Use of galvanic vestibular feedback for a balance prosthesis

Activation of vestibular afferents by a bilateral bipolar galvanic vestibular stimulus (GVS) evokes medial-lateral (ML) body sway. By applying a GVS feedback signal that is a function of measured ML head motion, the potential exists for GVS to restore a useful vestibular contribution to ML balance control in vestibular-deficient subjects who remain responsive to GVS. A key to developing an effective balance prosthesis using GVS is to determine the functional relationship between GVS and its influence on the brain´s internal estimate of head motion. We describe how a model-based interpretation of GVS-evoked body sway can be used to identify this functional relationship. Results indicate that the GVS-evoked internal motion estimate is effectively a low-pass filtered version of the GVS current. With preliminary data, we demonstrate that GVS feedback, compensated for the identified low-pass characteristics, can either remove the ability of a subject with normal vestibular function to use vestibular information for balance control, or can restore the ability of a subject with bilateral vestibular loss to maintain balance in a condition requiring vestibular information for balance control.