Effectiveness of multi-modal home-based videoconference interventions on sleep in older adults: study protocol for a randomized controlled trial.

Aging is characterized by substantial changes in sleep architecture that negatively impact fitness, quality of life, mood, and cognitive functioning. Older adults often fail to reach the recommended level of physical activity to prevent the age-related decline in sleep function, partly because of geographical barriers. Implementing home-based interventions could surmount these obstacles, thereby encouraging older adults to stay active, with videoconference administration emerging as a promising solution. Increasing the availability of biological rhythms synchronizers, such as physical activity, light exposure, or vestibular stimulation, represents a viable non-pharmacological strategy for entraining circadian rhythms and potentially fortifying the sleep-wake cycle, thereby enhancing sleep in aging. This study aims to (1) assess the impact of remote physical exercise training and its combination with bright light exposure, and (2) investigate the specific contribution of galvanic vestibular stimulation, to sleep quality among healthy older adults with sleep complaints. One hundred healthy older adults aged 60-70 years with sleep complaints will be randomly allocated to one of four groups: a physical exercise training group (n = 25), a physical exercise training combined with bright light exposure group (n = 25), a galvanic vestibular stimulation group (n = 25) or a control group (i.e., health education) (n = 25). While physical exercise training and health education will be supervised via videoconference at home, bright light exposure (for the physical exercise training combined with bright light exposure group) and vestibular stimulation will be self-administered at home. Pre-and post-tests will be conducted to evaluate various parameters, including sleep (polysomnography, subjective questionnaires), circadian rhythms (actigraphy, temperature), fitness (physical: VO2 peak, muscular function; and motor: balance, and functional mobility), cognition (executive function, long-term memory), quality of life and mood (anxiety and depression). The findings will be anticipated to inform the development of recommendations and non-pharmaceutical preventive strategies for enhancing sleep quality in older adults, potentially leading to improvements in fitness, cognition, quality of life, and mood throughout aging.

The complexity of center of pressure positions during quiet stance and its relationship to cognition, aging and falls.

BACKGROUND: In a secondary analysis of data taken from a publicly available database, we examined cognitive performance, postural sway, and relations between them for four groups: younger and older individuals with versus without a recent history of falls. Our objective was to compare linear versus nonlinear measures of postural activity as post-hoc predictors of cognitive performance and falling. METHODS: We evaluated standing body sway in 147 participants (18 to 85 years-old) over 60 seconds, separately with eyes-open and with eyes-closed. We evaluated cognitive performance using portions of the Trail Making Test. We evaluated postural activity in terms of standard deviation, velocity, and amplitude of the CoP. Separately, we used detrended fluctuation analysis (DFA) to examine the complexity of CoP displacements. Using analysis of variance, we conducted separate analyses of cognitive performance and postural activity comparing Younger and Older Adults and Non-fallers and Fallers, taking into account Vision (eyes-closed vs. open) and the direction of postural movements (AP vs. ML) while also controlling for participants' characteristics. We used moderation analyses to evaluate whether relationships between Trail Making Test scores and the linear and nonlinear outcomes were moderated by Age group or Fall status. RESULTS: For postural activity, only DFA differed between Non-fallers and Fallers. Older adults exhibited increased complexity associated with better processing speed function, while fallers show an opposite association, relying on processing speed to increase postural rigidity instead of facilitating adaptive control of balance. CONCLUSIONS: We conclude that DFA can provide information regarding postural activity and cognitive performance that cannot be obtained from more traditional, linear measures of postural activity, and that DFA may be a valuable tool for assessing fall risk.

Effects of sleep disturbances and circadian rhythms modifications on cognition in breast cancer women before and after adjuvant chemotherapy: the ICANSLEEP-1 protocol.

