In vivo and dosimetric investigation on electrical vestibular stimulation with frequency- and amplitude-modulated currents.

OBJECTIVE: Normal function of the vestibular system can be disturbed using a noninvasive technique called Electrical Vestibular Stimulation (EVS), which alters a person's sense of balance and causes false sensations of movement. EVS has been widely used to study the function of the vestibular system, and it has recently gained interest as a therapeutic tool to improve postural stability and help those suffering from vestibular dysfunction. Yet, understanding of how EVS stimulates the vestibular system, the current intensity needed to produce an effect and the frequencies at which it occurs have remained unclear. Methods: The effect of EVS on postural sway was examined in five participants using sinusoidal alternating current with time-varying amplitude from 0 to 1.5~mA and frequency from 0.1 to 10~Hz for three electrode configurations. Dosimetry of the current flow inside the head was conducted using anatomically realistic computational models created individually for each subject based on magnetic resonance imaging data. An estimate for the minimal field strength capable of affecting the vestibular system was calculated with the finite element method. Results: Bipolar EVS at frequencies up to 10~Hz caused harmonic full-body swaying, and the frequency of the sway was the same as that of the stimulation current. The size of the sway was amplified by increasing the current intensity. Dosimetry modeling indicated that, for 0.2~mA current, the average electric field strength in the vestibular system was approximately 10--30~mV/m, depending on the electrode montage. The size of the measured postural sway was proportional to the montage-specific electric field strength in the vestibular system. Significance: The results provide insight to EVS's working mechanisms and improve its potential as a tool to study the sense of balance.

Is activation of the vestibular system by electromagnetic induction a possibility in an MRI context?

In recent years, an increasing number of studies have discussed the mechanisms of vestibular activation in strong magnetic field settings such as occur in a magnetic resonance imaging scanner environment. Amid the different hypotheses, the Lorentz force explanation currently stands out as the most plausible mechanism, as evidenced by activation of the vestibulo-ocular reflex. Other hypotheses have largely been discarded. Nonetheless, both human data and computational modeling suggest that electromagnetic induction could be a valid mechanism which may coexist alongside the Lorentz force. To further investigate the induction hypothesis, we provide, herein, a first of its kind dosimetric analysis to estimate the induced electric fields at the vestibular system and compare them with what galvanic vestibular stimulation would generate. We found that electric fields strengths from induction match galvanic vestibular stimulation strengths generating vestibular responses. This review examines the evidence in support of electromagnetic induction of vestibular responses, and whether movement-induced time-varying magnetic fields should be further considered and investigated.

Vestibular Extremely Low-Frequency Magnetic and Electric Stimulation Effects on Human Subjective Visual Vertical Perception.

Electric fields from both extremely low-frequency magnetic fields (ELF-MF) and alternating current (AC) stimulations impact human neurophysiology. As the retinal photoreceptors, vestibular hair cells are graded potential cells and are sensitive to electric fields. Electrophosphene and magnetophosphene literature suggests different impacts of AC and ELF-MF on the vestibular hair cells. Furthermore, while AC modulates the vestibular system more globally, lateral ELF-MF stimulations could be more utricular specific. Therefore, to further address the impact of ELF-MF-induced electric fields on the human vestibular system and the potential differences with AC stimulations, we investigated the effects of both stimulation modalities on the perception of verticality using a subjective visual vertical (SVV) paradigm. For similar levels of SVV precision, the ELF-MF condition required more time to adjust SVV, and SVV variability was higher with ELF-MF than with AC vestibular-specific stimulations. Yet, the differences between AC and ELF-MF stimulations were small. Overall, this study highlights small differences between AC and ELF-MF vestibular stimulations, underlines a potential utricular contribution, and has implications for international exposure guidelines and standards. © 2022 Bioelectromagnetics Society.

Proprioceptive manipulations in orthograde posture modulate postural control in low back pain patients: a pilot study.

As we stand upright, perceptual afferences are crucial to successfully help generating postural motor commands. Non-Specific Low Back Pain patients frequently demonstrate a lack of proprioceptive acuity, often translating into postural control deficiencies. For the first time, to our knowledge, we studied the postural effects of proprioceptive manipulations in orthograde posture on Non-Specific Low Back Pain patients. Using static posturography recordings, we computed sway speed, speed variance, and the main direction of sway. We also addressed the patient's subjective feedbacks after being manipulated. Five minutes after the proprioceptive manipulations, our results revealed decreased speed and speed variance outcomes, but the main direction of sway was not modulated. Furthermore, after the proprioceptive manipulations, the patients also self-reported improved clinical outcomes. These findings provide new knowledge opening new fields of research as well as potential treatment strategies in Low Back Pain patients.

Impact of extremely low-frequency magnetic fields on human postural control.

Studies have found that extremely low-frequency (ELF, < 300 Hz) magnetic fields (MF) can modulate standing balance; however, the acute balance effects of high flux densities in this frequency range have not been systematically investigated yet. This study explores acute human standing balance responses of 22 participants exposed to magnetic induction at 50 and 100 mTrms (MF), and to 1.5 mA alternating currents (AC). The center of pressure displacement (COP) was collected and analyzed to investigate postural modulation. The path length, the area, the velocity, the power spectrum in low (< 0.5 Hz) and medium (0.5-2 Hz) bands have computed and showed the expected effect of the positive control direct current (DC) electric stimulation but failed to show any significant effect of the time-varying stimulations (AC and MF). However, we showed a significant biased stabilization effect on postural data from the custom experimental apparatus employed in this work, which might have neutralized the hypothesized results.