Noise-Enhanced Vestibular Input Improves Dynamic Walking Stability in Healthy Subjects

Wuehr, Max; Nusser, E.; Krafczyk, S.; Straube, Andreas; Brandt, Theo; Jahn, Klaus; Schniepp, Roman

doi:10.1016/j.brs.2015.08.017

Cited by 83 publications

(98 citation statements)

References 43 publications

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“…For the sinusoidal technique, a 1 Hz sinusoidal waveform with currents ranging from 0-1500 μA is applied to determine a motion threshold [21,24]; that is, the lowest stimulation intensity that elicits perceived or observable sway of the head or body. Alternatively, for the cutaneous technique, varying stimulation intensities using a 0-30 Hz stochastic signal are applied in a stepwise manner until a sensation is felt on the skin under the electrode site [17][18][19][20]. Both sinusoidal and cutaneous threshold techniques have proved beneficial, though, as we show in this study, yield different stimulation intensities.…”

Section: Introductionmentioning

confidence: 87%

“…Recently, several groups of researchers have demonstrated that the application of subthreshold stochastic vestibular stimulation (SVS), also known as noisy galvanic vestibular stimulation, is associated with improved balance control during standing and changes in walking patterns [13][14][15][16][17][18][19][20]. For example, SVS results in reduced postural sway length and velocity during eyes-open quiet standing in young and older adults [15,16] and during eyes-closed quiet standing in patients with bilateral vestibulopathy [13,17].…”

Section: Introductionmentioning

confidence: 99%

“…For example, SVS results in reduced postural sway length and velocity during eyes-open quiet standing in young and older adults [15,16] and during eyes-closed quiet standing in patients with bilateral vestibulopathy [13,17]. In addition, others found increased gait speed and changes in stride measures with SVS during treadmill and overground walking in healthy adults and patients with bilateral vestibulopathy [18][19][20]. If subthreshold SVS provides noise that increases the sensitivity of the vestibular system to respond to natural vestibular inputs, then its effectiveness should also be evident in more balance-challenged situations, when the vestibular system's contribution to balance is presumably more important.…”

Section: Introductionmentioning

confidence: 99%

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Subthreshold stochastic vestibular stimulation affects balance-challenged standing and walking

2020

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Subthreshold stochastic vestibular stimulation (SVS) is thought to enhance vestibular sensitivity and improve balance. However, it is unclear how SVS affects standing and walking when balance is challenged, particularly when the eyes are open. It is also unclear how different methods to determine stimulation intensity influence the effects. We aimed to determine (1) whether SVS affects stability when balance is challenged during eyes-open standing and overground walking tasks, and (2) how the effects differ based on whether optimal stimulation amplitude is derived from sinusoidal or cutaneous threshold techniques. Thirteen healthy adults performed balance-unchallenged and balance-challenged standing and walking tasks with SVS (0-30 Hz zero-mean, white noise electrical stimulus) or sham stimulation. For the balance-challenged condition, participants had inflatable rubber hemispheres attached to the bottom of their shoes to reduce the control provided by moving the center of pressure under their base of support. In different blocks of trials, we set SVS intensity to either 50% of participants' sinusoidal (motion) threshold or 80% of participants' cutaneous threshold. SVS reduced medial-lateral trunk velocity root mean square in the balance-challenged (p < 0.05) but not in the balance-unchallenged condition during standing. Regardless of condition, SVS decreased step-width variability and marginally increased gait speed when walking with the eyes open (p < 0.05). SVS intensity had minimal effect on the standing and walking measures. Taken together, our results provide insight into the effectiveness of SVS at improving balance-challenged, eyes-open standing and walking performance in healthy adults. OPEN ACCESSCitation: Piccolo C, Bakkum A, Marigold DS (2020) Subthreshold stochastic vestibular stimulation affects balance-challenged standing and walking. PLoS ONE 15(4): e0231334. https://doi.org/ 10.