BACKGROUND: Many patients treated for breast cancer (BC) complain about cognitive difficulties affecting their daily lives. Recently, sleep disturbances and circadian rhythm disruptions have been brought to the fore as potential contributors to cognitive difficulties in patients with BC. Yet, studies on these factors as well as their neural correlates are scarce. The purpose of the ICANSLEEP-1 (Impact of SLEEP disturbances in CANcer) study is to characterize sleep using polysomnography and its relationship with the evolution of cognitive functioning at both the behavioral and the neuroanatomical levels across treatment in BC patients treated or not with adjuvant chemotherapy. METHODS: ICANSLEEP-1 is a longitudinal study including BC patients treated with adjuvant chemotherapy (n = 25) or not treated with adjuvant chemotherapy (n = 25) and healthy controls with no history of BC (n = 25) matched for age (45-65 years old) and education level. The evaluations will take place within 6 weeks after inclusion, before the initiation of chemotherapy (for BC patients who are candidates for chemotherapy) or before the first fraction of radiotherapy (for BC patients with no indication for chemotherapy) and 6 months later (corresponding to 2 weeks after the end of chemotherapy). Episodic memory, executive functions, psychological factors, and quality of life will be assessed with validated neuropsychological tests and self-questionnaires. Sleep quantity and quality will be assessed with polysomnography and circadian rhythms with both actigraphy and saliva cortisol. Grey and white matter volumes, as well as white matter microstructural integrity, will be compared across time between patients and controls and will serve to further investigate the relationship between sleep disturbances and cognitive decline. DISCUSSION: Our results will help patients and clinicians to better understand sleep disturbances in BC and their relationship with cognitive functioning across treatment. This will aid the identification of more appropriate sleep therapeutic approaches adapted to BC patients. Improving sleep in BC would eventually help limit cognitive deficits and thus improve quality of life during and after treatments. TRIAL REGISTRATION: NCT05414357, registered June 10, 2022. PROTOCOL VERSION: Version 1.2 dated March 23, 2022.

Cognitive and balance functions of astronauts after spaceflight are comparable to those of individuals with bilateral vestibulopathy.

Introduction: This study compares the balance control and cognitive responses of subjects with bilateral vestibulopathy (BVP) to those of astronauts immediately after they return from long-duration spaceflight on board the International Space Station. Methods: Twenty-eight astronauts and thirty subjects with BVP performed five tests using the same procedures: sit-to-stand, walk-and-turn, tandem walk, duration judgment, and reaction time. Results: Compared to the astronauts' preflight responses, the BVP subjects' responses were impaired in all five tests. However, the BVP subjects' performance during the walk-and-turn and the tandem walk tests were comparable to the astronauts' performance on the day they returned from space. Moreover, the BVP subjects' time perception and reaction time were comparable to those of the astronauts during spaceflight. The BVP subjects performed the sit-to-stand test at a level that fell between the astronauts' performance on the day of landing and 1 day later. Discussion: These results indicate that the alterations in dynamic balance control, time perception, and reaction time that astronauts experience after spaceflight are likely driven by central vestibular adaptations. Vestibular and somatosensory training in orbit and vestibular rehabilitation after spaceflight could be effective countermeasures for mitigating these post-flight performance decrements.

Tackling Insomnia Symptoms through Vestibular Stimulation in Patients with Breast Cancer: A Perspective Paper.

Insomnia symptoms are common among patients with breast cancer (BC; 20-70%) and are predictors of cancer progression and quality of life. Studies have highlighted sleep structure modifications, including increased awakenings and reduced sleep efficiency and total sleep time. Such modifications may result from circadian rhythm alterations consistently reported in this pathology and known as carcinogenic factors, including lower melatonin levels, a flattened diurnal cortisol pattern, and lower rest-activity rhythm amplitude and robustness. Cognitive behavioral therapy and physical activity are the most commonly used non-pharmacological interventions to counter insomnia difficulties in patients with BC. However, their effects on sleep structure remain unclear. Moreover, such approaches may be difficult to implement shortly after chemotherapy. Innovatively, vestibular stimulation would be particularly suited to tackling insomnia symptoms. Indeed, recent reports have shown that vestibular stimulation could resynchronize circadian rhythms and improve deep sleep in healthy volunteers. Moreover, vestibular dysfunction has been reported following chemotherapy. This perspective paper aims to support the evidence of using galvanic vestibular stimulation to resynchronize circadian rhythms and reduce insomnia symptoms in patients with BC, with beneficial effects on quality of life and, potentially, survival.

