Combining Multi-Canal Vestibular Implant Stimulation to Restore the Vestibulo-Ocular Reflex in 3D

Introduction: Vestibular implants targeting the semi-circular canals might offer a potential treatment approach for vestibulopathy patients. Electrical stimulation is provided to all three canals to restore gaze stabilization in all three planes of space. This study evaluated the effect of electrica...

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Main Authors: Stan C. J. van Boxel, Bernd L. Vermorken, Benjamin Volpe, Nils Guinand, Angelica Perez-Fornos, Elke M. J. Devocht, Raymond van de Berg
Format: Article
Language:English
Published: IEEE 2025-01-01
Series:IEEE Transactions on Neural Systems and Rehabilitation Engineering
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Online Access:https://ieeexplore.ieee.org/document/11036170/
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author Stan C. J. van Boxel
Bernd L. Vermorken
Benjamin Volpe
Nils Guinand
Angelica Perez-Fornos
Elke M. J. Devocht
Raymond van de Berg
author_facet Stan C. J. van Boxel
Bernd L. Vermorken
Benjamin Volpe
Nils Guinand
Angelica Perez-Fornos
Elke M. J. Devocht
Raymond van de Berg
author_sort Stan C. J. van Boxel
collection DOAJ
description Introduction: Vestibular implants targeting the semi-circular canals might offer a potential treatment approach for vestibulopathy patients. Electrical stimulation is provided to all three canals to restore gaze stabilization in all three planes of space. This study evaluated the effect of electrically stimulating multiple canals at the same time. It was hypothesized that eye responses of single-canal stimulation could predict eye responses of multi-canal stimulation, using vector summation. This might provide valuable information for future vestibular implant fitting strategies. Methods: Nine subjects with an investigational vestibulo-cochlear implant participated in an experiment evaluating the vestibulo-ocular reflex in response to single and multi-canal electrical stimulations. Single-canal responses were combined by vector summation to predict the multi-canal response. The prediction was compared with measured multi-canal responses. The responses were evaluated based on peak eye velocity and alignment. Results: Eye responses to multi-canal vestibular stimulation did not consistently correspond to the sum of single-canal responses. Subsets of predictions appeared within the expected range of variation, while other subsets demonstrated over- or underestimation. Conclusion: Eye responses to combined multi-canal stimulation cannot be accurately predicted by summation of single-canal responses. These findings suggest that vestibular implant fitting should not rely exclusively on single-canal measurements. Instead, advanced fitting strategies that account for multi-canal interactions are likely necessary to optimize outcomes.
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spelling doaj-art-8d87810228e44eefb0cf7f2d5b016ce62025-08-20T03:27:26ZengIEEEIEEE Transactions on Neural Systems and Rehabilitation Engineering1534-43201558-02102025-01-01332449245510.1109/TNSRE.2025.357941711036170Combining Multi-Canal Vestibular Implant Stimulation to Restore the Vestibulo-Ocular Reflex in 3DStan C. J. van Boxel0https://orcid.org/0000-0002-9647-5056Bernd L. Vermorken1Benjamin Volpe2Nils Guinand3Angelica Perez-Fornos4Elke M. J. Devocht5https://orcid.org/0000-0001-5017-316XRaymond van de Berg6Department of Otorhinolaryngology and Head and Neck Surgery, Division of Vestibular Disorders, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Division of Vestibular Disorders, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Division of Vestibular Disorders, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Clinical Neurosciences, Service of Otorhinolaryngology Head and Neck Surgery, Geneva University Hospitals, Geneva, SwitzerlandDepartment of Clinical Neurosciences, Service of Otorhinolaryngology Head and Neck Surgery, Geneva University Hospitals, Geneva, SwitzerlandDepartment of Otorhinolaryngology and Head and Neck Surgery, Division of Vestibular Disorders, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Division of Vestibular Disorders, Maastricht University Medical Center, Maastricht, The NetherlandsIntroduction: Vestibular implants targeting the semi-circular canals might offer a potential treatment approach for vestibulopathy patients. Electrical stimulation is provided to all three canals to restore gaze stabilization in all three planes of space. This study evaluated the effect of electrically stimulating multiple canals at the same time. It was hypothesized that eye responses of single-canal stimulation could predict eye responses of multi-canal stimulation, using vector summation. This might provide valuable information for future vestibular implant fitting strategies. Methods: Nine subjects with an investigational vestibulo-cochlear implant participated in an experiment evaluating the vestibulo-ocular reflex in response to single and multi-canal electrical stimulations. Single-canal responses were combined by vector summation to predict the multi-canal response. The prediction was compared with measured multi-canal responses. The responses were evaluated based on peak eye velocity and alignment. Results: Eye responses to multi-canal vestibular stimulation did not consistently correspond to the sum of single-canal responses. Subsets of predictions appeared within the expected range of variation, while other subsets demonstrated over- or underestimation. Conclusion: Eye responses to combined multi-canal stimulation cannot be accurately predicted by summation of single-canal responses. These findings suggest that vestibular implant fitting should not rely exclusively on single-canal measurements. Instead, advanced fitting strategies that account for multi-canal interactions are likely necessary to optimize outcomes.https://ieeexplore.ieee.org/document/11036170/Vestibular implantmulti-canal stimulationvestibulo-ocular reflex
spellingShingle Stan C. J. van Boxel
Bernd L. Vermorken
Benjamin Volpe
Nils Guinand
Angelica Perez-Fornos
Elke M. J. Devocht
Raymond van de Berg
Combining Multi-Canal Vestibular Implant Stimulation to Restore the Vestibulo-Ocular Reflex in 3D
IEEE Transactions on Neural Systems and Rehabilitation Engineering
Vestibular implant
multi-canal stimulation
vestibulo-ocular reflex
title Combining Multi-Canal Vestibular Implant Stimulation to Restore the Vestibulo-Ocular Reflex in 3D
title_full Combining Multi-Canal Vestibular Implant Stimulation to Restore the Vestibulo-Ocular Reflex in 3D
title_fullStr Combining Multi-Canal Vestibular Implant Stimulation to Restore the Vestibulo-Ocular Reflex in 3D
title_full_unstemmed Combining Multi-Canal Vestibular Implant Stimulation to Restore the Vestibulo-Ocular Reflex in 3D
title_short Combining Multi-Canal Vestibular Implant Stimulation to Restore the Vestibulo-Ocular Reflex in 3D
title_sort combining multi canal vestibular implant stimulation to restore the vestibulo ocular reflex in 3d
topic Vestibular implant
multi-canal stimulation
vestibulo-ocular reflex
url https://ieeexplore.ieee.org/document/11036170/
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