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Journal of Neurology
Published in: Journal of Neurology 1/2020

01-12-2020 | Bilateral Vestibulopathy | Original Communication

Simultaneous activation of multiple vestibular pathways upon electrical stimulation of semicircular canal afferents

Authors: Anissa Boutabla, Samuel Cavuscens, Maurizio Ranieri, Céline Crétallaz, Herman Kingma, Raymond van de Berg, Nils Guinand, Angélica Pérez Fornos

Published in: Journal of Neurology | Special Issue 1/2020

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Abstract

Background and purpose

Vestibular implants seem to be a promising treatment for patients suffering from severe bilateral vestibulopathy. To optimize outcomes, we need to investigate how, and to which extent, the different vestibular pathways are activated. Here we characterized the simultaneous responses to electrical stimuli of three different vestibular pathways.

Methods

Three vestibular implant recipients were included. First, activation thresholds and amplitude growth functions of electrically evoked vestibulo-ocular reflexes (eVOR), cervical myogenic potentials (ecVEMPs) and vestibular percepts (vestibulo-thalamo-cortical, VTC) were recorded upon stimulation with single, biphasic current pulses (200 µs/phase) delivered through five different vestibular electrodes. Latencies of eVOR and ecVEMPs were also characterized. Then we compared the amplitude growth functions of the three pathways using different stimulation profiles (1-pulse, 200 µs/phase; 1-pulse, 50 µs/phase; 4-pulses, 50 µs/phase, 1600 pulses-per-second) in one patient (two electrodes).

Results

The median latencies of the eVOR and ecVEMPs were 8 ms (8–9 ms) and 10.2 ms (9.6–11.8 ms), respectively. While the amplitude of eVOR and ecVEMP responses increased with increasing stimulation current, the VTC pathway showed a different, step-like behavior. In this study, the 200 µs/phase paradigm appeared to give the best balance to enhance responses at lower stimulation currents.

Conclusions

This study is a first attempt to evaluate the simultaneous activation of different vestibular pathways. However, this issue deserves further and more detailed investigation to determine the actual possibility of selective stimulation of a given pathway, as well as the functional impact of the contribution of each pathway to the overall rehabilitation process.
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Metadata
Title
Simultaneous activation of multiple vestibular pathways upon electrical stimulation of semicircular canal afferents
Authors
Anissa Boutabla
Samuel Cavuscens
Maurizio Ranieri
Céline Crétallaz
Herman Kingma
Raymond van de Berg
Nils Guinand
Angélica Pérez Fornos
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue Special Issue 1/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-020-10120-1

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