Spaceflight alters reaction time and duration judgment of astronauts.

We report a study on astronauts aimed at characterizing duration judgment before, during, and after long-duration stays on board the International Space Station. Ten astronauts and a control group of 15 healthy (non-astronaut) participants performed a duration reproduction task and a duration production task using a visual target duration ranging from 2 to 38 s. Participants also performed a reaction time test for assessing attention. Compared to control participants and preflight responses, the astronauts' reaction time increased during spaceflight. Also, during spaceflight, time intervals were under-produced while counting aloud and under-reproduced when there was a concurrent reading task. We hypothesize that time perception during spaceflight is altered by two mechanisms: (a) an acceleration of the internal clock through the changes in vestibular inputs in microgravity, and (b) difficulties in attention and working memory when a concurrent reading task is present. Prolonged isolation in confined areas, weightlessness, stress related to workload, and high-performance expectations could account for these cognitive impairments.

Chronotype influence on the effects of COVID-19 lockdown on sleep and psychological status in France.

The present study aims to assess the influence of chronotype on lockdown-induced effects on sleep and psychological outcomes. A total of 1671 participants were recruited in France and filled out online questionnaires about their sleeping hours and sleep quality, their chronotype (morning, intermediate, evening type), and their depressive, anxiety and stress symptoms both retrospectively (before lockdown) and currently (during the lockdown). Statistical analyses estimated the chronotype effect on the impact of the lockdown on sleep and psychological outcomes. Results show that during the lockdown, sleep quality decreased, sleep duration increased, and sleep midpoint was delayed and, while fatigue perception decreased, anxiety and depression increased. The decrease in sleep quality varied according to the participants' chronotype. The evening type's sleep quality decreased the most. A similar chronotype effect was also observed on sleep duration and sleep midpoint. Evening-type participants also increased their depressive symptoms. These results suggest that evening-type individuals have lower resilience to lockdown effect on psychological status and sleep pattern.

Time perception in astronauts on board the International Space Station.

We perceive the environment through an elaborate mental representation based on a constant integration of sensory inputs, knowledge, and expectations. Previous studies of astronauts on board the International Space Station have shown that the mental representation of space, such as the perception of object size, distance, and depth, is altered in orbit. Because the mental representations of space and time have some overlap in neural networks, we hypothesized that perception of time would also be affected by spaceflight. Ten astronauts were tested before, during, and after a 6-8-month spaceflight. Temporal tasks included judging when one minute had passed and how long it had been since the start of the workday, lunch, docking of a vehicle, and a spacewalk. Compared to pre-flight estimates, there is a relative overestimation for the 1-min interval during the flight and a relative underestimation of intervals of hours in duration. However, the astronauts quite accurately estimated the number of days since vehicle dockings and spacewalks. Prolonged isolation in confined areas, stress related to workload, and high-performance expectations are potential factors contributing to altered time perception of daily events. However, reduced vestibular stimulations and slower motions in weightlessness, as well as constant references to their timeline and work schedule could also account for the change in the estimation of time by the astronauts in space.

Non-inferiority of a home-based videoconference physical training program in comparison with the same program administered face-to-face in healthy older adults: the MOTION randomised controlled trial.

