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      Milestones in the development of a vestibular implant


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          Purpose of review

          Bilateral vestibular deficits exist and their prevalence is more important than believed by the medical community. Their severe impact has inspired several teams to develop technical solutions in an attempt to rehabilitate patients. A particularly promising pathway is the vestibular implant. This article describes the main milestones in this field, mainly focusing on work conducted in human patients.

          Recent findings

          There have been substantial research efforts, first in animals and more recently in humans, toward the development of vestibular implants. Humans have demonstrated surprising adaptation capabilities to the artificial vestibular signal. Today, the possibility of restoring vestibular reflexes, particularly the vestibulo-ocular reflex, and even achieving useful function in close-to-reality tasks (i.e. improving visual abilities while walking) have been demonstrated in humans.


          The vestibular implant opens new perspectives, not only as an effective therapeutic tool, but also pushes us to go beyond current knowledge and well-established clinical concepts.

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          Most cited references54

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          Stochastic resonance and sensory information processing: a tutorial and review of application.

          To review the stochastic resonance phenomena observed in sensory systems and to describe how a random process ('noise') added to a subthreshold stimulus can enhance sensory information processing and perception. Nonlinear systems need a threshold, subthreshold information bearing stimulus and 'noise' for stochastic resonance phenomena to occur. These three ingredients are ubiquitous in nature and man-made systems, which accounts for the observation of stochastic resonance in fields and conditions ranging from physics and engineering to biology and medicine. The stochastic resonance paradigm is compatible with single-neuron models or synaptic and channels properties and applies to neuronal assemblies activated by sensory inputs and perceptual processes as well. Here we review a few of the landmark experiments (including psychophysics, electrophysiology, fMRI, human vision, hearing and tactile functions, animal behavior, single/multiunit activity recordings). Models and experiments show a peculiar consistency with known neuronal and brain physiology. A number of naturally occurring 'noise' sources in the brain (e.g. synaptic transmission, channel gating, ion concentrations, membrane conductance) possibly accounting for stochastic resonance phenomena are also reviewed. Evidence is given suggesting a possible role of stochastic resonance in brain function, including detection of weak signals, synchronization and coherence among neuronal assemblies, phase resetting, 'carrier' signals, animal avoidance and feeding behaviors. Stochastic resonance is a ubiquitous and conspicuous phenomenon compatible with neural models and theories of brain function. The available evidence suggests cautious interpretation, but justifies research and should encourage neuroscientists and clinical neurophysiologists to explore stochastic resonance in biology and medical science.
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            Physiology of peripheral neurons innervating semicircular canals of the squirrel monkey. I. Resting discharge and response to constant angular accelerations.

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              Assessing Neurocognition via Gamified Experimental Logic: A Novel Approach to Simultaneous Acquisition of Multiple ERPs

              The present study describes the development of a neurocognitive paradigm: “Assessing Neurocognition via Gamified Experimental Logic” (ANGEL), for performing the parametric evaluation of multiple neurocognitive functions simultaneously. ANGEL employs an audiovisual sensory motor design for the acquisition of multiple event related potentials (ERPs)—the C1, P50, MMN, N1, N170, P2, N2pc, LRP, P300, and ERN. The ANGEL paradigm allows assessment of 10 neurocognitive variables over the course of three “game” levels of increasing complexity ranging from simple passive observation to complex discrimination and response in the presence of multiple distractors. The paradigm allows assessment of several levels of rapid decision making: speeded up response vs. response-inhibition; responses to easy vs. difficult tasks; responses based on gestalt perception of clear vs. ambiguous stimuli; and finally, responses with set shifting during challenging tasks. The paradigm has been tested using 18 healthy participants from both sexes and the possibilities of varied data analyses have been presented in this paper. The ANGEL approach provides an ecologically valid assessment (as compared to existing tools) that quickly yields a very rich dataset and helps to assess multiple ERPs that can be studied extensively to assess cognitive functions in health and disease conditions.

                Author and article information

                Curr Opin Neurol
                Curr. Opin. Neurol
                Current Opinion in Neurology
                Lippincott Williams & Wilkins
                February 2019
                04 December 2018
                : 32
                : 1
                : 145-153
                Department of Clinical Neurosciences, Service of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital, Geneva, Switzerland
                Author notes
                Correspondence to Professor Jean-Philippe Guyot, Department of Clinical Neurosciences, Service of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital, Rue Gabrielle Perret-Gentil 4, 1211 Geneva 14, Switzerland. Tel: +41 22 372 82 42; fax: +41 22 372 82 40; e-mail: jph.guyot@ 123456bluewin.ch
                WCO320105 00024
                Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                NEURO-OTOLOGY: Edited by Thomas Brandt
                Custom metadata

                balance,neuroprosthesis,plasticity,vestibular function,vestibulopathy


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