Electrical Vestibular Stimulation in Humans: A Narrative Review

Area of Science:

• Neuroscience
• Biomedical Engineering
• Otolaryngology

Background:

• Bilateral vestibulopathy treatments like medication and surgery are often insufficient.
• Research is exploring electrical vestibular stimulation (EVS) to restore vestibular function.
• Three EVS approaches are under investigation: cochlear implant (CI) co-stimulation, vestibular implant (VI), and galvanic vestibular stimulation (GVS).

Purpose of the Study:

• To investigate the potential of EVS in restoring vestibular function for patients with bilateral vestibulopathy.
• To compare the efficacy and applicability of CI co-stimulation, VI, and GVS.
• To determine the most suitable EVS approach for different patient profiles.

Main Methods:

• Vestibular co-stimulation using existing cochlear implants.
• Development and testing of vestibular implant (VI) prototypes.
• Application of galvanic vestibular stimulation (GVS) using surface electrodes.

Main Results:

• CI activation can stimulate vestibular structures, suggesting potential for co-stimulation.
• VI prototypes have demonstrated feasibility and the ability to activate vestibular reflexes.
• GVS, while unspecific, is a non-invasive stimulation method.
• All investigated EVS methods show promising results in activating vestibular reflexes.

Conclusions:

• EVS approaches, including CI co-stimulation, VI, and GVS, show promise for treating bilateral vestibulopathy.
• Further research is needed to establish consensus on the ideal EVS method for specific patient groups.
• Multiple EVS strategies may be beneficial due to the diverse needs of patients with vestibular dysfunction.