Late human brain plasticity: vestibular substitution with a tongue BrainPort human-machine interface

The brain is capable of major reorganization even many years after an injury, with appropriate rehabilitation. The highly plastic brain responds best when the therapy is motivating and has a benefit that is recognized by the patient. The major objective of this study was to estimate feasibility and efficacy of an electro-tactile vestibular substitution system (ETVSS) in aiding recovery of posture control in patients with bilateral vestibular loss (BVL) during sitting and standing. Subjects used the BrainPort balance device for a period from 3 to 5 days. Subjects readily perceived both position and motion of a small 'target' stimulus on the tongue display, and interpreted this information to make corrective postural adjustments, causing the target stimulus to become centred. With two twenty minute sessions a day significant functional improvement lasts the whole day.