Sustained cortical and subcortical neuromodulation induced by electrical tongue stimulation
- 577 Downloads
This pilot study aimed to show that information-free stimulation of the tongue can improve behavioral measures and induce sustained neuromodulation of the balance-processing network in individuals with balance dysfunction. Twelve balance-impaired subjects received one week of cranial nerve non-invasive neuromodulation (CN-NINM). Before and after the week of stimulation, postural sway and fMRI activation were measured to monitor susceptibility to optic flow. Nine normal controls also underwent the postural sway and fMRI tests but did not receive CN-NINM. Results showed that before CN-NINM balance-impaired subjects swayed more than normal controls as expected (p ≤ 0.05), and that overall sway and susceptibility to optic flow decreased after CN-NINM (p ≤ 0.005 & p ≤ 0.05). fMRI showed upregulation of visual sensitivity to optic flow in balance-impaired subjects that decreased after CN-NINM. A region of interest analysis indicated that CN-NINM may induce neuromodulation by increasing activity within the dorsal pons (p ≤ 0.01).
KeywordsfMRI Optic flow Neuromodulation Balance disorders Brainstem Plasticity
The authors gratefully acknowledge Kelsey Hawkins for clinical coordination and Dana Tudorascu for statistical consultation. Also thank you to Sterling Johnson for use of the goggle display system. This study was supported by grant number T90DK070079 and R90DK071515 from the National Institute of Diabetes and Digestive and Kidney Diseases, 1UL1RR025011 from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health, and UW-I&EDR funding. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the National Institutes of Health.
Joseph Wildenberg was supported by grant numbers T90DK070079 and R90DK071515 from the National Institute of Diabetes and Digestive and Kidney Diseases. Authors Danilov, Kaczmarek, and Tyler have an ownership interest in Advanced Neurorehabilitation, LLC, which has intellectual property rights in the field of research reported in this publication. Mary Meyerand reported no financial or potential conflicts of interest.
- Anker, A. R., Ali, A., Arendt, H. E., Cass, S. P., Cotter, L. A., Jian, B. J., et al. (2003). Use of electrical vestibular stimulation to alter genioglossal muscle activity in awake cats. Journal of Vestibular Research, 13, 1–8.Google Scholar
- Buisseret-Delmas, C., Compoint, C., Delfini, C., & Buisseret, P. (1999). Organisation of reciprocal connections between trigeminal and vestibular nuclei in the rat. Journal of Comparative Neurology, 409, 153–168.Google Scholar
- Cardin, V., & Smith, A. T. (2010). Sensitivity of human visual and vestibular cortical regions to egomotion-compatible visual stimulation. Cerebral Cortex, doi: 10.1093/cercor/bhp268.
- Danilov, Y. P., Tyler, M. E., Skinner, K. L., & Bach-y-Rita, P. (2006). Efficacy of electrotactile vestibular substitution in patients with bilateral vestibular and central balance loss. Conference Proceedings—IEEE Engineering in Medicine and Biology Society, Suppl, 6605–6609.Google Scholar
- Duvernoy, H. M. (1995). The human brain stem and cerebellum (p. 430). New York: Springer-Verlag.Google Scholar
- Herrick, J. L., & Keifer, J. (2000). Central Trigeminal and Posterior Eighth Nerve Projections in the Turtle Chrysemys picta Studied in vitro. Brain, Behavior and Evolution, 51, 183–201.Google Scholar
- Kaczmarek, K. A., & Bach-y-Rita, P. (1995). Tactile displays. In W. Barfield & T. A. Furness (Eds.), Virtual environments and advanced interface design (pp. 349–414). USA: Oxford University Press.Google Scholar
- Kovacs, S., Peeters, R., Smits, M., De Ridder, D., Van Hecke, P., & Sunaert, S. (2006). Activation of cortical and subcortical auditory structures at 3T by means of a functional magnetic resonance imaging paradigm suitable for clinical use. Investigative Radiology, 41, 87–96.CrossRefPubMedGoogle Scholar
- Marano, E., Marcelli, V., Stasio, E. D., Bonuso, S., Vacca, G., Manganelli, F., et al. (2005). Trigeminal stimulation elicits a peripheral vestibular imbalance in migraine patients. Headache: the Journal of Head and Face Pain, 45, 325–331.Google Scholar
- Petrie, A., & Sabin, C. (2005). Medical statistics at a glance. Malden: Wiley-Blackwell. 160 pp.Google Scholar
- Pietrini, P., Ptito, M., & Kupers, R. (2009). Blindness and consciousness: New light from the dark. In S. Laureys, & G. Tononi G (Eds.), The neurology of consciousness. New York: Academic Press, pp. 360–374.Google Scholar
- Robinson, B. S., Cook, J. L., Richburg, C. M. C., & Price, S. E. (2009). Use of an electrotactile vestibular substitution system to facilitate balance and gait of an individual with gentamicin-induced bilateral vestibular hypofunction and bilateral transtibial amputation. Journal of Neurologic Physical Therapy, 33, 150–159.PubMedGoogle Scholar
- Satoh, Y., Ishizuka, K. I., & Murakami, T. (2009). Modulation of the masseteric monosynaptic reflex by stimulation of the vestibular nuclear complex in rats. Neurosci Lett, 466, 16–20.Google Scholar