.6%) groups based on the contour of MCL map. The MCL and D were lower and shorter in the curved group than the flat group, and CAP score 1 year after surgery and Speech Intelligibility Rating (SIR) 3 years after surgery were better (p < 0.05).Conclusion: Although abnormal reactions such as facial and vestibular nerve stimulation were observed to be more frequent, lower MCL and better outcomes were observed in relation to the shorter D.

Treatment of Parkinson's Disease with Cognitive Impairment: Current Approaches and Future Directions.

Cognitive impairment risk in Parkinson’s disease increases with disease progression and poses a significant burden to the patients, their families and society. There are no disease-modifying therapies or preventative measures for Parkinson’s disease mild cognitive impairment (PD-MCI), or Parkinson’s disease dementia (PDD). This article reviews current and previously investigated treatments and those under investigation, including pharmacologic, non-pharmacologic and surgical procedures. There are currently no effective pharmacologic or non-pharmacologic treatments for PD-MCI. The only recommended treatment for PDD currently is rivastigmine, a cholinesterase inhibitor. Donepezil and galantamine—other cholinesterase inhibitors—are possibly useful. Memantine, a N-methyl-D-aspartate (NMDA) receptor antagonist, is considered investigational in PDD. Drug repurposing (atomoxetine, levodopa, insulin, atomoxetine for PD-MCI; ambroxol and ceftriaxone for PDD) and novel medications (SYN120, GRF6021, NYX-458 for PD-MCI; ANAVEX2-73, LY3154207, ENT-01, DAAOI-P for PDD) currently have insufficient evidence. There is growing research supporting exercise in the treatment of PD-MCI, but most non-pharmacological approaches have insufficient evidence for use in PD-MCI (cognitive rehabilitation, deep brain stimulation, transcranial direct current stimulation, transcranial ultrasound, vestibular nerve stimulation) and PDD (cognitive intervention, deep brain stimulation, transcranial alternating current stimulation, transcranial ultrasound, temporal blood brain barrier disruption). Research is needed for both disease-modifying and symptomatic treatments in PD cognitive impairment.

Electrical vestibular nerve stimulation as an adjunctive therapy in the management of type 2 diabetes.

Vestibular nerve stimulation using the portable battery-operated vestibular nerve stimulator is a sophisticated method noninvasive, safe, and easy to operate. It was hypothesized that vestibular nerve stimulation is effective in the management of type 2 diabetes. Hence, the present study was undertaken to determine the effectiveness of vestibular nerve stimulation using portable battery-operated vestibular nerve stimulator in the management of diabetes. The present study was a double-blind randomized controlled trial with 1:1 split between the control and experimental groups. A total of 30 participants with type 2 diabetes were part of the study after obtaining the written informed consent. After recording the baseline values, the vestibular nerve stimulation was administered to the participants in the intervention group for 90days. Sham stimulation was administered to the control group for 90days. Outcome measures were recorded after 30days and after 90days of the intervention in both the groups. There was significant decrease in the total body weight, fasting, postprandial blood glucose, glycosylated hemoglobin levels, leptin, very low density lipoproteins levels followed by the intervention. There was significant improvement in both spatial and verbal memory scores. Depression and stress scores and systolic blood pressure decreased and remained in normal limits. The study results have proven multimodal action of vestibular stimulation. It not only acts on regulation of the glucose metabolism but also can regulate the autonomic activity and improve cognition and relieve stress. This is the interesting finding of our study, which needs detailed further research to support implementation of vestibular nerve stimulation as an adjunctive therapy in the management of diabetes.

Modulation of sleep using electrical vestibular nerve stimulation prior to sleep onset: a pilot study.

