Vection in virtual reality modulates vestibular‐evoked myogenic potentials

Gallagher, Maria; dowsett, ross kay and david; Ferrè, Elisa Raffaella

doi:10.1111/ejn.14499

Cited by 23 publications

(24 citation statements)

References 63 publications

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“…While the patient receives visual signals informing him or her that he or she is moving, no corroborating information is provided by the vestibular organs. Cybersickness has been described to occur in 20% to 80% of cases [ 29 ], although it occurred in only 18.8% of the sample in Bruno et al’s [ 17 ] study. In our study, the occurrence of this side effect was even lower (6.3%) and may be due to younger age, fewer comorbidities, and better hemodynamic stability in patients undergoing AF ablation compared to those who underwent the transcatheter aortic valve implantation procedure.…”

Section: Discussionmentioning

confidence: 99%

Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

Roxburgh¹,

Li²,

Guenancia³

et al. 2021

J Med Internet Res

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Background Connected devices are dramatically changing many aspects in health care. One such device, the virtual reality (VR) headset, has recently been shown to improve analgesia in a small sample of patients undergoing transcatheter aortic valve implantation. Objective We aimed to investigate the feasibility and effectiveness of VR in patients undergoing atrial fibrillation (AF) ablation under conscious sedation. Methods All patients who underwent an AF ablation with VR from March to May 2020 were included. Patients were compared to a consecutive cohort of patients who underwent AF ablation in the 3 months prior to the study. Primary efficacy was assessed by using a visual analog scale, summarizing the overall pain experienced during the ablation. Results The AF cryoablation procedure with VR was performed for 48 patients (mean age 63.0, SD 10.9 years; n=16, 33.3% females). No patient refused to use the device, although 14.6% (n=7) terminated the VR session prematurely. Preparation of the VR headset took on average 78 (SD 13) seconds. Compared to the control group, the mean perceived pain, assessed with the visual analog scale, was lower in the VR group (3.5 [SD 1.5] vs 4.3 [SD 1.6]; P=.004), and comfort was higher in the VR group (7.5 [SD 1.6] vs 6.8 [SD 1.7]; P=.03). On the other hand, morphine consumption was not different between the groups. Lastly, complications, as well as procedure and fluoroscopy duration, were not different between the two groups. Conclusions We found that VR was associated with a reduction in the perception of pain in patients undergoing AF ablation under conscious sedation. Our findings demonstrate that VR can be easily incorporated into the standard ablation workflow.

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Section: Discussionmentioning

confidence: 99%

Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

Roxburgh¹,

Li²,

Guenancia³

et al. 2021

J Med Internet Res

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“…According to Bayesian optimal integration frameworks (Ernst and Banks, 2002;Ernst and Bülthoff, 2004;Gu et al, 2008;Angelaki et al, 2011), when exposed to an environment in which visual cues are present and vestibular cues are uncertain or conflicting, such as VR, the weighting of the vestibular cues may be decreased, and the brain extracts self-motion information primarily from visual signals (Gallagher and Ferrè, 2018;Gallagher et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Multisensory Interactions in Virtual Reality: Optic Flow Reduces Vestibular Sensitivity, but Only for Congruent Planes of Motion

2020

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During exposure to Virtual Reality (VR) a sensory conflict may be present, whereby the visual system signals that the user is moving in a certain direction with a certain acceleration, while the vestibular system signals that the user is stationary. In order to reduce this conflict, the brain may down-weight vestibular signals, which may in turn affect vestibular contributions to self-motion perception. Here we investigated whether vestibular perceptual sensitivity is affected by VR exposure. Participants’ ability to detect artificial vestibular inputs was measured during optic flow or random motion stimuli on a VR head-mounted display. Sensitivity to vestibular signals was significantly reduced when optic flow stimuli were presented, but importantly this was only the case when both visual and vestibular cues conveyed information on the same plane of self-motion. Our results suggest that the brain dynamically adjusts the weight given to incoming sensory cues for self-motion in VR; however this is dependent on the congruency of visual and vestibular cues.

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“…Changes in wave latencies and increased amplitudes in the cVEMP test performed in healthy individuals in the presence of optic illusion suggest that vestibular reflex pathways are also affected by the vestibular and visual cortex. Giving a visual stimulus causes physiological changes in the reflex arc which creates cVEMP response with a high amplitude [ 24 ]. Fowler, et al [ 25 ] obtained higher cVEMP amplitudes in people with motion sickness and stated that there is a correlation between these two factors.…”

Section: Discussionmentioning

confidence: 99%

“…Gallagher, et al [ 24 ] created an optical illusion (perception of movement) in adult participants by using VR goggles. They observed a significant increase in left cVEMP amplitude during exposure to optical illusion.…”

Section: Discussionmentioning

confidence: 99%

“…They also observed that in the left cVEMP waves, the P1 latency was significantly shorter in the presence of optical illusion and the latency between the P1- N1 peaks was increased. As a result, they have stated that optical illusion affects the cVEMP reflex path, shortening latency and enlarging the wave amplitude [ 24 ]. This correlates well with our study, as we also found significant increase in left cVEMP amplitudes as well as earlier latencies in the presence of optical illusion compared to the values obtained in the absence of optical illusion.…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Optical Illusions on the Vestibular System

et al. 2021

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Background and Objectives: Balance control is maintained in stationary and dynamic conditions, with coordinated muscle responses generated by somatosensory, vestibular, and visual inputs. This study aimed to investigate how the vestibular system is affected in the presence of an optical illusion to better understand the interconnected pathways of the visual and vestibular systems. Subjects and Methods: The study involved 54 young adults (27 males and 27 females) aged 18-25 years. The recruited participants were subjected to the cervical vestibular evoked myogenic potentials (cVEMP) test and video head impulse test (vHIT). The cVEMP and vHIT tests were performed once each in the absence and presence of an optical illusion. In addition, after each test, whether the individuals felt balanced was determined using a questionnaire. Results: cVEMP results in the presence of the optical illusion showed shortened latencies and increased amplitudes for the left side in comparison to the results in the absence of the optical illusion (p≤0.05). When vHIT results were compared, it was seen that the right lateral and bilateral anterior canal gains were increased, almost to 1.0 (p<0.05). Conclusions: It is thought that when the visual-vestibular inputs are incompatible with each other, the sensory reweighting mechanism is activated, and this mechanism strengthens the more reliable (vestibular) inputs, while suppressing the less reliable (visual) inputs. As long as the incompatible condition persists, the sensory reweighting mechanism will continue to operate, thanks to the feedback loop from the efferent vestibular system.

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Vection in virtual reality modulates vestibular‐evoked myogenic potentials

Cited by 23 publications

References 63 publications

Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

Multisensory Interactions in Virtual Reality: Optic Flow Reduces Vestibular Sensitivity, but Only for Congruent Planes of Motion

The Impact of Optical Illusions on the Vestibular System

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