From ear to uncertainty: vestibular contributions to cognitive function

Abstract

In addition to the deficits in the vestibulo-ocular and vestibulo-spinal reflexes that occur following vestibular dysfunction, there is substantial evidence that vestibular loss also causes cognitive disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and neocortex play in spatial orientation. In this review we summarize the evidence that vestibular loss causes cognitive disorders, especially spatial memory deficits, in animals and humans and critically evaluate the evidence that these deficits are not due to hearing loss, problems with motor control, oscillopsia or anxiety and depression. We review the evidence that vestibular lesions affect head direction and place cells as well as the emerging evidence that artificial activation of the vestibular system, using galvanic vestibular stimulation (GVS), can modulate cognitive function.

The development of a new questionnaire for cognitive complaints in vertigo: the Neuropsychological Vertigo Inventory (NVI)

“…For the space perception subscale, the absence of significant difference was surprising. The Cronbach's alphas showed a good internal consistency (0.821), and we would have expected a significant difference between vertigo and non-vertigo participants based one the previous literature (see [62] for an extensive review). There are a number of explanations that can explain the lack of effect for the space perception subscale.…”

Vestibular contribution to three-dimensional dynamic (allocentric) and two-dimensional static (egocentric) spatial memory

“…Use of the Morris Water Task in rodents revealed that vestibular failure causes an impairment of spatial memory and navigation [1,2]. Human studies of patients with bilateral vestibular loss also exhibited significant spatial memory deficits associated with a bilateral hippocampal atrophy [3].…”

Vestibular Implants: 8 Years of Experience with Electrical Stimulation of the Vestibular Nerve in 11 Patients with Bilateral Vestibular Loss

“…Some even report feeling ashamed to be seen in public as others often think they are drunk. Moreover, due to multifocal cortical and thalamic projections of vestibular afferents, emotions, memory, cognitive abilities and personality can also be affected [3,4,5]. In most cases, a BVL cannot be compensated and sensory substitution is insufficient so that there is no or little spontaneous improvement to be expected in the long term [6].…”