Vestibular implants studied in animal models: clinical and scientific implications

Lewis, Richard

doi:10.1152/jn.00601.2016

Cited by 26 publications

(25 citation statements)

References 57 publications

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“…Animal experiments were undertaken to prove the feasibility of vestibular implants (Della Santina et al, 2007 ; Fridman and Della Santina, 2012 ; Rubinstein et al, 2012 ; Nie et al, 2013 ; Lewis, 2016 ) and also to analyze the effects of different stimulation parameters on the stimulation of the vestibular nerve (Fridman et al, 2010 ; Davidovics et al, 2011 ). The feasibility of vestibular implants was also confirmed in humans (Guyot et al, 2011 ; Perez Fornos et al, 2014 ; Guinand et al, 2015 ; van de Berg et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Model-based Vestibular Afferent Stimulation: Modular Workflow for Analyzing Stimulation Scenarios in Patient Specific and Statistical Vestibular Anatomy

et al. 2017

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Our sense of balance and spatial orientation strongly depends on the correct functionality of our vestibular system. Vestibular dysfunction can lead to blurred vision and impaired balance and spatial orientation, causing a significant decrease in quality of life. Recent studies have shown that vestibular implants offer a possible treatment for patients with vestibular dysfunction. The close proximity of the vestibular nerve bundles, the facial nerve and the cochlear nerve poses a major challenge to targeted stimulation of the vestibular system. Modeling the electrical stimulation of the vestibular system allows for an efficient analysis of stimulation scenarios previous to time and cost intensive in vivo experiments. Current models are based on animal data or CAD models of human anatomy. In this work, a (semi-)automatic modular workflow is presented for the stepwise transformation of segmented vestibular anatomy data of human vestibular specimens to an electrical model and subsequently analyzed. The steps of this workflow include (i) the transformation of labeled datasets to a tetrahedra mesh, (ii) nerve fiber anisotropy and fiber computation as a basis for neuron models, (iii) inclusion of arbitrary electrode designs, (iv) simulation of quasistationary potential distributions, and (v) analysis of stimulus waveforms on the stimulation outcome. Results obtained by the workflow based on human datasets and the average shape of a statistical model revealed a high qualitative agreement and a quantitatively comparable range compared to data from literature, respectively. Based on our workflow, a detailed analysis of intra- and extra-labyrinthine electrode configurations with various stimulation waveforms and electrode designs can be performed on patient specific anatomy, making this framework a valuable tool for current optimization questions concerning vestibular implants in humans.

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Section: Introductionmentioning

confidence: 99%

Model-based Vestibular Afferent Stimulation: Modular Workflow for Analyzing Stimulation Scenarios in Patient Specific and Statistical Vestibular Anatomy

et al. 2017

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“…Determining meaningful and distinguishing gait parameters in BVP is vital for the development of interventions, as is using tasks that sufficiently replicate the day-to-day challenges of these patients, in order to determine candidates for intervention and to assess the effect of those interventions. Two promising interventions currently under development and investigation include noisy galvanic vestibular stimulation (nGVS) and vestibular implants (Guinand et al 2015;Lewis 2016;Perez Fornos et al 2017;Wuehr et al 2017). Discussions of these treatment options can be found elsewhere Wuehr et al 2017), but in the context of this study, it is important to note that both options show early signs of utility for improving the gait of people with BVP (McCrum et al 2016;Wuehr et al 2016).…”

Section: Discussionmentioning

confidence: 99%

“…BVP, a severe bilateral reduction of vestibular function that results in severe balance deficits and an increased risk of falls (Guinand et al 2012a;Horak et al 2016;Lucieer et al 2016;Schlick et al 2016;Sprenger et al 2017;, was recently defined by the Bárány Society and represents one of the most debilitating vestibular disorders. The study of the severe balance and gait deficits in people with BVP is both important for improving clinical care and for objective quantification of the effects of novel interventions, such as vestibular implants Lewis 2016). Furthermore, it is fundamental to our understanding of the vestibular contributions to gait and balance control.…”

Section: Introductionmentioning

confidence: 99%

Is faster always better? The walking speed-dependency of gait variability in bilateral vestibulopathy