Electrical stimulation of the vestibular system (VeNS) has been shown to improve Insomnia Severity Index (ISI) when delivered during sleep. We hypothesize that repeated electrical vestibular stimulation, when delivered prior to sleep onset, will improve ISI scores. The primary aim of this study was to assess the effect that VeNS had on ISI scores when delivered prior to sleep onset. A secondary aim was to provide initial data indicating "length of time to effect" that will allow more appropriate design of a larger randomized control trial (RCT). The present study was an experimental study (pre and post without control). The participants acted asself-controls. After recording the baseline values, electrical vestibular nerve stimulation was administered as intervention once in a day for 30min, 1h prior to sleep onset using ML1000 device (Neurovalens, UK) for 14days. There was significant decrease in the ISI scores followed by the electrical vestibular nerve stimulation. Further, participants reported a significant increase in well-rested sleep post the intervention period. This study supports our hypothesis that VeNS has a positive impact on ISI scores when delivered on a regular basis prior to sleep onset.

Anti-diabetic effect of vestibular stimulation is mediated via AMP-activated protein kinase

There is abundant animal evidence that vestibular stimulation, particularly of the otolith organs, can trigger a shift in body mass composition towards a leaner physique. One way of non-invasively stimulating the otolith organs is via a small electrical current applied to the skin behind the ears. This technique is called vestibular nerve stimulation, or VeNS, and is believed to have a good safety profile. Thus, it has previously been argued that VeNS could be used in human health as a means of treating the complications of metabolic syndrome, such as obesity and type 2 diabetes mellitus. Weight loss itself is known to improve diabetic control, however, tantalizing evidence is now emerging that the improvements seen in the glycemic control of type 2 diabetics who undergo repeated vestibular stimulation are significantly better than would be expected on the basis of weight loss alone. As vestibular stimulation has been shown to increase levels of an anti-inflammatory protein, called sirtuin 1, we hypothesize here that VeNS will increase levels of an associated enzyme called AMP-activated protein kinase (AMPK). AMPK plays an important role in glucose and fat metabolism and is activated by exercise, as well as being a known target for certain anti-diabetic drugs. This hypothesis is readily amenable to clinical testing as specific assays for testing human AMPK are available. If substantiated, then this hypothesis could prove an important clinical insight and potentially offer a new treatment avenue for patients with type 2 diabetes; a condition which remains a major cause of morbidity and premature mortality worldwide.

Effect of Leakage Currents on the Formation of Electrical Pulse for the Vestibular Nerve Stimulation

A theoretical and experimental study was performed of a frequency dependence of the amplitude-phase characteristics of the vestibular nerve stimulation signal and its changes during passage from the stimulating electrodes to the end of the vestibular nerve. To assess the influence of leakage currents on the change in the stimulating current pulse, a physico-mathematical model of the vestibular organ and electrical processes occurring in its tissues was developed on the basis of experimental data on electrophysical and anatomical characteristics of the vestibular labyrinth tissues by the example of a guinea pig. The calculations and measurements of the frequency dependence of the amplitude-phase characteristics of the stimulating signal at a recording electrode located in the Scarp’s ganglion are performed. It is established that the influence of leakage currents on the signal amplitude at the recording electrode is significant in the entire frequency range considered. Compensation of the influence of leakage currents will improve the stimulating signal quality and increase the transfer function of the vestibular implant.

ELECTRICAL VESTIBULAR NERVE STIMULATION FOR THE MANAGEMENT OF TENSION HEADACHE

Tension headache is the most common type of headache and typically it is described as pain or pressure in the head, scalp, or neck, often associated with localized muscle discomfort. It was hypothesized that stimulation of vestibular nerve may relieve pain. In this single-person study, vestibular nerve stimulation was administered daily for a period of 6 weeks. The participant was an 18 years male with a 4 years history of moderate headache at least once week and with repeated periods of moderate stress. He was under medications; however, the pain was not relieved. Stress levels were measured using DASS 21 scale. Pain was measured using pain scale, autonomic, and cognitive parameters recorded by standard methods. During this study, the participant reported a significant reduction in both the frequency and intensity of headaches and by the end of the 6 weeks of the study, it was noticed that he reduced the usage of pain medication. Autonomic parameters remained within normal limits after the periods of stimulation and cognitive functions were improved. This study suggests that electrical stimulation of the vestibular nerve may help to reduce tension headache and highlights the need for larger studies in this area and further exploratory studies in the management of other regional pain such as orofacial pain, dental pain, and management of pain after mandibular surgery.