Electrical stimulation of the vestibular nerve: evaluating effects and potential starting points for optimization in vestibular implants.

IF 1.9 4区医学 Q2 OTORHINOLARYNGOLOGY

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2024-10-01 Epub Date: 2024-08-29 DOI:10.1097/MOO.0000000000001001

Marieke Ten Hoor, Raymond van de Berg, Angélica Pérez Fornos, Joost Johannes Antonius Stultiens

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Abstract

Purpose of review: Oscillopsia and unsteadiness are common and highly debilitating symptoms in individuals with bilateral vestibulopathy. A lack of adequate treatment options encouraged the investigation of vestibular implants, which aim to restore vestibular function with motion-modulated electrical stimulation. This review aims to outline the ocular and postural responses that can be evoked with electrical prosthetic stimulation of the semicircular canals and discuss potential approaches to further optimize evoked responses. Particular focus is given to the stimulation paradigm.

Recent findings: Feasibility studies in animals paved the way for vestibular implantation in human patients with bilateral vestibulopathy. Recent human trials demonstrated prosthetic electrical stimulation to partially restore vestibular reflexes, enhance dynamic visual acuity, and generate controlled postural responses. To further optimize prosthetic performance, studies predominantly targeted eye responses elicited by the vestibulo-ocular reflex, aiming to minimize misalignments and asymmetries while maximizing the response. Changes of stimulation parameters are shown to hold promise to increase prosthetic efficacy, together with surgical refinements and neuroplastic effects.

Summary: Optimization of the stimulation paradigm, in combination with a more precise electrode placement, holds great potential to enhance the clinical benefit of vestibular implants.

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前庭神经电刺激：评估效果和优化前庭植入物的潜在起点。

综述的目的：震荡和不稳定性是双侧前庭病变患者常见的症状，也是极易使人衰弱的症状。由于缺乏适当的治疗方案，人们开始研究前庭植入物，旨在通过运动调节电刺激恢复前庭功能。本综述旨在概述半规管假体电刺激可诱发的眼部和姿势反应，并讨论进一步优化诱发反应的潜在方法。最近的研究结果特别关注刺激范例：在动物身上进行的可行性研究为在患有双侧前庭神经病的人类患者身上进行前庭植入铺平了道路。最近的人体试验表明，假体电刺激可部分恢复前庭反射，提高动态视敏度，并产生可控的姿势反应。为了进一步优化假体性能，研究主要针对前庭-眼反射引起的眼部反应，目的是尽量减少错位和不对称，同时最大限度地提高反应。小结：刺激范式的优化与更精确的电极放置相结合，有望提高前庭植入物的临床疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Otolaryngology & Head and Neck Surgery OTORHINOLARYNGOLOGY-

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Otolaryngology & Head and Neck Surgery is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With eleven disciplines published across the year – including maxillofacial surgery, head and neck oncology and speech therapy and rehabilitation – every issue also contains annotated references detailing the merits of the most important papers.