title: Vestibular implantation and longitudinal electrical stimulation of the semicircular canal afferents in human subjects.
abstract: Animal experiments and limited data in humans suggest that electrical stimulation of the vestibular end organs could be used to treat loss of vestibular function. In this paper we demonstrate that canal-specific two-dimensionally (2D) measured eye velocities are elicited from intermittent brief 2 s biphasic pulse electrical stimulation in four human subjects implanted with a vestibular prosthesis. The 2D measured direction of the slow phase eye movements changed with the canal stimulated. Increasing pulse current over a 0-400 μA range typically produced a monotonic increase in slow phase eye velocity. The responses decremented or in some cases fluctuated over time in most implanted canals but could be partially restored by changing the return path of the stimulation current. Implantation of the device in Meniere's patients produced hearing and vestibular loss in the implanted ear. Electrical stimulation was well tolerated, producing no sensation of pain, nausea, or auditory percept with stimulation that elicited robust eye movements. There were changes in slow phase eye velocity with current and over time, and changes in electrically evoked compound action potentials produced by stimulation and recorded with the implanted device. Perceived rotation in subjects was consistent with the slow phase eye movements in direction and scaled with stimulation current in magnitude. These results suggest that electrical stimulation of the vestibular end organ in human subjects provided controlled vestibular inputs over time, but in Meniere's patients this apparently came at the cost of hearing and vestibular function in the implanted ear.
authors: Department of Otolaryngology-HNS, University of Washington, Seattle, Washington; National Primate Research Center, University of Washington, Seattle, Washington; and Virginia Merrill Bloedel Hearing Research Center, University of Washington, Seattle, Washington jop@u.washington.edu.
authors: James O
authors: JO
authors: Phillips
authors: Department of Otolaryngology-HNS, University of Washington, Seattle, Washington; National Primate Research Center, University of Washington, Seattle, Washington; and.
authors: Leo
authors: L
authors: Ling
authors: Department of Otolaryngology-HNS, University of Washington, Seattle, Washington; Virginia Merrill Bloedel Hearing Research Center, University of Washington, Seattle, Washington.
authors: Kaibao
authors: K
authors: Nie
authors: Department of Otolaryngology-HNS, University of Washington, Seattle, Washington;
authors: Elyse
authors: E
authors: Jameyson
authors: Department of Otolaryngology-HNS, University of Washington, Seattle, Washington; National Primate Research Center, University of Washington, Seattle, Washington; and.
authors: Christopher M
authors: CM
authors: Phillips
authors: Department of Otolaryngology-HNS, University of Washington, Seattle, Washington; National Primate Research Center, University of Washington, Seattle, Washington; and.
authors: Amy L
authors: AL
authors: Nowack
authors: Department of Otolaryngology-HNS, University of Washington, Seattle, Washington;
authors: Justin S
authors: JS
authors: Golub
authors: Department of Otolaryngology-HNS, University of Washington, Seattle, Washington; Department of Bioengineering, University of Washington, Seattle, Washington; National Primate Research Center, University of Washington, Seattle, Washington; and Virginia Merrill Bloedel Hearing Research Center, University of Washington, Seattle, Washington.
authors: Jay T
authors: JT
authors: Rubinstein
mesh_terms: D000368:Aged; D001703:Biophysics; D019929:Cochlear Implantation / Q000379:methods*; D004558:Electric Stimulation / Q000379:methods*; D005133:Eye Movements; D005260:Female; D006309:Hearing / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008575:Meniere Disease / Q000628:therapy*; D008875:Middle Aged; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology*; D012399:Rotation; D012665:Semicircular Canals / Q000502:physiology*; D013997:Time Factors
keywords: Meniere's; human; implant; vestibular
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