Altered Connectivity of the Balance Processing Network After Tongue Stimulation in Balance-Impaired Individuals

Wildenberg, Joseph C.; Tyler, Marcus; Danilov, Yuri; Kaczmarek, K.A.; Meyerand, M. Elizabeth

doi:10.1089/brain.2012.0123

Cited by 26 publications

(30 citation statements)

References 79 publications

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“…This is an ongoing challenge with non-invasive neuromodulation studies in general: reproduction of a comparable procedural experience for sham-arm subjects as compared with active-arm subjects. Wildenberg at al. (2013) hypothesized that the afferent output from tongue stimulation enters the brainstem in proximity to the vestibular and trigeminal nuclei, moving upwards to the cortex, and is able to influence cortical processing of visual motion.…”

Section: Cfc -Cross Frequency Correlationmentioning

confidence: 99%

“…A crucial observation is that this approach to sensory neuromodulation enables stimulation of brainstem regions. But the modulatory effects progress up from the brainstem to areas including the visual cortex and parieto-insular vestibular cortex (Wildenberg, 2013). And, importantly, the modulation signal follows endogenous sensory pathways.…”

Section: Cfc -Cross Frequency Correlationmentioning

confidence: 99%

“…TCD revealed that time-varying CVS (and not constant temperature CVS) created cerebral blood flow velocity oscillations, possibly providing a target of relevance for migraines (Black et al, 2016). Functional imaging studies do not lend themselves to routine application for individual patients, but general lessons can be learned about how best to deliver sensory neuromodulation (Wildenberg et al, 2013). It may be possible to use inexpensive and non-invasive methods, like heart-rate variability, as a proxy for more elaborate procedures once the relevant parameters are identified.…”

Section: Why It Helps and Doesn't Hurtmentioning

confidence: 99%

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Sensory Neuromodulation

Black¹,

Rogers²

2018

Preprint

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We describe a model of neurological disease based on dysfunctional brain oscillators.  This is not a new model, but it is not one that is generally appreciated by clinicians.  The value of this model lies in the predictions it makes and the utility it provides in translational applications, in particular for neuromodulation devices.  We provide a perspective on the difference between neuromodulation devices that enforce an externally administered stimulus with devices that provide input to sensory receptors and thus stimulate endogenous sensory networks.  Current forms of clinically applied neuromodulation are of the former type, including devices such as (implanted) deep brain stimulators (DBS) and various, noninvasive methods such as transcranial magnetic stimulation (TMS) and transcranial current methods (tACS, tDCS).  The challenge with these methods is that they are not sensitive to underlying neuronal dynamics and work by applying an empirically derived electrical current waveform to affect dynamical patterns. Neuromodulation of a sensory organ accesses the same pathways that natural environmental stimuli do and, importantly, the modulatory signal will be transformed as it travels through the brain, allowing the modulation input to be consistent with regional dynamics.  We present specific examples of devices that rely on sensory neuromodulation and evaluate the translational potential of these approaches.  We argue that sensory neuromodulation is well suited to probe and, ideally, repair dysfunctional brain oscillators, thus providing a novel therapeutic approach for neurological diseases.

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Section: Cfc -Cross Frequency Correlationmentioning

confidence: 99%

Section: Cfc -Cross Frequency Correlationmentioning

confidence: 99%

Section: Why It Helps and Doesn't Hurtmentioning

confidence: 99%

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Sensory Neuromodulation

Black¹,

Rogers²

2018

Preprint

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show abstract

“…This non-intuitive discovery underlies the clinical focus of the tongue stimulator for balance disorders. Wildenberg et al (2013) hypothesized that the afferent output from tongue stimulation enters the brainstem in proximity to the vestibular and trigeminal nuclei, moving upwards to the cortex, and is able to influence cortical processing of visual motion. Leonard et al (2017) undertook an imaging study with multiple sclerosis subjects to assess the effects of PONS stimulation over a 14-weeks treatment period.…”

Section: Somatosensory Stimulationmentioning

confidence: 99%

Sensory Neuromodulation

Black¹,

Rogers²

2020

Front. Syst. Neurosci.

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We describe a model of neurological disease based on dysfunctional brain oscillators. This is not a new model, but it is not one that is widely appreciated by clinicians. The value of this model lies in the predictions it makes and the utility it provides in translational applications, in particular for neuromodulation devices. Specifically, we provide a perspective on devices that provide input to sensory receptors and thus stimulate endogenous sensory networks. Current forms of clinically applied neuromodulation, including devices such as (implanted) deep brain stimulators (DBS) and various, noninvasive methods such as transcranial magnetic stimulation (TMS) and transcranial current methods (tACS, tDCS), have been studied extensively. The potential strength of neuromodulation of a sensory organ is access to the same pathways that natural environmental stimuli use and, importantly, the modulatory signal will be transformed as it travels through the brain, allowing the modulation input to be consistent with regional neuronal dynamics. We present specific examples of devices that rely on sensory neuromodulation and evaluate the translational potential of these approaches. We argue that sensory neuromodulation is well suited to, ideally, repair dysfunctional brain oscillators, thus providing a broad therapeutic approach for neurological diseases.

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“…Wildenberg et al (2010) showed that stimulation that doesn't convey information about body posture or gravity can improve balance performance in people with balance dysfunction [102]. They've also investigated the effects of electrotactile tongue stimulation on balance performance and have used imaging techniques such as MRI and fMRI to show that stimulation upregulates visual sensitivity to optic flow in people with balance impairments [102][103][104][105].…”

Section: Mechanismmentioning

confidence: 99%

The role of sensory augmentation for people with vestibular deficits: Real-time balance aid and/or rehabilitation device?

Sienko

Whitney

Carender

et al. 2017

VES

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This narrative review highlights findings from the sensory augmentation field for people with vestibular deficits and addresses the outstanding questions that are critical to the translation of this technology into clinical and/or personal use. Prior research has demonstrated that the real-time use of visual, vibrotactile, auditory, and multimodal sensory augmentation technologies can improve balance during static and dynamic stance tasks within a laboratory setting. However, its application in improving gait requires additional investigation, as does its efficacy as a rehabilitation device for people with vestibular deficits. In some locomotor studies involving sensory augmentation, gait velocity decreased and secondary task performance worsened, and subjects negatively altered their segmental control strategies when cues were provided following short training sessions. A further question is whether the retention and/or carry-over effects of training with a sensory augmentation technology exceed the retention and/or carry-over effects of training alone, thereby supporting its use as a rehabilitation device. Preliminary results suggest that there are short-term improvements in balance performance following a small number of training sessions with a sensory augmentation device. Long-term clinical and home-based controlled training studies are needed. It is hypothesized that sensory augmentation provides people with vestibular deficits with additional sensory input to promote central compensation during a specific exercise/activity; however, research is needed to substantiate this theory. Major obstacles standing in the way of its use for these critical applications include determining exercise/activity specific feedback parameters and dosage strategies. This paper summarizes the reported findings that support sensory augmentation as a balance aid and rehabilitation device, but does not critically examine efficacy or the quality of the research methods used in the reviewed studies.

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Altered Connectivity of the Balance Processing Network After Tongue Stimulation in Balance-Impaired Individuals

Cited by 26 publications

References 79 publications

Sensory Neuromodulation

Sensory Neuromodulation

Sensory Neuromodulation

The role of sensory augmentation for people with vestibular deficits: Real-time balance aid and/or rehabilitation device?

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