Effectiveness of an electro-tactile vestibular substitution system in improving upright postural control in unilateral vestibular-defective patients

Vuillerme, Nicolas; Pinsault, Nicolas; Fleury, Anthony; Chenu, Olivier; Demongeot, Jacques; Payan, Yohan; Pavan, Paul

doi:10.1016/j.gaitpost.2008.05.017

Cited by 27 publications

(13 citation statements)

References 15 publications

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“…We allowed individual adjustment rather than setting a fixed amplitude across all subjects, because of known inter-subject differences in tongue sensitivity, with the rationale that it is more important to hold invariant the result of the stimulation rather than its physical level [54]. From our previous research, we have observed that with experience, subjects set the intensity level at between 50 and 80% of the maximum dynamic range of sensation [43-48,50-52]. If subjects could not feel it, they were reassured that they were still receiving stimulation but it was below their individual threshold of perception.…”

Section: Methodsmentioning

confidence: 99%

Non-invasive neuromodulation to improve gait in chronic multiple sclerosis: a randomized double blind controlled pilot trial

Tyler

Kaczmarek

Rust

et al. 2014

J NeuroEngineering Rehabil

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BackgroundThis study sought to examine the effect of targeted physical therapy with and without cranial nerve non-invasive neuromodulation (CN-NINM), on the walking ability of people with MS who exhibited a dysfunctional gait. We hypothesized that subjects who received electrical stimulation would have greater improvement than those who had a control device after a 14-week intervention. Gait disturbance is a common problem for people with multiple sclerosis (MS). Current management may include exercise, pharmacology, functional electrical stimulation, compensatory strategies, use of assistive devices, and implanted electrical devices. We have developed an effective rehabilitative strategy using neuromodulation of the cranial nerves via electrical stimulation of the tongue to enhance the plasticity of the brain.MethodsThe study is a within-subject blinded randomized control design. Twenty chronic MS subjects with an identified gait disturbance were assigned to either an active or control group. Both groups completed a 14-week intervention program using a standardized combination of exercise and a device that provided electrical stimulation to the tongue. Those in the active group received electrical stimulation on the tongue that they could perceive. Those in the control group used a device that did not provide a physiologically significant stimulus and was not perceivable. Subjects were assessed with the Dynamic Gait Index (DGI).ResultsThe DGI scores improved for both groups. There were significant between-group differences, with the active group showing statistically greater improvement than the control group mean.ConclusionPeople with MS demonstrated improved gait with CN-NINM training in a pilot randomized controlled trial. This study suggests that tongue-based neurostimulation may amplify the benefits of exercise for improving gait in people with chronic MS.

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Section: Methodsmentioning

confidence: 99%

Non-invasive neuromodulation to improve gait in chronic multiple sclerosis: a randomized double blind controlled pilot trial

Tyler

Kaczmarek

Rust

et al. 2014

J NeuroEngineering Rehabil

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“…This route to the brain was originally used for sensory substitution in both balance-impaired and blind individuals (Chebat et al, 2007; Danilov et al, 2006; Robinson et al, 2009; Tyler, Danilov, Bach-Y-Rita 2003; Vuillerme et al, 2008; Vuillerme and Cuisinier 2009). Cross-modal recruitment theories of plasticity can explain why individuals using the tongue stimulation for sensory substitution show improvement in behavioral tasks (Collignon et al, 2009; Pietrini, Ptito, Kupers 2009; Poirier, De Volder, Scheiber 2007; Ptito et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

High-resolution fMRI detects neuromodulation of individual brainstem nuclei by electrical tongue stimulation in balance-impaired individuals

et al. 2011

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High resolution functional magnetic resonance imaging (fMRI) can be used to precisely identify blood-oxygen-level dependent (BOLD) activation of small structures within the brainstem not accessible with standard fMRI. A previous study identified a region within the pons exhibiting sustained neuromodulation due to electrical tongue stimulation, but was unable to precisely identify the neuronal structure involved. For this study, high-resolution images of neural activity induced by optic flow were acquired in nine healthy controls and nine individuals with balance dysfunction before and after information-free tongue stimulation. Subjects viewed optic flow videos to activate the structures of interest. Sub-millimeter in-plane voxels of structures within the posterior fossa were acquired using a restricted field of view. Whole-brain functional imaging verified that global activation patterns due to optic flow were consistent with previous studies. Optic flow activated the visual association cortices, the vestibular nuclei, and the superior colliculus, as well as multiple regions within the cerebellum. The anterior cingulate cortex showed decreased activity after stimulation, while a region within the pons had increased post-stimulation activity. These observations suggest the pontine region is the trigeminal nucleus and that tongue stimulation interfaces with the balance-processing network within the pons. This high-resolution imaging allows detection of activity within individual brainstem nuclei not possible using standard resolution imaging.

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“…The Fatigue condition was executed 5 min after the No fatigue condition. recently observed in sensory conditions of absent visual information [15], altered foot and ankle somatosensory information [6,16], and degraded vestibular and neck proprioceptive information [17,18]. Finally, even though the present study has been conducted in young healthy individuals, we believe that the present findings could have significant implications in the fields of orthopaedics and rehabilitation, for increasing/restoring the ability to sense force at the ankle.…”

Section: Discussionmentioning

confidence: 59%

Effectiveness of a tongue-placed electrotactile biofeedback to improve ankle force sense following plantar-flexor muscles fatigue

Vuillerme

Boisgontier

2009

Gait & Posture

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Effectiveness of an electro-tactile vestibular substitution system in improving upright postural control in unilateral vestibular-defective patients

Cited by 27 publications

References 15 publications

Non-invasive neuromodulation to improve gait in chronic multiple sclerosis: a randomized double blind controlled pilot trial

Non-invasive neuromodulation to improve gait in chronic multiple sclerosis: a randomized double blind controlled pilot trial

High-resolution fMRI detects neuromodulation of individual brainstem nuclei by electrical tongue stimulation in balance-impaired individuals

Effectiveness of a tongue-placed electrotactile biofeedback to improve ankle force sense following plantar-flexor muscles fatigue

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