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Galvanic vestibular stimulation in hemi-spatial neglect

Wilkinson, David, Zubko, Olga, Sakel, Mohamed, Coulton, Simon, Higgins, Tracy, Pullicino, Patrick (2014) Galvanic vestibular stimulation in hemi-spatial neglect. Frontiers in Integrative Neuroscience, 8 . pp. 1-13. ISSN 1662-5145. E-ISSN 1662-5145. (doi:10.3389/fnint.2014.00004) (KAR id:38098)

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http://dx.doi.org/10.3389/fnint.2014.00004

Abstract

Hemi-spatial neglect is an attentional disorder in which the sufferer fails to acknowledge or respond to stimuli appearing in contralesional space. In recent years, it has become clear that a measurable reduction in contralesional neglect can occur during galvanic vestibular stimulation, a technique by which transmastoid, small amplitude current induces lateral, attentional shifts via asymmetric modulation of the left and right vestibular nerves. However, it remains unclear whether this reduction persists after stimulation is stopped. To estimate longevity of effect, we therefore conducted a double-blind, randomized, dose-response trial involving a group of stroke patients suffering from left-sided neglect (n = 52, mean age = 66 years). To determine whether repeated sessions of galvanic vestibular stimulation more effectively induce lasting relief than a single session, participants received 1, 5, or 10 sessions, each lasting 25 min, of sub-sensory, left-anodal right-cathodal noisy direct current (mean amplitude = 1 mA). Ninety five percent confidence intervals indicated that all three treatment arms showed a statistically significant improvement between the pre-stimulation baseline and the final day of stimulation on the primary outcome measure, the conventional tests of the Behavioral Inattention Test. More remarkably, this change (mean change = 28%, SD = 18) was still evident 1 month later. Secondary analyses indicated an allied increase of 20% in median Barthel Index (BI) score, a measure of functional capacity, in the absence of any adverse events or instances of participant non-compliance. Together these data suggest that galvanic vestibular stimulation, a simple, cheap technique suitable for home-based administration, may produce lasting reductions in neglect that are clinically important. Further protocol optimization is now needed ahead of a larger effectiveness study.

Item Type: Article
DOI/Identification number: 10.3389/fnint.2014.00004
Uncontrolled keywords: stroke, neuro-stimulation, clinical trial, hemi-inattention, rehabilitation
Subjects: R Medicine > RC Internal medicine > RC321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Faculties > Social Sciences > School of Psychology
Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tracy Pellatt-Higgins
Date Deposited: 30 Jan 2014 09:09 UTC
Last Modified: 07 Oct 2020 14:00 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/38098 (The current URI for this page, for reference purposes)
Wilkinson, David: https://orcid.org/0000-0002-9973-6477
Coulton, Simon: https://orcid.org/0000-0002-7704-3274
Higgins, Tracy: https://orcid.org/0000-0002-2543-461X
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