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The Vestibular Implant Input Interacts with Residual Natural Function.

Raymond van de Berg1,2, Nils Guinand3, Maurizio Ranieri3

  • 1Division of Balance Disorders, Faculty of Health Medicine and Life Sciences, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands.

Frontiers in Neurology
|January 10, 2018
PubMed
Summary

Artificial vestibular implant input interacts non-linearly with natural vestibular function in bilateral vestibulopathy patients. This suggests the vestibular implant can influence natural input, showing potential as a "vestibular pacemaker."

Keywords:
bilateral vestibular areflexiabilateral vestibulopathyneural prosthesisvestibular implantvestibular prosthesisvestibulo-ocular reflex

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Area of Science:

  • Neuroscience
  • Biomedical Engineering
  • Ophthalmology

Background:

  • Bilateral vestibulopathy (BV) patients retain residual natural vestibular function.
  • This residual function can interact with artificial vestibular implant (VI) input.
  • Such interactions may cause vertigo, necessitating investigation into their integration.

Purpose of the Study:

  • To investigate the integration of artificial VI input with residual natural input by the central vestibular system.
  • To determine if residual natural input counteracts VI misalignment.
  • To assess if VI input can influence or counteract natural input, exploring VI as a "vestibular pacemaker".

Main Methods:

  • Responses to natural and artificial VI inputs were measured separately in four BV patients with vestibular electrodes.
  • Inputs were combined to simulate collaboration or counteraction.
  • Eye movement responses (gain, asymmetry, phase, angle) were analyzed using signal averaging.

Main Results:

  • Combining natural and artificial inputs resulted in significantly different eye movement responses compared to individual inputs (p < 0.0013).
  • Input vector magnitude influenced combination weighting in a non-linear manner.
  • Artificial VI input significantly influenced and counteracted natural input, and did not sufficiently compensate for VI misalignment.

Conclusions:

  • Residual natural and artificial VI inputs interact non-linearly in the acute phase of VI activation.
  • Optimizing VI function may require advanced stimulation paradigms and signal processing for chronic use.
  • Findings support the potential of VI as a "vestibular pacemaker".