BACKGROUND: older adults often fail to reach the recommended amount of physical activity to prevent the age-related decline in metabolic, cardiorespiratory and muscular function. Effective home-based physical training programs could neutralise barriers preventing older adults from being active, and administration/supervision through videoconference may be an optimal solution. The present randomised controlled trial aimed to test the non-inferiority of training program administered through videoconference against the same program administered face-to-face in healthy older adults. METHODS: participants were randomised in a no-training control group (n = 13), a face-to-face training group (n = 15) and a videoconference training group (n = 13). The intervention groups completed the same home-based, structured, progressive and combined training program for 16 weeks, 1-h twice a week. Pre-intervention and post-intervention evaluations included body composition, cardiorespiratory fitness and muscle function measures. RESULTS: non-inferiority of videoconferencing against face-to-face training was observed for changes in body weight (P < 0.01), fat mass (P = 0.015), maximal aerobic power (P = 0.013), maximal heart rate (P = 0.034), maximal oxygen consumption (P < 0.01), knee extension strength (P = 0.044) and lower limb power (P = 0.019), but not for muscle mass (P = 0.067), handgrip strength (P = 0.171), trunk extension strength (P = 0.241) and knee flexion strength (P = 0.462). CONCLUSION: a training program administered through videoconferencing was not inferior to the same program administered face-to-face for reducing body weight and fat mass, and for improving maximal aerobic power and oxygen consumption as well as lower limb power and knee extension strength in healthy older subjects. However, videoconferencing training was not as effective as face-to-face training for improving handgrip, trunk extension and knee flexion isometric strength.

Circadian rhythm of postural control, sleepiness and verticality perception in older adults.

INTRODUCTION: with ageing, the risk of falling increases. It has been reported that fall frequency may depend on the time of the day, suggesting a possible circadian rhythm of postural control. The objective was to test whether postural control in older adults followed a circadian rhythm. Then, in order to examine the possible functions involved in circadian variations in balance performances, circadian rhythm of sleepiness and vertical perception were also tested. METHODS: eight participants (70.7 ± 4.7 years) were included. Baseline circadian rhythm profile was assessed through continuous core temperature measurement. Static and dynamic balance, subjective sleepiness and fatigue, and verticality perception were measured at 2:00, 6:00, 10:00, 14:00, 18:00 and 22:00, on separate weeks in a random order. RESULTS: temperature followed a circadian rhythm, with lowest temperature occurring at 03:50. Circadian rhythm was detected for the centre of pressure displacement length and velocity, in dynamic condition eyes closed, with lowest performances occurring at 18:33 and 16:59, respectively. Subjective sleepiness and fatigue also followed circadian rhythm with lowest sleepiness occurring at 15:46 and 15:50, for the Karolinska Sleeping Scale and the Visual Analogic Scale of fatigue, respectively. Finally, the vertical perception was not significantly following a circadian rhythm. CONCLUSION: older adults present a circadian rhythm of balance, in particular in more challenging conditions, and the lowest performances occurred in the late afternoon These circadian rhythms could explain some of the falls happening at this time in community-dwelling older adults.

Videoconference-Based Adapted Physical Exercise Training Is a Good and Safe Option for Seniors.

Videoconference-based adapted physical exercise combines the benefits of supervised exercise training with staying at home, when conventional training is inaccessible. However, exercising with the use of a screen can be considered an optokinetic stimulation, and could therefore induce changes in sensory processing, affecting postural stability. The objectives of this study were to compare the effectiveness of the training delivered Face-to-Face and by Videoconferencing in improving physical capacities of older adults, and to evaluate the possible effects of the Videoconference mode on the processing of sensory information that could affect postural control. Twenty eight older adults underwent the supervised exercise program for sixteen weeks either Face-to-Face or by Videoconference. Muscular strength of knee and ankle flexors and extensors, maximum oxygen uptake, postural stability and horizontal rotational vestibulo-ocular reflex were evaluated before and after the training. Both modes of training similarly increased the VO2 peak and strength of the motor muscles of lower limbs in all participants. The use of the Videoconference did not modify the vestibulo-ocular reflex in subjects or the importance of vision for postural control. Therefore, the Videoconference-based exercise training can be considered a safe and effective way to maintain good functional capacity in seniors.

A web-based adapted physical activity program (e-APA) versus health education program (e-HE) in patients with schizophrenia and healthy volunteers: study protocol for a randomized controlled trial (PEPSY V@Si).