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Section: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subthreshold stochastic vestibular stimulation affects balance-challenged standing and walking

2020

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“…Galvanic vestibular stimulation is another common method in which electric current is used to stimulate the vestibular nerve via electrodes placed over the mastoid bones (Lobel et al, 1998; Yamamoto et al, 2005; Wuehr et al, 2016). GVS activates the entire vestibular nerve and thus activates pathways associated with both the semicircular canals and the otoliths, whereas CVS mainly activates the horizontal semicircular canals (Dieterich, 2003; Stephan et al, 2005; Day et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Functional Brain Activation in Response to a Clinical Vestibular Test Correlates with Balance

Noohi

Kinnaird

DeDios

et al. 2017

Front. Syst. Neurosci.

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The current study characterizes brain fMRI activation in response to two modes of vestibular stimulation: Skull tap and auditory tone burst. The auditory tone burst has been used in previous studies to elicit either a vestibulo-spinal reflex [saccular-mediated colic Vestibular Evoked Myogenic Potentials (cVEMP)], or an ocular muscle response [utricle-mediated ocular VEMP (oVEMP)]. Research suggests that the skull tap elicits both saccular and utricle-mediated VEMPs, while being faster and less irritating for subjects than the high decibel tones required to elicit VEMPs. However, it is not clear whether the skull tap and auditory tone burst elicit the same pattern of brain activity. Previous imaging studies have documented activity in the anterior and posterior insula, superior temporal gyrus, inferior parietal lobule, inferior frontal gyrus, and the anterior cingulate cortex in response to different modes of vestibular stimulation. Here we hypothesized that pneumatically powered skull taps would elicit a similar pattern of brain activity as shown in previous studies. Our results provide the first evidence of using pneumatically powered skull taps to elicit vestibular activity inside the MRI scanner. A conjunction analysis revealed that skull taps elicit overlapping activation with auditory tone bursts in the canonical vestibular cortical regions. Further, our postural control assessments revealed that greater amplitude of brain activation in response to vestibular stimulation was associated with better balance control for both techniques. Additionally, we found that skull taps elicit more robust vestibular activity compared to auditory tone bursts, with less reported aversive effects, highlighting the utility of this approach for future clinical and basic science research.

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“…Recently, our group showed that a 30-s application of nGVS can improve postural stability in healthy individuals and in patients with untreatable persistent unsteadiness caused by bilateral vestibulopathy (BV)8. This kind of vestibular stimulation also improves dynamic stability during walking in healthy subjects and BV patients91011. The rationale behind these ameliorating effects is stochastic resonance, in which an optimal amount of noise added to nonlinear systems can enhance information processing within the system12.…”

mentioning

confidence: 99%

Noisy galvanic vestibular stimulation induces a sustained improvement in body balance in elderly adults

Fujimoto

Yamamoto

Kamogashira

et al. 2016

Sci Rep

113

119

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Vestibular dysfunction causes postural instability, which is prevalent in the elderly. We previously showed that an imperceptible level of noisy galvanic vestibular stimulation (nGVS) can improve postural stability in patients with bilateral vestibulopathy during the stimulus, presumably by enhancing vestibular information processing. In this study, we investigated the after-effects of an imperceptible long-duration nGVS on body balance in elderly adults. Thirty elderly participants underwent two nGVS sessions in a randomised order. In Session 1, participants received nGVS for 30 min twice with a 4-h interval. In Session 2, participants received nGVS for 3 h. Two-legged stance tasks were performed with eyes closed while participants stood on a foam rubber surface, with and without nGVS, and parameters related to postural stability were measured using posturography. In both sessions, the postural stability was markedly improved for more than 2 h after the cessation of the stimulus and tended to decrease thereafter. The second stimulation in Session 1 caused a moderate additional improvement in body balance and promoted the sustainability of the improvement. These results suggest that nGVS can lead to a postural stability improvement in elderly adults that lasts for several hours after the cessation of the stimulus, probably via vestibular neuroplasticity.

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Noise-Enhanced Vestibular Input Improves Dynamic Walking Stability in Healthy Subjects

Cited by 83 publications

References 43 publications

Subthreshold stochastic vestibular stimulation affects balance-challenged standing and walking

Subthreshold stochastic vestibular stimulation affects balance-challenged standing and walking

Functional Brain Activation in Response to a Clinical Vestibular Test Correlates with Balance

Noisy galvanic vestibular stimulation induces a sustained improvement in body balance in elderly adults

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