Effect of Rotating Auditory Scene on Postural Control in Normal Subjects, Patients With Bilateral Vestibulopathy, Unilateral, or Bilateral Cochlear Implants

Abstract

Objective: The aim of this study was to investigate the impact of a rotating sound stimulation on the postural performances in normal subjects, patients with bilateral vestibulopathy (BVP), unilateral (UCI), and bilateral (BCI) cochlear implantees. Materials and Methods: Sixty-nine adults were included (32 women and 37 men) in a multicenter prospective study. The group included 37 healthy subjects, 10 BVP, 15 UCI, and 7 BCI patients. The average of age was 47 ± 2.0 (range: 23-82). In addition to a complete audiovestibular work up, a dynamic posturography (Multitest Framiral, Grasse) was conducted in silence and with a rotating cocktail party sound delivered by headphone. The center of pressure excursion surface (COPS), sensory preferences, as well as fractal, diffusion, and wavelet analysis of stabilometry were collected. Results: The rotating sound seemed to influenced balance in all subgroups except in controls. COPS increased with sound in the BVP and BCI groups in closed eyes and sway-referenced condition indicating a destabilizing effect while it decreased in UCI in the same condition suggesting stabilization (p 0.05, linear mixed model corrected for age, n = 69). BVP had higher proprioceptive preferences, BCI had higher vestibular and visual preferences, and UCI had only higher vestibular preferences than controls. Sensory preferences were not altered by rotating sound. Conclusions: The rotating sound destabilized BVP and BCI patients with binaural hearing while it stabilized UCI patients with monaural hearing and no sound rotation effect. This difference suggests that binaural auditory cues are exploited in BCI patients for their balance.