The vestibular system is located in the inner ear and is responsible for maintaining balance
in humans. Bilateral vestibular dysfunction (BVD) is a disorder that adversely affects vestibular
function. This results in symptoms such as postural imbalance and vertigo, increasing the incidence
of falls and worsening quality of life. ...
The vestibular system is located in the inner ear and is responsible for maintaining balance
in humans. Bilateral vestibular dysfunction (BVD) is a disorder that adversely affects vestibular
function. This results in symptoms such as postural imbalance and vertigo, increasing the incidence
of falls and worsening quality of life. Current therapeutic options are often ineffective, with a focus
on symptom management. Artificial stimulation of the vestibular system, via a vestibular
prosthesis, is a technique being explored to restore vestibular function. This review systematically
searched for literature that reported the effect of artificial vestibular stimulation on human
behaviours related to balance, using the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) technique. A total of 21 papers matched the inclusion criteria of the
literature search conducted using the PubMed and Web of Science databases (February 2019). The
populations for these studies included both healthy adults and patients with BVD. In every paper,
artificial vestibular stimulation caused an improvement in certain behaviours related to balance,
although the extent of the effect varied greatly. Various behaviours were measured such as the
vestibulo-ocular reflex, postural sway and certain gait characteristics. Two classes of prosthesis were
evaluated and both showed a significant improvement in at least one aspect of balance-related
behaviour in every paper included. No adverse effects were reported for prostheses using noisy
galvanic vestibular stimulation, however, prosthetic implantation sometimes caused hearing or
vestibular loss. Significant heterogeneity in methodology, study population and disease aetiology
were observed. The present study confirms the feasibility of vestibular implants in humans for
restoring balance in controlled conditions, but more research needs to be conducted to determine
their effects on balance in non-clinical settings.