The Moving History of Vestibular Stimulation as a Therapeutic Intervention

Abstract

Although the discovery and understanding of the function of the vestibular system date back only to the 19th century, strategies that involve vestibular stimulation were used long before to calm, soothe and even cure people. While such stimulation was classically achieved with various motion devices, like Cox's chair or Hallaran's swing, the development of caloric and galvanic vestibular stimulation has opened up new possibilities in the 20th century. With the increasing knowledge and recognition of vestibular contributions to various perceptual, motor, cognitive, and emotional processes, vestibular stimulation has been suggested as a powerful and non-invasive treatment for a range of psychiatric, neurological and neurodevelopmental conditions. Yet, the therapeutic interventions were, and still are, often not hypothesis-driven as broader theories remain scarce and underlying neurophysiological mechanisms are often vague. We aim to critically review the literature on vestibular stimulation as a form of therapy in various selected disorders and present its successes, expectations, and drawbacks from a historical perspective. AbstractAlthough the discovery and understanding of the function of the vestibular system date back only to the

Vestibular neuromodulation: stimulating the neural crossroads of psychiatric illness

“… As cited in Miller and Ngo and Grabherr et al., and in the text. Other reported effects of vestibular stimulation, particularly motion‐induced stimulation in neurodevelopmental disorders, are not listed here but can be found in Grabherr et al …”

“…Extrapolated to a clinical context, this finding is consistent with the excessive spending and risky financial decision‐making observed in mania. Vestibular stimulation also has (complex) effects on sleep in healthy subjects, and interestingly in the context of mania, historical records refer to the sedating and sleep‐promoting effects of rotation apparatuses …”

“…The gold standard for assessing therapeutic efficacy however is the double‐blind randomized placebo‐controlled trial (RCT). RCTs of repeated CVS (rCVS) are needed for mania, depression (both bipolar and unipolar depression), persistent pain, postlesional conditions, and other psychiatric and neurological disorders . RCTs of repeated GVS (rGVS) in hemispatial neglect have commenced, with enduring therapeutic benefits reported (see also Schindler et al; though see Ruet et al for a negative study).…”

“…However, the several hundred-year history of attempting to treat psychiatric illness with vestibular stimulation (usually motion-induced stimulation) is far less known. 5 In the midlate 20th century, reports also emerged of the remarkable ability of cold left-ear CVS -which predominantly activates right-sided structures -to temporarily reverse unilateral attentional neglect and anosognosia (denial of illness) associated with right-hemisphere stroke. 6 Subsequently, a model of bipolar disorder -the 'Sticky Interhemispheric Switch' model -was proposed based on new findings of slow binocular rivalry in bipolar disorder (see below) and CVS modulation of binocular rivalry, as well as existing evidence for hemispheric lateralization of cognitive style, mood and mood disorders.…”

The vestibular system

“…While swings and rotating chairs have long been used with the aim of curing anxiety, mania, and depression [113], only two studies suggested that continuous body motions modify mood [114,115]. Interestingly, CVS also changes participants' responses to affective images [116 & ] and decisionmaking tasks [117 & ].…”