Enormous medical and technical progress has been made in detecting, treating, and reducing the adverse impact of nearly all other sensory impairments, except for loss of the sense of balance. Time and training in compensatory skills can help ameliorate some of the life-altering effects of this syndrome for patients with mild to moderate symptoms. At present, however, there is no approved or standardized therapeutic device available for those with chronic balance loss due to vestibulo-cerebellar dysfunction. The overall objective of this project is to develop a practical, wearable, cosmetically acceptable substitute for vestibular information that will improve the postural and functional abilities of these individuals. The BrainPort balance device presents head-postural information via electrotactile stimulation to the superior surface of the tongue. The subject then uses this tactile information to obtain correct head and body alignment and maintain balance. After training with the BrainPort balance device, adult subjects with severe balance loss due to various forms of vestibular dysfunction exhibited improved balance and postural control, as evidenced by a reduction in the number of falls and increased composite scores on standardized posturographic tests (NeuroCom CDP). Subjects also retain improved balance control for up to 6 hours after a 20-minute training session, and exhibited functional transfer to more stable and symmetric gait. Our objective in this Phase-2.2 project is to expand the applicability of the BrainPort balance device under the following Specific Aims: (1) to evolve and refine the BrainPort balance device by implementing a Pulse- Width-Modulation method of the electrotactile stimulation, (2) recruit and train subjects with severe chronic balance deficit due to central and mixed vestibulo-cerebellar etiologies, and (3) standardize and optimize the regimen for training these clinical populations using the current program as a template. We hypothesize that people with chronic balance loss (affecting an estimated 18 million people in the US, including elderly) will be similarly aided by use of this system. The studies funded by SBIR Phase-1 & 2 clearly demonstrate the effectiveness of the BrainPort balance device. The proposed Phase-2.2 studies will confirm the effectiveness of pulse-width-modulation stimulation method, and better define the population of vestibular disorder patients that will derive benefit from this system. Ultimately, we envision that the BrainPort balance device will become a key component of a comprehensive vestibular therapy program. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
Project #
2R44DC004738-04
Application #
7107638
Study Section
Special Emphasis Panel (ZRG1-IFCN-G (10))
Program Officer
Platt, Christopher
Project Start
2001-05-11
Project End
2008-06-30
Budget Start
2006-06-15
Budget End
2007-06-30
Support Year
4
Fiscal Year
2006
Total Cost
$568,906
Indirect Cost
Name
Wicab, Inc.
Department
Type
DUNS #
158610712
City
Middleton
State
WI
Country
United States
Zip Code
53562
Robinson, Barbara Susan; Cook, Jeanne L; Richburg, Cynthia McCormick et al. (2009) Use of an electrotactile vestibular substitution system to facilitate balance and gait of an individual with gentamicin-induced bilateral vestibular hypofunction and bilateral transtibial amputation. J Neurol Phys Ther 33:150-9
Danilov, Y P; Tyler, M E; Skinner, K L et al. (2007) Efficacy of electrotactile vestibular substitution in patients with peripheral and central vestibular loss. J Vestib Res 17:119-30
Danilov, Y P; Tyler, M E; Skinner, K L et al. (2006) Efficacy of electrotactile vestibular substitution in patients with bilateral vestibular and central balance loss. Conf Proc IEEE Eng Med Biol Soc Suppl:6605-9