Vestibular prosthesis: from basic research to clinics.

IF 2.6 3区 医学 Q2 BEHAVIORAL SCIENCES Frontiers in Integrative Neuroscience Pub Date : 2023-01-01 DOI:10.3389/fnint.2023.1161860
Enrique Soto, Adriana Pliego, Rosario Vega
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Abstract

Balance disorders are highly prevalent worldwide, causing substantial disability with high personal and socioeconomic impact. The prognosis in many of these patients is poor, and rehabilitation programs provide little help in many cases. This medical problem can be addressed using microelectronics by combining the highly successful cochlear implant experience to produce a vestibular prosthesis, using the technical advances in micro gyroscopes and micro accelerometers, which are the electronic equivalents of the semicircular canals (SCC) and the otolithic organs. Reaching this technological milestone fostered the possibility of using these electronic devices to substitute the vestibular function, mainly for visual stability and posture, in case of damage to the vestibular endorgans. The development of implantable and non-implantable devices showed diverse outcomes when considering the integrity of the vestibular pathways, the device parameters (current intensity, impedance, and waveform), and the targeted physiological function (balance and gaze). In this review, we will examine the development and testing of various prototypes of the vestibular implant (VI). The insight raised by examining the state-of-the-art vestibular prosthesis will facilitate the development of new device-development strategies and discuss the feasibility of complex combinations of implantable devices for disorders that directly affect balance and motor performance.

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前庭假体:从基础研究到临床。
平衡障碍在世界范围内非常普遍,造成严重的残疾,对个人和社会经济都有很大的影响。这些患者的预后很差,康复计划在许多情况下几乎没有帮助。这一医学问题可以利用微电子技术来解决,通过结合高度成功的人工耳蜗植入经验来制造前庭假体,利用微陀螺仪和微加速度计的技术进步,这是半规管(SCC)和耳石器官的电子等效。达到这一技术里程碑促进了使用这些电子设备替代前庭功能的可能性,主要是为了视觉稳定性和姿势,以防前庭终末器官受损。当考虑前庭通路的完整性、设备参数(电流强度、阻抗和波形)以及目标生理功能(平衡和凝视)时,植入式和非植入式装置的发展显示出不同的结果。在这篇综述中,我们将研究各种前庭假体原型的开发和测试。通过研究最先进的前庭假体提出的见解将有助于开发新的设备开发策略,并讨论直接影响平衡和运动表现的疾病的复杂植入设备组合的可行性。
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来源期刊
Frontiers in Integrative Neuroscience
Frontiers in Integrative Neuroscience Neuroscience-Cellular and Molecular Neuroscience
CiteScore
4.60
自引率
2.90%
发文量
148
审稿时长
14 weeks
期刊介绍: Frontiers in Integrative Neuroscience publishes rigorously peer-reviewed research that synthesizes multiple facets of brain structure and function, to better understand how multiple diverse functions are integrated to produce complex behaviors. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Our goal is to publish research related to furthering the understanding of the integrative mechanisms underlying brain functioning across one or more interacting levels of neural organization. In most real life experiences, sensory inputs from several modalities converge and interact in a manner that influences perception and actions generating purposeful and social behaviors. The journal is therefore focused on the primary questions of how multiple sensory, cognitive and emotional processes merge to produce coordinated complex behavior. It is questions such as this that cannot be answered at a single level – an ion channel, a neuron or a synapse – that we wish to focus on. In Frontiers in Integrative Neuroscience we welcome in vitro or in vivo investigations across the molecular, cellular, and systems and behavioral level. Research in any species and at any stage of development and aging that are focused at understanding integration mechanisms underlying emergent properties of the brain and behavior are welcome.
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