The effect of galvanic vestibular stimulation on postural balance in Parkinson's disease: A systematic review and meta-analysis

Mahmud, Mohammad; Hadi, Zaeem; Prendergast, Mabel; Ciocca, Matteo; Saad, Abdel Rahman; Pondeca, Yuscah; Tai, Yen; Scott, Gregory; Seemungal, Barry

doi:10.1016/j.jns.2022.120414

Cited by 9 publications

(5 citation statements)

References 61 publications

(153 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The modulation of vestibular signalling by means of non-invasive brain stimulation techniques has gained increasing interest over the recent years as a treatment for some neurodegenerative conditions. Particularly, galvanic vestibular stimulation has been used to improve balance and vestibular outputs in patients with bilateral vestibulopathy (Schniepp et al, 2018), Parkinson's disease (Mahmud et al, 2022), multiple sclerosis (Lotfi et al, 2021), anddizziness (Woll et al, 2019). Galvanic vestibular stimulation may modulate balance, potentially by modulating the PPNthalamic connections, as shown in neuroimaging studies (Cai et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Vestibular prepulse inhibition of the human blink reflex

Ciocca,

Hosli,

Hadi

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

ObjectiveAuditory and somatosensory prepulses are commonly used to assess prepulse inhibition (PPI). The effect of a vestibular prepulse upon blink reflex (BR) excitability has not been hitherto assessed.MethodsTwenty-two healthy subjects and two patients with bilateral peripheral vestibular failure took part in the study. Whole body yaw rotation in the dark provided a vestibular inertial prepulse. BR was electrically evoked after the end of the rotation. The area-under-the-curve (area) of the BR responses (R1, R2, and R2c) was recorded and analysed.ResultsA vestibular prepulse inhibited the R2 (p < 0.001) and R2c area (p < 0.05). Increasing the angular acceleration did not increase the R2/R2c inhibition (p>0.05). Voluntary suppression of the vestibular-ocular reflex did not affect the magnitude of inhibition (p>0.05). Patients with peripheral vestibular failure did not show any inhibition.ConclusionsOur data support a vestibular-gating mechanism in humans.SignificanceThe main brainstem nucleus mediating PPI – the pedunculopontine nucleus (PPN) – is heavily vestibular responsive, which is consistent with our findings of a vestibular-mediated PPI. Our technique may be used to interrogate the fidelity of brain circuits mediating vestibular-related PPN functions. Given the PPN’s importance in human postural control, our technique may also provide a neurophysiological biomarker of balance.HighlightsThis is the first report of a vestibular prepulse inhibition of the blink reflex.A vestibular prepulse inhibits the R2/R2c area in healthy subjects but not in patients with bilateral peripheral vestibular failure.Vestibular PPI is a potential neurophysiological marker of vestibular-motor integration at the brainstem level.

show abstract

Section: Discussionmentioning

confidence: 99%

Vestibular prepulse inhibition of the human blink reflex

Ciocca,

Hosli,

Hadi

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…An additional study used GVS applied to the mastoid process and C7 vertebrae, with small improvements seen in PD subjects’ antero-posterior sway while static balancing on foam with their eyes closed; this result was only seen with low intensity stimulation, however [ 126 ]. These results and others were combined in a recent meta-analysis, which suggested that GVS likely has an overall positive effect on PI in this population, but the existing data is relatively inconclusive [ 127 ]. While both tDCS and GVS remain promising options for treating PI in people with PD, much additional work is needed to optimize stimulation protocols, including the number of treatment sessions, intensity and location of stimulation, and selection of appropriate subjects [ 125 , 127 ].…”

Section: Additional Neuromodulatory Interventions On Postural Instabi...mentioning

confidence: 99%

“…These results and others were combined in a recent meta-analysis, which suggested that GVS likely has an overall positive effect on PI in this population, but the existing data is relatively inconclusive [ 127 ]. While both tDCS and GVS remain promising options for treating PI in people with PD, much additional work is needed to optimize stimulation protocols, including the number of treatment sessions, intensity and location of stimulation, and selection of appropriate subjects [ 125 , 127 ].…”

Section: Additional Neuromodulatory Interventions On Postural Instabi...mentioning

confidence: 99%

Unraveling the threads of stability: A review of the neurophysiology of postural control in Parkinson's disease

Bath,

Wang

2024

Neurotherapeutics

View full text Add to dashboard Cite

“…Other groups have also demonstrated the utility of GVS as a strategy to enhance postural balance in a range of populations-elderly healthy [13], patients with bilateral vestibular failure [14] to Parkinson's disease [15]. A recent review of the effect of GVS on postural balance (restricted to Parkinson's disease) concluded favorable effect but suggested caution due to limited studies as well as inconsistent methodological details across them [16].…”

Section: Plos Onementioning

confidence: 99%

Impact of galvanic vestibular stimulation electrode current density on brain current flow patterns: Does electrode size matter?

et al. 2023

View full text Add to dashboard Cite

Background Galvanic vestibular stimulation (GVS) uses at least one electrode placed on the mastoid process with one or multiple placed over other head areas to stimulate the vestibular system. The exact electrode size used is not given much importance in the literature and has not been reported in several studies. In a previous study, we compared the clinical effects of using different electrode sizes (3 cm2 and 35 cm2) with placebo but with the same injected current, on postural control. We observed significant improvement using the smaller size electrode but not with the bigger size electrode. The goal of this study was to simulate the current flow patterns with the intent to shed light and potentially explain the experimental outcome. Methods We used an ultra-high-resolution structural dataset and developed a model to simulate the application of different electrode sizes. We considered current flow in the brain and in the vestibular labyrinth. Results Our simulation results verified the focality increase using smaller electrodes that we postulated as the main reason for our clinical effect. The use of smaller size electrodes in combination with the montage employed also result in higher induced electric field (E-field) in the brain. Conclusions Electrode size and related current density is a critical parameter to characterize any GVS administration as the choice impacts the induced E-field. It is evident that the higher induced E-field likely contributed to the clinical outcome reported in our prior study.

show abstract

The effect of galvanic vestibular stimulation on postural balance in Parkinson's disease: A systematic review and meta-analysis

Cited by 9 publications

References 61 publications

Vestibular prepulse inhibition of the human blink reflex

Vestibular prepulse inhibition of the human blink reflex

Unraveling the threads of stability: A review of the neurophysiology of postural control in Parkinson's disease

Impact of galvanic vestibular stimulation electrode current density on brain current flow patterns: Does electrode size matter?

Contact Info

Product

Resources

About