Patients with schizophrenia (SZ) have a high level of cardiovascular morbidity and some clinical symptoms of illness remain resistant to pharmacological approaches. A large number of studies support the effectiveness of physical activity (PA) in SZ. The aims of this trial is to assess the effects of a remote, web-based adapted PA program (e-APA) compared to a health education program (e-HE) on brain plasticity in SZ and healthy volunteers (HV) and on psychiatric, neurocognitive, circadian and physical variables. The study is an interventional, multicenter, randomized open-label trial. Forty-two SZ will be randomized to either the active group (e-APA, N = 21) or nonactive group (e-HE, N = 21), and 21 HV will be matched to SZ according to age, gender, and level of PA in both e-APA and e-HE groups. Interventions will consist of 32 sessions (2 × 60 min/week, for 16 weeks) via supervised home-based videoconferencing. Cerebral magnetic resonance imaging, psychiatric symptoms, neurocognitive and circadian rhythms assessments as well as physical tests and biological analyses will be assessed at baseline and 16 weeks after the intervention. To our knowledge, this is the first study aiming to evaluate the efficacy of APA delivered by supervised home-based videoconferencing in SZ. Moreover, using multimodal MRI, this study could clarify the pathophysiological mechanisms underlying the efficacy of APA. Finally, this innovative approach might also increase participation in long-term PA since PA-based programs are known to have low adherence and early dropout. Trial registration: ClinicalTrials.gov identifier: NCT03261817. Registered on 16 August 2017.

Twenty-four-hour variation of vestibular function in young and elderly adults.

Animal and human studies demonstrate anatomical and functional links between the vestibular nuclei and the circadian timing system. This promotes the hypothesis of a circadian rhythm of vestibular function. The objective of this study was to evaluate the vestibular function through the vestibulo-ocular reflex using a rotatory chair at different times of the day to assess circadian rhythmicity of vestibular function. Two identical studies evaluating temporal variation of the vestibulo-ocular reflex (VOR) were performed, the first in young adults (age: 22.4 ± 1.5 y), and the second in older adults (70.7 ± 4.7 y). The slow phase velocity and time constant of the VOR were evaluated in six separate test sessions, i.e., 02:00, 06:00, 10:00, 14:00, 18:00, and 22:00 h. In both studies, markers of circadian rhythmicity (temperature, fatigue, and sleepiness) displayed expected usual temporal variation. In young adults, the time constant of the VOR showed variation throughout the day (p < .005), being maximum 12:25 h (06:00 h test session) before the acrophase of temperature circadian rhythm. In older adults, the slow phase velocity and time constant also displayed temporal variation (p < .05). Maximum values were recorded at 10:35 h (06:00 h test session) before the acrophase of temperature circadian rhythm. The present study demonstrates that vestibular function is not constant throughout the day. The implication of the temporal variation in vestibular system in equilibrium potentially exposes the elderly, in particular, to differential risk during the 24 h of losing balance and falling.

Effect of vestibular stimulation using a rotatory chair in human rest/activity rhythm.

The vestibular system is responsible for sensing every angular and linear head acceleration, mainly during periods of motor activity. Previous animal and human experiments have shown biological rhythm disruptions in small rodents exposed to a hypergravity environment, but also in patients with bilateral vestibular loss compared to a control population. This raised the hypothesis of the vestibular afferent influence on circadian rhythm synchronization. The present study aimed to test the impact of vestibular stimulation induced by a rotatory chair on the rest/activity rhythm in human subjects. Thirty-four healthy adults underwent both sham (SHAM) and vestibular stimulation (STIM) sessions scheduled at 18:00 h. An off-vertical axis rotation on a rotatory chair was used to ecologically stimulate the vestibular system by head accelerations. The rest/activity rhythm was continuously registered by actigraphy. The recording started one week before the first session (BASELINE), continued in the week between the two sessions and one week after the second session. Vestibular stimulation caused a significant decrease in the average activity level in the evening following the vestibular stimulation. A significant phase advance in the rest/activity rhythm occurred two days after the 18:00 h vestibular stimulation session. Moreover, the level of motion sickness symptoms increased significantly after vestibular stimulation. The present study confirms previous results on the effect of vestibular stimulation and the role of vestibular afferents on circadian biological rhythmicity. Our results support the hypothesis of the implication of vestibular afferents as non-photic stimuli acting on circadian rhythms.

