Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution Hypothesis
An ongoing EU Horizon 2020 Project called BionicVEST is investigating the effect of constant electrical stimulation (ES) of the inferior vestibular nerve in patients with bilateral vestibular dysfunction (BVD). The evidence is that constant ES results in improved postural stability and gait performa...
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| Format: | Article |
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MDPI AG
2022-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/4/1132 |
| _version_ | 1797479033166888960 |
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| author | Ian S. Curthoys Paul F. Smith Angel Ramos de Miguel |
| author_facet | Ian S. Curthoys Paul F. Smith Angel Ramos de Miguel |
| author_sort | Ian S. Curthoys |
| collection | DOAJ |
| description | An ongoing EU Horizon 2020 Project called BionicVEST is investigating the effect of constant electrical stimulation (ES) of the inferior vestibular nerve in patients with bilateral vestibular dysfunction (BVD). The evidence is that constant ES results in improved postural stability and gait performance, and so the question of central importance concerns how constant ES of mainly saccular afferents in these BVD patients could cause this improved performance. We suggest that the constant ES substitutes for the absent saccular neural input to the vestibular nuclei and the cerebellum in these BVD patients and indirectly via these structures to other structures, which have been of great recent interest in motor control. One target area, the anterior midline cerebellum (the uvula), has recently been targeted as a location for deep-brain stimulation in human patients to improve postural stability and gait. There are projections from midline cerebellum to basal ganglia, including the striatum, which are structures involved in the initiation of gait. It may be that the effect of this activation of peripheral saccular afferent neurons is analogous to the effect of deep-brain stimulation (DBS) by electrodes in basal ganglia acting to help alleviate the symptoms of patients with Parkinson’s disease. |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:40:05Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-5cf6ad13649c4c888473e8a0997c45fd2023-11-23T20:32:10ZengMDPI AGJournal of Clinical Medicine2077-03832022-02-01114113210.3390/jcm11041132Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution HypothesisIan S. Curthoys0Paul F. Smith1Angel Ramos de Miguel2Vestibular Research Laboratory, School of Psychology, The University of Sydney, Sydney, NSW 2006, AustraliaDepartment of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New ZealandDepartment of Otolaryngology, and Head and Neck Surgery, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, 35016 Las Palmas de Gran Canaria, SpainAn ongoing EU Horizon 2020 Project called BionicVEST is investigating the effect of constant electrical stimulation (ES) of the inferior vestibular nerve in patients with bilateral vestibular dysfunction (BVD). The evidence is that constant ES results in improved postural stability and gait performance, and so the question of central importance concerns how constant ES of mainly saccular afferents in these BVD patients could cause this improved performance. We suggest that the constant ES substitutes for the absent saccular neural input to the vestibular nuclei and the cerebellum in these BVD patients and indirectly via these structures to other structures, which have been of great recent interest in motor control. One target area, the anterior midline cerebellum (the uvula), has recently been targeted as a location for deep-brain stimulation in human patients to improve postural stability and gait. There are projections from midline cerebellum to basal ganglia, including the striatum, which are structures involved in the initiation of gait. It may be that the effect of this activation of peripheral saccular afferent neurons is analogous to the effect of deep-brain stimulation (DBS) by electrodes in basal ganglia acting to help alleviate the symptoms of patients with Parkinson’s disease.https://www.mdpi.com/2077-0383/11/4/1132bilateral vestibular dysfunctionsaccularposturegaitvestibular implantotolith |
| spellingShingle | Ian S. Curthoys Paul F. Smith Angel Ramos de Miguel Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution Hypothesis Journal of Clinical Medicine bilateral vestibular dysfunction saccular posture gait vestibular implant otolith |
| title | Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution Hypothesis |
| title_full | Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution Hypothesis |
| title_fullStr | Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution Hypothesis |
| title_full_unstemmed | Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution Hypothesis |
| title_short | Why Should Constant Stimulation of Saccular Afferents Modify the Posture and Gait of Patients with Bilateral Vestibular Dysfunction? The Saccular Substitution Hypothesis |
| title_sort | why should constant stimulation of saccular afferents modify the posture and gait of patients with bilateral vestibular dysfunction the saccular substitution hypothesis |
| topic | bilateral vestibular dysfunction saccular posture gait vestibular implant otolith |
| url | https://www.mdpi.com/2077-0383/11/4/1132 |
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