Vestibular Implants: 8 Years of Experience with Electrical Stimulation of the Vestibular Nerve in 11 Patients with Bilateral Vestibular Loss
Vestibular Implants: 8 Years of Experience with Electrical Stimulation of the Vestibular Nerve in 11 Patients with Bilateral Vestibular Loss
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DOI：
10.1159/000433554
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发表时间：
2015-01-01
影响因子：
1.3
通讯作者：
Perez-Fornos, Angelica
中科院分区：
文献类型：
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作者：
Guinand, Nils;van de Berg, Raymond;Perez-Fornos, Angelica
背景资料：前庭植入物的概念主要是通过使用前庭神经的电刺激向中枢神经系统提供运动信息来人工恢复双侧前庭丧失（BVL）患者的前庭功能。我们的团队大约在10年前开始了人体试验。研究方法：在2007年至2013年期间，11名BVL患者接受了前庭植入物原型，该原型提供电极以刺激前庭神经的壶腹分支。记录并分析眼球运动以评估电刺激的效果。记录电刺激诱导的感知。结果如下：在所有患者中获得了平稳、受控的眼球运动，表明电刺激成功地激活了前庭-眼通路。然而，眼动的电动态范围和幅度在不同患者之间是可变的。在24个测试电极中，有17个电极的反应轴与刺激的神经分支一致。此外，在至少1例病例中，诱发的眼球运动显示出与在自然活动（如行走）期间观察到的代偿性眼球运动相似的特征。最后，报告了电刺激后的不同感知（即，旋转感觉、声音、搔痒或压力），其强度随着刺激电流的增加而增加。结论：这些结果表明，电刺激是激活前庭系统的安全有效的手段，即使在具有非常不同的病因和疾病持续时间的异质患者群体中也是如此。成功调整这些信息可以将前庭植入物原型变成成功的人工平衡器官。(C)2015 S. Karger AG，巴塞尔
Background: The concept of the vestibular implant is primarily to artificially restore the vestibular function in patients with a bilateral vestibular loss (BVL) by providing the central nervous system with motion information using electrical stimulation of the vestibular nerve. Our group initiated human trials about 10 years ago. Methods: Between 2007 and 2013, 11 patients with a BVL received a vestibular implant prototype providing electrodes to stimulate the ampullary branches of the vestibular nerve. Eye movements were recorded and analyzed to assess the effects of the electrical stimulation. Perception induced by electrical stimulation was documented. Results: Smooth, controlled eye movements were obtained in all patients showing that electrical stimulation successfully activated the vestibulo-ocular pathway. However, both the electrical dynamic range and the amplitude of the eye movements were variable from patient to patient. The axis of the response was consistent with the stimulated nerve branch in 17 out of the 24 tested electrodes. Furthermore, in at least 1 case, the elicited eye movements showed characteristics similar to those of compensatory eye movements observed during natural activities such as walking. Finally, diverse percepts were reported upon electrical stimulation (i.e., rotatory sensations, sound, tickling or pressure) with intensity increasing as the stimulation current increased. Conclusions: These results demonstrate that electrical stimulation is a safe and effective means to activate the vestibular system, even in a heterogeneous patient population with very different etiologies and disease durations. Successful tuning of this information could turn this vestibular implant prototype into a successful artificial balance organ. (C) 2015 S. Karger AG, Basel