A mobile electrical stimulator for therapeutic modulation of the vestibular system - design, safety, and functionality

Front Neurol. 2024 Nov 13:15:1502204. doi: 10.3389/fneur.2024.1502204. eCollection 2024.

Abstract

Low-intensity noisy galvanic vestibular stimulation (nGVS) is a promising non-invasive treatment for enhancing vestibular perceptual performance and postural control in patients with chronic vestibular hypofunction. However, this approach has so far been studied mainly under laboratory conditions. Evidence indicates that continuous application of nGVS in daily life is necessary for it to be effective. To address this need, we have developed a mobile nGVS stimulator and conducted a series of pilot studies to evaluate its safety, tolerability, functionality, and therapeutic effects. The device is a lightweight, compact, and portable AC stimulator featuring a user-friendly interface for the individualized adjustment of nGVS parameters. It includes an integrated motion sensor that automatically activates stimulation during body movement and deactivates it during inactivity, optimizing its practical use in real-world settings. The stimulator adheres to strict safety standards and, in initial long-term use, has exhibited only mild side effects (e.g., skin irritation and headaches), likely attributable to the current electrode placement, which requires further optimization. As expected, the device consistently elicits known vestibular sensorimotor reflex responses in healthy individuals. Importantly, further pilot studies in healthy participants demonstrate that the device can reliably replicate known facilitating effects on vestibular perception and postural control. Together, these findings suggest that this mobile stimulation device can facilitate the translation of nGVS into therapeutic everyday use.

Keywords: balance disorders; bilateral vestibulopathy; electrical stimulation; galvanic vestibular stimulation; motion sensor; remote therapy; stochastic resonance.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by the German Federal Ministry of Education and Research (BMBF 13GW0490B).