Galvanic vestibular stimulation in hemi-spatial neglect

Hemi-spatial neglect is an attentional disorder in which the sufferer fails to acknowledge or respond to stimuli appearing in contralesional space. In recent years, it has become clear that a measurable reduction in contralesional neglect can occur during galvanic vestibular stimulation, a technique...

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Main Authors:	Wilkinson, David, Zubko, Olga, Sakel, Mohamed, Coulton, Simon, Higgins, Tracy, Pullicino, Patrick
Format:	Online
Language:	English
Published:	Frontiers Media S.A. 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905204/

id	pubmed-3905204
recordtype	oai_dc
spelling	pubmed-39052042014-02-12 Galvanic vestibular stimulation in hemi-spatial neglect Wilkinson, David Zubko, Olga Sakel, Mohamed Coulton, Simon Higgins, Tracy Pullicino, Patrick Neuroscience Hemi-spatial neglect is an attentional disorder in which the sufferer fails to acknowledge or respond to stimuli appearing in contralesional space. In recent years, it has become clear that a measurable reduction in contralesional neglect can occur during galvanic vestibular stimulation, a technique by which transmastoid, small amplitude current induces lateral, attentional shifts via asymmetric modulation of the left and right vestibular nerves. However, it remains unclear whether this reduction persists after stimulation is stopped. To estimate longevity of effect, we therefore conducted a double-blind, randomized, dose-response trial involving a group of stroke patients suffering from left-sided neglect (n = 52, mean age = 66 years). To determine whether repeated sessions of galvanic vestibular stimulation more effectively induce lasting relief than a single session, participants received 1, 5, or 10 sessions, each lasting 25 min, of sub-sensory, left-anodal right-cathodal noisy direct current (mean amplitude = 1 mA). Ninety five percent confidence intervals indicated that all three treatment arms showed a statistically significant improvement between the pre-stimulation baseline and the final day of stimulation on the primary outcome measure, the conventional tests of the Behavioral Inattention Test. More remarkably, this change (mean change = 28%, SD = 18) was still evident 1 month later. Secondary analyses indicated an allied increase of 20% in median Barthel Index (BI) score, a measure of functional capacity, in the absence of any adverse events or instances of participant non-compliance. Together these data suggest that galvanic vestibular stimulation, a simple, cheap technique suitable for home-based administration, may produce lasting reductions in neglect that are clinically important. Further protocol optimization is now needed ahead of a larger effectiveness study. Frontiers Media S.A. 2014-01-29 /pmc/articles/PMC3905204/ /pubmed/24523679 http://dx.doi.org/10.3389/fnint.2014.00004 Text en Copyright © 2014 Wilkinson, Zubko, Sakel, Coulton, Higgins and Pullicino. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Wilkinson, David Zubko, Olga Sakel, Mohamed Coulton, Simon Higgins, Tracy Pullicino, Patrick
spellingShingle	Wilkinson, David Zubko, Olga Sakel, Mohamed Coulton, Simon Higgins, Tracy Pullicino, Patrick Galvanic vestibular stimulation in hemi-spatial neglect
author_facet	Wilkinson, David Zubko, Olga Sakel, Mohamed Coulton, Simon Higgins, Tracy Pullicino, Patrick
author_sort	Wilkinson, David
title	Galvanic vestibular stimulation in hemi-spatial neglect
title_short	Galvanic vestibular stimulation in hemi-spatial neglect
title_full	Galvanic vestibular stimulation in hemi-spatial neglect
title_fullStr	Galvanic vestibular stimulation in hemi-spatial neglect
title_full_unstemmed	Galvanic vestibular stimulation in hemi-spatial neglect
title_sort	galvanic vestibular stimulation in hemi-spatial neglect
description	Hemi-spatial neglect is an attentional disorder in which the sufferer fails to acknowledge or respond to stimuli appearing in contralesional space. In recent years, it has become clear that a measurable reduction in contralesional neglect can occur during galvanic vestibular stimulation, a technique by which transmastoid, small amplitude current induces lateral, attentional shifts via asymmetric modulation of the left and right vestibular nerves. However, it remains unclear whether this reduction persists after stimulation is stopped. To estimate longevity of effect, we therefore conducted a double-blind, randomized, dose-response trial involving a group of stroke patients suffering from left-sided neglect (n = 52, mean age = 66 years). To determine whether repeated sessions of galvanic vestibular stimulation more effectively induce lasting relief than a single session, participants received 1, 5, or 10 sessions, each lasting 25 min, of sub-sensory, left-anodal right-cathodal noisy direct current (mean amplitude = 1 mA). Ninety five percent confidence intervals indicated that all three treatment arms showed a statistically significant improvement between the pre-stimulation baseline and the final day of stimulation on the primary outcome measure, the conventional tests of the Behavioral Inattention Test. More remarkably, this change (mean change = 28%, SD = 18) was still evident 1 month later. Secondary analyses indicated an allied increase of 20% in median Barthel Index (BI) score, a measure of functional capacity, in the absence of any adverse events or instances of participant non-compliance. Together these data suggest that galvanic vestibular stimulation, a simple, cheap technique suitable for home-based administration, may produce lasting reductions in neglect that are clinically important. Further protocol optimization is now needed ahead of a larger effectiveness study.
publisher	Frontiers Media S.A.
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905204/
_version_	1612052246772580352

Galvanic vestibular stimulation in hemi-spatial neglect

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