Central vestibular networking for sensorimotor control, cognition, and emotion

Abstract

Purpose of review The aim of this study was to illuminate the extent of the bilateral central vestibular network from brainstem and cerebellum to subcortical and cortical areas and its interrelation to higher cortical functions such as spatial cognition and anxiety. Recent findings The conventional view that the main function of the vestibular system is the perception of self-motion and body orientation in space and the sensorimotor control of gaze and posture had to be developed further by a hierarchical organisation with bottom-up and top-down interconnections. Even the vestibulo-ocular and vestibulo-spinal reflexes are modified by perceptual cortical processes, assigned to higher vestibulo-cortical functions. A first comparative fMRI meta-analysis of vestibular stimulation and fear-conditioning studies in healthy participants disclosed widely distributed clusters of concordance, including the prefrontal cortex, anterior insula, temporal and inferior parietal lobe, thalamus, brainstem and cerebellum. In contrast, the cortical vestibular core region around the posterior insula was activated during vestibular stimulation but deactivated during fear conditioning. In recent years, there has been increasing evidence from studies in animals and humans that the central vestibular system has numerous connections related to spatial sensorimotor performance, memory, and emotion. The clinical implication of the complex interaction within various networks makes it difficult to assign some higher multisensory disorders to one particular modality, for example in spatial hemineglect or room-tilt illusion. Summary Our understanding of higher cortical vestibular functions is still in its infancy. Different brain imaging techniques in animals and humans are one of the most promising methodological approaches for further structural and functional decoding of the vestibular and other intimately interconnected networks. The multisensory networking including cognition and emotion determines human behaviour in space.

Appropriate Vestibular Stimulation in Children and Adolescents—A Prerequisite for Normal Cognitive, Motor Development and Bodily Homeostasis—A Review

“…Similarly, spinning chairs, with their high-frequency stimulation, have been used to treat mental illnesses, such as manic episodes [3,4]. In relation to the influence on emotions, vestibular dysfunction can not only induce or cause a worsening of anxiety, depression and other affective disorders, but there is evidence that affective conditions may also influence the central vestibular systems [85,[94][95][96]. This is not surprising, knowing the effects of vestibular impairment on everyday functioning, daily activities, social interactions and the connections of the vestibular system with the limbic system (Figure 3).…”