Guinand Nils, van de Berg Raymond, Cavuscens Samuel, Stokroos Robert J, Ranieri Maurizio, Pelizzone Marco, Kingma Herman, Guyot Jean-Philippe, Perez-Fornos Angelica
ORL J Otorhinolaryngol Relat Spec. 2015;77(4):227-240. doi: 10.1159/000433554. Epub 2015 Sep 15.
The concept of the vestibular implant is primarily to artificially restore the vestibular function in patients with a bilateral vestibular loss (BVL) by providing the central nervous system with motion information using electrical stimulation of the vestibular nerve. Our group initiated human trials about 10 years ago.
Between 2007 and 2013, 11 patients with a BVL received a vestibular implant prototype providing electrodes to stimulate the ampullary branches of the vestibular nerve. Eye movements were recorded and analyzed to assess the effects of the electrical stimulation. Perception induced by electrical stimulation was documented.
Smooth, controlled eye movements were obtained in all patients showing that electrical stimulation successfully activated the vestibulo-ocular pathway. However, both the electrical dynamic range and the amplitude of the eye movements were variable from patient to patient. The axis of the response was consistent with the stimulated nerve branch in 17 out of the 24 tested electrodes. Furthermore, in at least 1 case, the elicited eye movements showed characteristics similar to those of compensatory eye movements observed during natural activities such as walking. Finally, diverse percepts were reported upon electrical stimulation (i.e., rotatory sensations, sound, tickling or pressure) with intensity increasing as the stimulation current increased.
These results demonstrate that electrical stimulation is a safe and effective means to activate the vestibular system, even in a heterogeneous patient population with very different etiologies and disease durations. Successful tuning of this information could turn this vestibular implant prototype into a successful artificial balance organ.
前庭植入物的概念主要是通过用电刺激前庭神经向中枢神经系统提供运动信息，从而人为恢复双侧前庭丧失（BVL）患者的前庭功能。我们团队大约在10年前开始了人体试验。
在2007年至2013年期间，11例BVL患者接受了前庭植入物原型，该原型提供电极以刺激前庭神经的壶腹分支。记录并分析眼动以评估电刺激的效果。记录电刺激引起的感觉。
所有患者均获得了平稳、可控的眼动，表明电刺激成功激活了前庭眼反射通路。然而，电刺激的动态范围和眼动幅度在患者之间存在差异。在24个测试电极中的17个中，反应轴与受刺激的神经分支一致。此外，至少在1例患者中，诱发的眼动表现出与自然活动（如行走）中观察到的代偿性眼动相似的特征。最后，电刺激时报告了多种感觉（即旋转感、声音、瘙痒或压力），且随着刺激电流增加，感觉强度也增加。
这些结果表明，即使在病因和病程差异很大的异质性患者群体中，电刺激也是激活前庭系统的一种安全有效的方法。成功调整这些信息可能会使这种前庭植入物原型成为一种成功的人工平衡器官。
