One of the presentations at the 2026 NYC Neuromodulation Conference held this weekend was titled “Innovations in wearable non-invasive sensory neuromodulation and restorative treatments for age-related motor-cognitive decline.”
Losing yourbalance as you age is not a minor inconvenience. It is one of the leadingcauses of falls, fractures, and loss of independence in older adults. Standardvestibular rehabilitation helps people compensate for a weakening balancesystem by relying more on vision and proprioception. This wearable device takesa different approach: it tries to improve the balance signal itself.
The vestibularsystem, located in the inner ear, helps the brain sense head position andmovement in space. With aging, that signal can weaken or get distorted. Thedevice delivers an extremely gentle electrical current through small padsplaced behind the ears and on the upper neck. The stimulation is below thelevel of conscious perception. The idea is that adding a tiny amount ofelectrical “noise” can actually make a weak signal easier for the brain todetect.
In the studydescribed at the conference, people used the device for 20 minutes per session,across 18 sessions over roughly 4 to 6 weeks.
The wearableitself is new, but the concept behind it has been studied for more than adecade. An early study found that imperceptible vestibular stimulation improvedbalance in people with bilateral loss of inner ear function, a condition withvery limited treatment options. Fujimoto and colleagues then asked thepractical question of whether the benefit persists after the device is removed.In a study of 30 older adults, balance remained improved for more than twohours after stimulation ended, and a second session extended the effectfurther.
Nooristani andcolleagues conducted a randomized study comparing real stimulation with a shamdevice; they found that balance improved with the active treatment. Balancestudies without a sham control can be misleading, since people often improvesimply from repeating the test. The sham-controlled result therefore carriesmore weight. A pilot trial in older adults, with an average age of 78, comparedthe active device with a sham device three times a week for six weeks. Balanceimproved in the treated group within the first one to two weeks, and the gainswere still present six months later.
The conferencepresentation was encouraging, but it had no sham group. Thirty of 32 olderadults improved in balance and walking, and the number considered at high riskof falling dropped substantially, with no reported side effects in peopleranging from 50 to 95 years old. Without a control group, some of that improvementcould reflect practice effects.
One caveat isthat these studies measured balance and walking, not actual falls. Better testscores do not yet prove fewer fractures, fewer hospitalizations, or fewerreal-world injuries.
Researchers havealso registered studies testing this type of stimulation in adults withvestibular migraine, where dizziness and vertigo are the main symptoms. Resultshave not yet been published, so this remains a promising idea rather than anestablished treatment.
Vestibularmigraine is a common and often frustrating cause of episodic dizziness. Theevidence base for treatment is still limited. Vestibular rehabilitation is thebest-supported non-drug option, and some patients improve with preventivemedications, supplements, or neuromodulation strategies such as TMS. Still,many remain symptomatic despite trying multiple treatments.
I would beinterested in trying this device in vestibular migraine even before definitivestudies are finished. I tend to be an early adopter when a treatment appearsvery safe, and there are few good alternatives. About 35 years ago, I beganusing Botox for headaches when many people thought the idea was far-fetched.What made it reasonable to try was its safety. Botox was not approved by theFDA for chronic migraine until 2010. Waiting for approval would have meant hundredsof my patients living without relief and suffering unnecessarily for years.