Vestibular stimulation by 2G hypergravity modifies resynchronization in temperature rhythm in rats.

Input from the light/dark (LD) cycle constitutes the primary synchronizing stimulus for the suprachiasmatic nucleus (SCN) circadian clock. However, the SCN can also be synchronized by non-photic inputs. Here, we hypothesized that the vestibular system, which detects head motion and orientation relative to gravity, may provide sensory inputs to synchronize circadian rhythmicity. We investigated the resynchronization of core temperature (Tc) circadian rhythm to a six-hour phase advance of the LD cycle (LD + 6) using hypergravity (2 G) as a vestibular stimulation in control and bilateral vestibular loss (BVL) rats. Three conditions were tested: an LD + 6 exposure alone, a series of seven 2 G pulses without LD + 6, and a series of seven one-hour 2 G pulses (once a day) following LD + 6. First, following LD + 6, sham rats exposed to 2 G pulses resynchronized earlier than BVL rats (p = 0.01), and earlier than sham rats exposed to LD + 6 alone (p = 0.002). Each 2 G pulse caused an acute drop of Tc in sham rats (-2.8 ± 0.3 °C; p < 0.001), while BVL rats remained unaffected. This confirms that the vestibular system influences chronobiological regulation and supports the hypothesis that vestibular input, like physical activity, should be considered as a potent time cue for biological rhythm synchronization, acting in synergy with the visual system.

Vestibulo-Ocular Responses, Visual Field Dependence, and Motion Sickness in Aerobatic Pilots.

BACKGROUND: Aerobatic flight is a challenge for the vestibular system, which is likely to lead to adaptive changes in the vestibular responses of pilots. We investigated whether aerobatic pilots, as individuals who experience intense vestibular stimulation, present modifications of the vestibular-ocular reflex, motion sickness susceptibility and intensity, visual vertical estimation, and visual dependence as compared to normal volunteers.METHODS: To evaluate vestibulo-ocular reflexes, eye movements were recorded with videonystagmography while subjects were rotated on a rotatory chair with the axis of rotation being vertical (canal-ocular reflex) or inclined to 17° (otolith-ocular reflex). Motion sickness was evaluated after the rotatory test using the Graybiel diagnostic criteria. General motion sickness susceptibility and visual field dependence were also evaluated.RESULTS: Averaged data did not show significant difference in canal-ocular reflex and otolith ocular-reflex between groups. However, a significant asymmetry in otolith-driven ocular responses was found in pilots (CW 0.50 ± 1.21° · s-1 vs. CCW 1.59 ± 1.12° · s-1), though visual vertical estimation was not altered in pilots and both groups were found field independent. Pilots were generally less susceptible to motion sickness (MSSQ scores: 2.52 ± 5.59 vs. 13.5 ± 11.36) and less affected by the nauseogenic stimulation (Graybiel diagnostic criteria 3.36 ± 3.81 vs. 8.39 ± 7.01).DISCUSSION: We did not observe the expected habituation in the group of aerobatic pilots. However, there was a significant asymmetry in the otolith-driven ocular responses in pilots, but not in the controls, which may result from the asymmetry in piloting protocols.Kuldavletova O, Tanguy S, Denise P, Quarck G. Vestibulo-ocular responses, visual field dependence, and motion sickness in aerobatic pilots. Aerosp Med Hum Perform. 2020; 91(4):326-331.

Plantar Flexor Strength Training With Home-Based Neuromuscular Electrical Stimulation Improves Limits of Postural Stability in Older Adults.

