OBJECTIVE: To examine the effect of an imperceptible level of galvanic vestibular stimulation (GVS), delivered as zero-mean current noise (noisy GVS), on postural performance in healthy subjects as well as in patients with bilateral peripheral vestibular dysfunction. METHODS: White noise GVS with an amplitude ranging from 0 to 1,000 μA was applied in 21 healthy subjects and 11 patients with bilateral vestibular dysfunction. Two-legged stance tasks were performed with the eyes closed during a 60-second period, which consisted of a baseline period without stimulation and a stimulation period with GVS. We examined 3 parameters: the velocity, the envelopment area, and the root mean square (RMS) of the center of pressure. RESULTS: White noise GVS improved all 3 parameters in 76% of healthy subjects. The amplitude of the optimal stimulus was 281 ± 40 μA, and it improved the velocity, area, and RMS by 18.4% ± 2%, 37.9% ± 3.5%, and 20.4% ± 2.2%, respectively (p < 0.01). The GVS improved all 3 parameters in 91% of patients. The amplitude of the optimal stimulus was 456 ± 82 μA, and it improved the velocity, area, and RMS by 29.4% ± 4.9%, 45.6% ± 4.7%, and 22% ± 3.3%, respectively (p < 0.01). CONCLUSIONS: Noisy GVS is effective in improving postural stability in healthy subjects as well as in patients with bilateral vestibular dysfunction. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that in patients with bilateral vestibular dysfunction, an imperceptible level of noisy GVS may improve postural stability.
OBJECTIVE: To examine the effect of an imperceptible level of galvanic vestibular stimulation (GVS), delivered as zero-mean current noise (noisy GVS), on postural performance in healthy subjects as well as in patients with bilateral peripheral vestibular dysfunction. METHODS: White noise GVS with an amplitude ranging from 0 to 1,000 μA was applied in 21 healthy subjects and 11 patients with bilateral vestibular dysfunction. Two-legged stance tasks were performed with the eyes closed during a 60-second period, which consisted of a baseline period without stimulation and a stimulation period with GVS. We examined 3 parameters: the velocity, the envelopment area, and the root mean square (RMS) of the center of pressure. RESULTS: White noise GVS improved all 3 parameters in 76% of healthy subjects. The amplitude of the optimal stimulus was 281 ± 40 μA, and it improved the velocity, area, and RMS by 18.4% ± 2%, 37.9% ± 3.5%, and 20.4% ± 2.2%, respectively (p < 0.01). The GVS improved all 3 parameters in 91% of patients. The amplitude of the optimal stimulus was 456 ± 82 μA, and it improved the velocity, area, and RMS by 29.4% ± 4.9%, 45.6% ± 4.7%, and 22% ± 3.3%, respectively (p < 0.01). CONCLUSIONS: Noisy GVS is effective in improving postural stability in healthy subjects as well as in patients with bilateral vestibular dysfunction. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that in patients with bilateral vestibular dysfunction, an imperceptible level of noisy GVS may improve postural stability.