The effect of repeated sessions of galvanic vestibular stimulation on target cancellation in visuo-spatial neglect: Preliminary evidence from two cases

Zubko, Olga; Wilkinson, David T.; Langston, Deborah; Sakel, Mohamed

doi:10.3109/02699052.2013.767938

Cited by 19 publications

(12 citation statements)

References 27 publications

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“…These studies suggest that repeated administration not only increases the length of recovery, but also the magnitude of recovery. Contrary to the preliminary data described above (Kerkhoff et al, 2011; Schmidt et al, 2013; Zubko et al, 2013), these studies imply that GVS may be most effective when repeatedly, as opposed to singularly, applied.…”

Section: Introductioncontrasting

confidence: 79%

“…However, as mentioned in the Introduction, three, small GVS studies have shown carry-over from a single session (Kerkhoff et al, 2011; Schmidt et al, 2013; Zubko et al, 2013). This may partly stem from the fact that the vestibular nerve is stimulated many thousands of times during a single 25–30 min session.…”

Section: Discussionmentioning

confidence: 99%

“…A second design issue concerns the best current amplitude to apply. We chose a 1 mA waveform because this is usually subliminal in older stroke patients yet known to modulate relevant neurophysiological and visual functions (Wilkinson et al, 2005, 2008, 2010, 2012; Zubko et al, 2013). But studies that perturb the vestibular stimulation via the more potent stimulus of ice-cold irrigation of the external ear canal have tended to eliminate (albeit transiently) rather than merely reduce neglect (Rubens, 1985; Cappa et al, 1987).…”

Section: Discussionmentioning

confidence: 99%

“…Several recent studies also hint, but by no means confirm, that the beneficial effects of GVS persist after stimulation is stopped. In an unblinded study performed on two neglect patients, Zubko et al (2013) showed that a week's programme of GVS was associated with statistically fewer omissions on the star and letter cancellation tasks 3 days post-stimulation. In two other small-group studies conducted on non-neglectors, Kerkhoff and colleagues showed that GVS induced lasting relief for up to 12 weeks from the somatosensory disorder of tactile extinction (Kerkhoff et al, 2011; Schmidt et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Galvanic vestibular stimulation in hemi-spatial neglect

Wilkinson

Zubko

Sakel

et al. 2014

Front. Integr. Neurosci.

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Hemi-spatial neglect is an attentional disorder in which the sufferer fails to acknowledge or respond to stimuli appearing in contralesional space. In recent years, it has become clear that a measurable reduction in contralesional neglect can occur during galvanic vestibular stimulation, a technique by which transmastoid, small amplitude current induces lateral, attentional shifts via asymmetric modulation of the left and right vestibular nerves. However, it remains unclear whether this reduction persists after stimulation is stopped. To estimate longevity of effect, we therefore conducted a double-blind, randomized, dose-response trial involving a group of stroke patients suffering from left-sided neglect (n = 52, mean age = 66 years). To determine whether repeated sessions of galvanic vestibular stimulation more effectively induce lasting relief than a single session, participants received 1, 5, or 10 sessions, each lasting 25 min, of sub-sensory, left-anodal right-cathodal noisy direct current (mean amplitude = 1 mA). Ninety five percent confidence intervals indicated that all three treatment arms showed a statistically significant improvement between the pre-stimulation baseline and the final day of stimulation on the primary outcome measure, the conventional tests of the Behavioral Inattention Test. More remarkably, this change (mean change = 28%, SD = 18) was still evident 1 month later. Secondary analyses indicated an allied increase of 20% in median Barthel Index (BI) score, a measure of functional capacity, in the absence of any adverse events or instances of participant non-compliance. Together these data suggest that galvanic vestibular stimulation, a simple, cheap technique suitable for home-based administration, may produce lasting reductions in neglect that are clinically important. Further protocol optimization is now needed ahead of a larger effectiveness study.

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Section: Introductioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Galvanic vestibular stimulation in hemi-spatial neglect

Wilkinson

Zubko

Sakel

et al. 2014

Front. Integr. Neurosci.

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“…Wilkinson and colleagues have also found that noisy GVS can attenuate prosopagnosia (Wilkinson et al, 2005) and figure copying deficits (Wilkinson et al, 2010). In the most recent study involving two patients with visuo-spatial neglect, GVS was found to have a lasting beneficial effect in a target cancellation task (Zubko et al, 2013). In one of the most systematic studies to date, Dilda et al (2012) found that suprathreshold GVS significantly increased the error rates for match-to-sample and perspective-taking tasks compared to a subthreshold GVS group; however, reaction time, dual tasking, mental rotation and manual tracking were not significantly affected.…”

Section: Effects Of Artificial Vestibular Activation On Memory In Humansmentioning

confidence: 99%

From ear to uncertainty: vestibular contributions to cognitive function

Smith

Zheng

2013

Front. Integr. Neurosci.

126

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In addition to the deficits in the vestibulo-ocular and vestibulo-spinal reflexes that occur following vestibular dysfunction, there is substantial evidence that vestibular loss also causes cognitive disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and neocortex play in spatial orientation. In this review we summarize the evidence that vestibular loss causes cognitive disorders, especially spatial memory deficits, in animals and humans and critically evaluate the evidence that these deficits are not due to hearing loss, problems with motor control, oscillopsia or anxiety and depression. We review the evidence that vestibular lesions affect head direction and place cells as well as the emerging evidence that artificial activation of the vestibular system, using galvanic vestibular stimulation (GVS), can modulate cognitive function.

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Galvanic vestibular stimulation impairs cell proliferation and neurogenesis in the rat hippocampus but not spatial memory

et al. 2014

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Galvanic vestibular stimulation (GVS) is a method of activating the peripheral vestibular system using direct current that is widely employed in clinical neurological testing. Since movement is recognized to stimulate hippocampal neurogenesis and movement is impossible without activation of the vestibular system, we speculated that activating the vestibular system in rats while minimizing movement, by delivering GVS under anesthesia, would affect hippocampal cell proliferation and neurogenesis, and spatial memory. Compared with the sham control group, the number of cells incorporating the DNA replication marker, bromodeoxyuridine (BrdU), was significantly reduced in the bilateral hippocampi in both the cathode left‐anode right and cathode right‐anode left stimulation groups (P ≤ 0.0001). The majority of the BrdU+ve cells co‐expressed Ki‐67, a marker for the S phase of the cell cycle, suggesting that these BrdU+ve cells were still in the cell cycle; however, there was no significant difference in the degree of co‐labeling between the two stimulation groups. Single labeling for doublecortin (DCX), a marker of immature neurons, showed that while there was no significant difference between the different groups in the number of DCX+ve cells in the right dentate gryus, in the left dentate gyrus there was a significant decrease in the cathode left‐anode right group compared with the sham controls (P ≤ 0.03). Nonetheless, when animals were tested in place recognition, object exploration and Morris water maze tasks, there were no significant differences between the GVS groups and the sham controls. These results suggest that GVS can have striking effects on cell proliferation and possibly neurogenesis in the hippocampus, without affecting spatial memory. © 2014 Wiley Periodicals, Inc.

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The effect of repeated sessions of galvanic vestibular stimulation on target cancellation in visuo-spatial neglect: Preliminary evidence from two cases

Cited by 19 publications

References 27 publications

Galvanic vestibular stimulation in hemi-spatial neglect

Galvanic vestibular stimulation in hemi-spatial neglect

From ear to uncertainty: vestibular contributions to cognitive function

Galvanic vestibular stimulation impairs cell proliferation and neurogenesis in the rat hippocampus but not spatial memory

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