BACKGROUND: The study aimed to determine whether improved muscle strength after 12 weeks of neuromuscular electrical stimulation (NMES) of plantar and dorsiflexors could result in better limits of stability in older adults. METHODS: Twenty-seven participants were divided into a control group and a neuromuscular home-based training group. The training group performed a 3-month long NMES training of both plantar and dorsiflexors. Ankle flexor strength and limits of stability were measured. A mediation analysis was conducted to determine whether the NMES effect on the limits of stability was mediated by increased strength. RESULTS: The NMES training increased plantar flexor strength (+47%; ß = 0.217, P = .02), and this increase predicted the anterior limits of stability improvement (+27%; ß = 0.527, P = .02). The effect of the NMES on the limits of stability was fully mediated by the plantar flexor strength increase (indirect effect: ß = 0.1146; 95% confidence interval, 0.020-0.240). CONCLUSION: It seems that NMES improves the limits of stability through its positive effect on muscle strength. NMES may be utilized in fall-prevention programs.

Corrigendum: Impact of Galvanic Vestibular Stimulation on Anxiety Level in Young Adults.

[This corrects the article DOI: 10.3389/fnsys.2019.00014.].

Impact of Galvanic Vestibular Stimulation on Anxiety Level in Young Adults.

Galvanic vestibular stimulation (GVS) is a non-invasive method used to stimulate the vestibular system. The vestibular system includes the sensors, neural pathways, vestibular nuclei and the cortical areas receiving integrated vestibular inputs. In addition to its role in postural control or gaze stabilization, the vestibular system is involved in some cognitive functions and in emotion processing. Several studies have revealed a modulating effect of vestibular stimulation on mood state, emotional control, and anxiety level. Nevertheless, GVS is known to induce motion sickness symptoms such as nausea. The aim of the present study was to evaluate the tolerability and efficacy of a GVS protocol to be used potentially as a treatment for anxiety, and also to test the impact of stimulation parameters (duration) on anxiety. Twenty-two students underwent three stimulation conditions: (1) a sham session (no stimulation); (2) a single-duration session (38 min of GVS); and (3) a double-duration session (76 min of GVS). Before and after each stimulation, participants completed a Graybiel Scale form for motion sickness symptoms evaluation and a visual analog scale form for anxiety. We observed a significant diminution of anxiety level after a 38-min session of GVS, while a low level of motion sickness was only found following a 76-min session of GVS. Our preliminary study confirms the feasibility of using GVS to modulate anxiety and corroborates the involvement of the vestibular system in the emotional process.

Exploration of Circadian Rhythms in Patients with Bilateral Vestibular Loss.

BACKGROUND: New insights have expanded the influence of the vestibular system to the regulation of circadian rhythmicity. Indeed, hypergravity or bilateral vestibular loss (BVL) in rodents causes a disruption in their daily rhythmicity for several days. The vestibular system thus influences hypothalamic regulation of circadian rhythms on Earth, which raises the question of whether daily rhythms might be altered due to vestibular pathology in humans. The aim of this study was to evaluate human circadian rhythmicity in people presenting a total bilateral vestibular loss (BVL) in comparison with control participants. METHODOLOGY AND PRINCIPAL FINDINGS: Nine patients presenting a total idiopathic BVL and 8 healthy participants were compared. Their rest-activity cycle was recorded by actigraphy at home over 2 weeks. The daily rhythm of temperature was continuously recorded using a telemetric device and salivary cortisol was recorded every 3 hours from 6:00AM to 9:00PM over 24 hours. BVL patients displayed a similar rest activity cycle during the day to control participants but had higher nocturnal actigraphy, mainly during weekdays. Sleep efficiency was reduced in patients compared to control participants. Patients had a marked temperature rhythm but with a significant phase advance (73 min) and a higher variability of the acrophase (from 2:24 PM to 9:25 PM) with no correlation to rest-activity cycle, contrary to healthy participants. Salivary cortisol levels were higher in patients compared to healthy people at any time of day. CONCLUSION: We observed a marked circadian rhythmicity of temperature in patients with BVL, probably due to the influence of the light dark cycle. However, the lack of synchronization between the temperature and rest-activity cycle supports the hypothesis that the vestibular inputs are salient input to the circadian clock that enhance the stabilization and precision of both external and internal entrainment.