Anwendung von Galvanischer Vestibulärer Stimulation zur Behandlung der Bilateralen Vestibulopathie

Eder, Josefine (2025): Anwendung von Galvanischer Vestibulärer Stimulation zur Behandlung der Bilateralen Vestibulopathie. Dissertation, LMU München: Medizinische Fakultät

Abstract

Patients with bilateral vestibulopathy (BVP) are suffering from a complete or incomplete loss of function of peripheral vestibular structures, presenting with chronic dizziness including postural imbalance when standing or walking, especially in darkness or on uneven ground. Head or body movements cause blurring of the visual scene, which causes difficulties in gaze stabilization and keeping one’s balance. In most patients, this results in a lower quality of life and a higher risk of falls. The only therapeutic option currently available to sufficiently improve the outcome for BVP patients is vestibular rehabilitation therapy. However, the long-term effects of this intervention are limited. This thesis occupies with an alternative therapy for BVP patients, i.e. noisy galvanic vestibular stimulation (nGVS). It follows the mechanism of stochastic resonance, which is hypothesized to enhance the ability of a sensory system to detect and process weak signals if a subthreshold amplitude of noise is added. This way, nGVS transcutaneously delivered to the vestibular system of BVP patients has been shown to facilitate postural stabilization while standing or walking in healthy subjects as well as in patients with BVP in previous studies. Based on these findings, the first study of this thesis combined nGVS with the customary vestibular rehabilitation therapy on BVP patients. We could prove a positive effect of the vestibular rehabilitation training objectively measured as well as subjectively experienced by patients. However, there was no significant difference between stimulated and non-stimulated patients. In the second study we compared the ability of movement detection of BVP patients while seated with and without nGVS. Here we could detect an improvement of perception thresholds through nGVS in 73% of the participants. The combination of vestibular rehabilitation therapy and nGVS does not improve the therapeutic effect. However, both therapy options on their own bring their benefit and might be suitable partners for a complementary treatment strategy to improve BVP patients ́ quality of life.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: Bilateral vestibulopathy, Noisy galvanic vestibular rehabilitation, Vestibular rehabilitation, stochastic resonance, Vestibular perception
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 7. April 2025
• 1. Bericht­erstatter:in: Jahn, Klaus