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

Autor:	Ten Hoor M; Department of Otorhinolaryngology & Head and Neck Surgery, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands., van de Berg R; Department of Otorhinolaryngology & Head and Neck Surgery, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands., Pérez Fornos A; Service of Otorhinolaryngology and Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland., Stultiens JJA; Department of Otorhinolaryngology & Head and Neck Surgery, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Current opinion in otolaryngology & head and neck surgery [Curr Opin Otolaryngol Head Neck Surg] 2024 Oct 01; Vol. 32 (5), pp. 313-321. Date of Electronic Publication: 2024 Aug 29.
DOI:	10.1097/MOO.0000000000001001
Abstrakt:	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. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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