Wiboonsaksakul Kantapon Pum, Leavitt Brown Olivia M E, Cullen Kathleen E
Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, United States.
Kavli Neuroscience Discovery Institute, Johns Hopkins University, Baltimore, United States.
Elife. 2024 Dec 17;13:e99516. doi: 10.7554/eLife.99516.
The vestibular system is integral to behavior; the loss of peripheral vestibular function leads to disabling consequences, such as blurred vision, dizziness, and unstable posture, severely limiting activities of daily living. Fortunately, the vestibular system's well-defined peripheral structure and well-understood encoding strategies offer unique opportunities for developing sensory prostheses to restore vestibular function. While these devices show promising results in both animal models and implanted patients, substantial room for improvement remains. Research from an engineering perspective has largely focused on optimizing stimulation protocol to improve outcomes. However, this approach has often been pursued in isolation from research in neuroscience that has enriched our understanding of neural responses at the synaptic, cellular, and circuit levels. Accordingly, this review bridges the domains of neuroscience and engineering to consider recent progress and challenges in vestibular prosthesis development. We advocate for interdisciplinary approaches that leverage studies of neural circuits at the population level, especially in light of recent advancement in large-scale recording technology, to identify impediments still to overcome and to develop more naturalistic stimulation strategies. Fully integrating neuroscience and engineering in the context of prosthesis development will help advance the field forward and ultimately improve patient outcomes.
前庭系统对行为至关重要；外周前庭功能丧失会导致视力模糊、头晕和姿势不稳等致残后果，严重限制日常生活活动。幸运的是，前庭系统明确的外周结构和广为人知的编码策略为开发感觉假体以恢复前庭功能提供了独特机会。虽然这些设备在动物模型和植入患者中都显示出了有前景的结果，但仍有很大的改进空间。从工程学角度进行的研究主要集中在优化刺激方案以改善结果。然而，这种方法往往是在与神经科学研究相隔离的情况下进行的，而神经科学研究丰富了我们对突触、细胞和回路水平神经反应的理解。因此，本综述弥合了神经科学和工程学领域，以探讨前庭假体开发的最新进展和挑战。我们提倡跨学科方法，利用群体水平神经回路的研究，特别是鉴于大规模记录技术的最新进展，来识别仍需克服的障碍，并制定更自然的刺激策略。在假体开发的背景下将神经科学和工程学完全整合，将有助于推动该领域向前发展，并最终改善患者的治疗效果。
