Beneficial effects of caloric vestibular stimulation on denial of illness and manic delusions in schizoaffective disorder: A case report

Levine, Joseph; Toder, Doron; Geller, Vadim; M, Kraus; Gauchman, Tamara; Puterman, Moshe; Grisaru, Nimrod

doi:10.1016/j.brs.2011.03.004

Cited by 36 publications

(37 citation statements)

References 35 publications

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“…The positive effect of CVS on mania can be attributed to an activation of right hemispheric structures. Levine et al (2012) showed an increase in bilateral frontal and central alpha EEG band activation in three patients suffering from a schizoaffective disorder. They proposed that left cold CVS can have a short lived beneficial effect on manic delusions and insight of illness that appear in mania and other types of psychoses (i.e., schizophrenia).…”

Section: Affective Processes and Disordersmentioning

confidence: 99%

Spatial cognition, body representation and affective processes: the role of vestibular information beyond ocular reflexes and control of posture

Mast

Preuss

Hartmann

et al. 2014

Front. Integr. Neurosci.

108

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A growing number of studies in humans demonstrate the involvement of vestibular information in tasks that are seemingly remote from well-known functions such as space constancy or postural control. In this review article we point out three emerging streams of research highlighting the importance of vestibular input: (1) Spatial Cognition: Modulation of vestibular signals can induce specific changes in spatial cognitive tasks like mental imagery and the processing of numbers. This has been shown in studies manipulating body orientation (changing the input from the otoliths), body rotation (changing the input from the semicircular canals), in clinical findings with vestibular patients, and in studies carried out in microgravity. There is also an effect in the reverse direction; top-down processes can affect perception of vestibular stimuli. (2) Body Representation: Numerous studies demonstrate that vestibular stimulation changes the representation of body parts, and sensitivity to tactile input or pain. Thus, the vestibular system plays an integral role in multisensory coordination of body representation. (3) Affective Processes and Disorders: Studies in psychiatric patients and patients with a vestibular disorder report a high comorbidity of vestibular dysfunctions and psychiatric symptoms. Recent studies investigated the beneficial effect of vestibular stimulation on psychiatric disorders, and how vestibular input can change mood and affect. These three emerging streams of research in vestibular science are—at least in part—associated with different neuronal core mechanisms. Spatial transformations draw on parietal areas, body representation is associated with somatosensory areas, and affective processes involve insular and cingulate cortices, all of which receive vestibular input. Even though a wide range of different vestibular cortical projection areas has been ascertained, their functionality still is scarcely understood.

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Section: Affective Processes and Disordersmentioning

confidence: 99%

Spatial cognition, body representation and affective processes: the role of vestibular information beyond ocular reflexes and control of posture

Mast

Preuss

Hartmann

et al. 2014

Front. Integr. Neurosci.

108

View full text Add to dashboard Cite

show abstract

“…Artificial stimulation of the peripheral balance organs, via either galvanic or thermal current, up-regulates metabolic activity across a range of cortical, striatal and cerebellar brain areas (Lopez, Blanke & Mast, 2012). The clinical relevance of this metabolic activity has been demonstrated in a number of acquired neurological conditions including hemi-spatial neglect (Wilkinson et al, 2014), aphasia (Wilkinson, Morris, Milberg & Sakel, 2013), mania (Levine et al, 2012), central pain (McGeoch, Williams, Lee & Ramachandran, 2008) and post-stroke postural instability (Sturt & Punt, 2013). Despite these promising results, comparably little investigation has been conducted with individuals who suffer from neuro-degenerative disease.…”

Section: Introductionmentioning

confidence: 99%

A durable gain in motor and non-motor symptoms of Parkinson’s Disease following repeated caloric vestibular stimulation: A single-case study

Wilkinson

Podlewska

Sakel

2016

NRE

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Objective: To gain Ôfirst-in-manÕ evidence that repeated caloric vestibular stimulation (CVS), a non-invasive form of neuro-modulation, can induce a lasting and clinicallyrelevant reduction in ParkinsonÕs Disease (PD) symptoms.Methods: A 70yr old male, diagnosed with PD 7 years prior to study enrolment, selfadministered CVS at home 2x20 minutes per day for three months using a solid-state portable device. Standardised neuropsychological assessments of motor, cognitive, affective and independent function were carried out prior to stimulation, at the start and end of the sham (month 1) and active (months 2-3) phases, and 5 months poststimulation.Results: Relative to the pre-stimulation baseline, behavioural improvements that exceeded the minimal detectable change were observed on the EQ5D, Unified ParkinsonÕs Disease Rating Scale, Schwab and England scale, 2 minute walk, Timed up and go, Non-motor symptom assessment scale for PD, Montreal cognitive assessment, Hospital depression scale and Epworth sleepiness scale. The level of change exceeded the threshold for a minimal clinically important difference on all scales for which a threshold has been published. By contrast, little improvement was seen during the sham (i.e. placebo) phase. Conclusion:Caloric vestibular stimulation may offer a novel, home-based method of relieving everyday symptoms of PD, and merits further evaluative study.3

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“…When used in single sessions, however, these techniques appear to effect only small, transient changes (~15 to 60 min duration) in insight or related phenomena (Fierro et al, 2000; Oliveri et al, 2001; Giglia et al, 2011; Levine et al, 2012). There exist a number of valid, commonly used clinician-rated (McEvoy et al, 1989; David et al, 1992; Amador et al, 1993) and self-report (Marks et al, 2000; Birchwood et al, 1994) scales that assess the components of insight into psychosis.…”

Section: Introductionmentioning

confidence: 99%

The VAGUS insight into psychosis scale – Self-report and clinician-rated versions

Gerretsen

Remington

Borlido

et al. 2014

Psychiatry Research

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The aim of this study was to develop self-report and clinician-rated versions of an insight scale that would be easy to administer, sensitive to small changes, and inclusive of the core dimensions of clinical insight into psychosis. Ten-item self-report (VAGUS-SR) and five-item clinician-rated (VAGUS-CR) scales were designed to measure the dimensions of insight into psychosis and evaluated in 215 and 140 participants, respectively (www.vagusonline.com). Tests of reliability and validity were performed. Both the VAGUS-SR and VAGUS-CR showed good internal consistency and reliability. They demonstrated good convergent and discriminant validity. Both versions were strongly correlated with one another and with the Schedule for the Assessment of Insight and Birchwood Insight Scale. Exploratory factor analyses identified three possible latent components of insight. The VAGUS-CR and VAGUS-SR are valid, reliable and easy to administer. They are build on previous insight scales with separate clinician-rated and self-report versions. The VAGUS-SR exhibited a multidimensional factor structure. Using a 10-point Likert scale for each item, the VAGUS has the capacity to detect small, temporally sensitive changes in insight, which is essential for intervention studies with neurostimulation or rapidly acting medications.

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Beneficial effects of caloric vestibular stimulation on denial of illness and manic delusions in schizoaffective disorder: A case report

Cited by 36 publications

References 35 publications

Spatial cognition, body representation and affective processes: the role of vestibular information beyond ocular reflexes and control of posture

Spatial cognition, body representation and affective processes: the role of vestibular information beyond ocular reflexes and control of posture

A durable gain in motor and non-motor symptoms of Parkinson’s Disease following repeated caloric vestibular stimulation: A single-case study

The VAGUS insight into psychosis scale – Self-report and clinician-rated versions

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