Perception of the vertical in patients with right hemispheric lesion: effect of galvanic vestibular stimulation.

Patients with right-brain injury present, more frequently in the acute phase, with a deviation of the subjective vertical (SV) contralateral to the lesion. The aim of this study was to investigate the influence of galvanic vestibular stimulation (GVS) on this disorder. Twelve patients presenting with a right hemispheric lesion, seven with neglect (N+) and five without (N-) were compared to eight control subjects. They had to orient vertically a luminous rod in darkness, in three galvanic stimulation (1.5 mA) conditions: cathode left, cathode right and no stimulation (baseline). Without stimulation, the patients' SV, and especially that of N+, showed an anticlockwise deviation. In comparison with baseline values, GVS induced a deviation toward the side opposite to the cathode in the three groups. In the patients, the deviation was of larger amplitude and appeared greater for left than for right cathodic stimulation. In conclusion, we showed an influence of vestibular stimulation on the SV of right brain-injured patients, especially when spatial neglect was present. As left cathodic stimulation can reduce the SV deviation associated with spatial neglect, such a tool could be introduced in rehabilitation.