When Noise Isnt Simply Noise: Deterministic Postural Drive During Noisy Galvanic Vestibular Stimulation (nGVS)

Age- and disease-related vestibular decline can cause dizziness and postural instability, motivating interventions such as noisy galvanic vestibular stimulation (nGVS). nGVS is commonly delivered at "subsensory" amplitudes and explained by stochastic resonance, yet because galvanic stimulation directly modulates vestibular afferents, even imperceptible currents may also exert deterministic effects on balance. This study examined whether low-amplitude nGVS (<1 mA), as typically used in stochastic resonance paradigms, directly influences postural behavior through stimulus-response coupling. Twenty healthy young adults stood on a force plate with feet together and eyes closed on either a rigid surface or 10-cm foam. In randomized order, they completed 300-second trials with band-limited (0-30 Hz), zero-mean nGVS at {+/-}0, 0.1, 0.2, 0.3, 0.5, and 0.7 mA. Coupling between the stimulation waveform and mediolateral ground-reaction force was assessed using coherence and time-cumulant density. Mean coherence was significant mainly at higher amplitudes (0.5-0.7 mA) on both surfaces, whereas time-cumulant density identified significant time-locked vestibular-evoked response components at much lower amplitudes, down to 0.1 mA. These included an early response around 135-155 ms and a later, prominent response around 360-410 ms. Individually, significant coherence was common at 0.5-0.7 mA (15-19 of 20 participants), while cumulant-based responses appeared in some participants even at 0.1 mA. Responses were clearer on foam, consistent with greater vestibular reliance when somatosensory input is less reliable. Overall, low-amplitude nGVS can entrain postural output, suggesting that balance changes during "subsensory" stimulation may reflect both stochastic-resonance-like effects and deterministic vestibular drive, underscoring the need to quantify coupling alongside performance outcomes.