# Vestibular implantation in older adults

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2022 · $516,444

## Abstract

Project Summary
 Bilateral loss of vestibular sensation is disabling, with affected individuals suffering chronic disequilibrium,
increased risk of falls, and inability to maintain stable vision during head movements typical of daily life. Most
individuals with mild or moderate loss compensate through rehabilitative strategies enlisting other senses;
however, those with severe loss who fail to compensate have no good therapeutic options. For older
individuals who are already contending with decreases in vision, proprioception and other systems that
normally contribute to maintaining balance, lack of compensatory reserve can make loss of vestibular
sensation even more impactful. Fortunately, when the vestibular nerves are anatomically intact, as is true in
most such cases, electrical stimuli encoding head rotation can artificially drive nerve activity to partially restore
vestibular sensation, much as a cochlear implant partially restores auditory sensation. In the first-in-human
early feasibility study designed to test the safety and efficacy of long-term prosthetic vestibular nerve
stimulation as a sensory restoration treatment, we performed unilateral vestibular implantation in 8 adults aged
51-66 years old who had been disabled for 2-23 years by bilateral vestibular hypofunction. We found that
vestibular implantation and 24 hr/day motion-modulated prosthetic stimulation targeting the three implanted
semicircular canals drives directionally-aligned vestibulo-ocular reflexes, improves objective measures of
posture and gait, and improves patient-reported dizziness handicap and vestibular-related disability. However,
we do not yet know whether this sensory-restoration treatment will work well in older adults, who are thought to
have greater difficultly adapting to asymmetry in input from the two vestibular labyrinths. Drawing on an
established design, experienced study team and protocol that have already yielded highly impactful results in
the existing study of younger subjects, the proposed research will extend this approach to older adults disabled
by bilateral vestibular hypofunction. Results are very likely to yield sustained impact, by clarifying the relative
risks and benefits of this intervention in older adults and by providing data that can inform decisions by
regulators, policy-makers and third-party payers regarding whether older adults disabled by bilateral vestibular
loss should have access to vestibular implantation.

## Key facts

- **NIH application ID:** 10419861
- **Project number:** 1R01AG076701-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Charles C Della Santina
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $516,444
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10419861

## Citation

> US National Institutes of Health, RePORTER application 10419861, Vestibular implantation in older adults (1R01AG076701-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10419861. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*