McCrum

Lucieer

Berg

et al. 2018

Preprint

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2 5 chris.mccrum@maastrichtuniversity.nl 2 6 2 7 2 Abstract 2 8Study of balance and gait deficits associated with vestibulopathy is important for improving clinical care and is 2 9 critical to our understanding of the vestibular contributions to gait and balance control. Previous studies report a 3 0 speed-dependency of the vestibular contributions to gait, so we examined the walking speed effects on gait 3 1 variability in healthy young and older adults and in adults with bilateral vestibulopathy (BVP). Forty-four 3 2 people with BVP, 12 healthy young adults and 12 healthy older adults completed walking trials at 0.4m/s to 3 3 1.6m/s in 0.2m/s intervals on a dual belt, instrumented treadmill. Using a motion capture system and kinematic 3 4 data, the means and coefficients of variation for step length, time, width and double support time were 3 5 calculated. The BVP group also completed a video head impulse test and examinations of ocular and cervical 3 6 vestibular evoked myogenic potentials and dynamic visual acuity. Walking speed significantly affected all 3 7assessed gait parameters.Step length variability at slower speeds and step width variability at faster speeds were 3 8 the most distinguishing parameters between the healthy participants and people with BVP, and within people 3 9with BVP with different locomotor capacities. We observed for step width variability, specifically, an apparent 4 0 persistent importance of vestibular function at increasing speeds. Gait variability was not associated with the 4 1 clinical vestibular tests. Our results indicate that gait variability at multiple walking speeds has potential as an 4 2 assessment tool for vestibular interventions. 4 3 4 4

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“…Determining meaningful and distinguishing gait parameters in BVP is vital for the development of interventions, as is using tasks that sufficiently replicate the day-to-day challenges of these patients, to determine candidates for intervention and to assess the effect of those interventions. Two promising interventions currently under development and investigation include noisy galvanic vestibular stimulation (nGVS) and vestibular implants (Guyot et al, 2016, Lewis, 2016, Perez Fornos et al, 2017. Discussions of these treatment options can be found elsewhere (Guyot et al, 2016, but it is important to note that both…”

Section: Discussionmentioning

confidence: 99%

“…However, further research into the relationships between vestibulopathy, walking speed and gait variability is needed to confirm and expand on these previous findings, as these three previous studies had some potential drawbacks, namely a limited number of gait parameters being analysed (Schniepp et al, 2012), too few strides (Owings and Grabiner, 2003, Hollman et al, 2010, Konig et al, 2014, Riva et al, 2014 for a robust analysis of gait variability (Schniepp et al, 2012, the use of only preferred walking speeds or percentages of preferred walking speeds (ecologically valid, but less control over influencing factors) (Schniepp et al, 2012, small sample size (Wuehr et al, 2016), lack of a healthy control group (Wuehr et al, 2016 and the presence of sham vestibular stimulation in the control condition (Wuehr et al, 2016). The study of the severe balance and gait deficits in people with BVP is both important for improving clinical care and for objective quantification of the effects of novel interventions, such as vestibular implants (Guyot et al, 2016, Lewis, 2016. Furthermore, it is fundamental to our understanding of the vestibular contributions to gait and balance control.…”

Section: Introductionmentioning

confidence: 99%

A trip to remember

McCrum¹

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People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal. Part Three: Gait Perturbation Methodology 51 3.1: A systematic review of gait perturbation paradigms for improving reactive stepping responses and falls risk among healthy older adults 3.2: Stability-normalised walking speed: a new approach for human gait perturbation research Part Four: Reactive Gait Stability and Adaptability 83 4.1: Retention, savings and interlimb transfer of reactive gait adaptations in humans following unexpected perturbations 4.2: Older adults demonstrate interlimb transfer of reactive gait adaptations to repeated unpredictable gait perturbations

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Vestibular implants studied in animal models: clinical and scientific implications

Cited by 26 publications

References 57 publications

Model-based Vestibular Afferent Stimulation: Modular Workflow for Analyzing Stimulation Scenarios in Patient Specific and Statistical Vestibular Anatomy

Model-based Vestibular Afferent Stimulation: Modular Workflow for Analyzing Stimulation Scenarios in Patient Specific and Statistical Vestibular Anatomy

Is faster always better? The walking speed-dependency of gait variability in bilateral vestibulopathy

A trip to remember

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