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The vestibular system: balancing more than just the body

Lopez, Christophe

doi: 10.1097/WCO.0000000000000286
NEURO-OPHTHALMOLOGY AND NEURO-OTOLOGY: Edited by David S. Zee and Francine Behar-Cohen

Purpose of review The review presents a selection of recent studies in the field of vestibular neuroscience, including how vestibular stimulation modulates space and body perception.

Recent findings Recent neuroimaging studies identified the operculo-insular/retroinsular cortex as the core vestibular cortex and showed how it is reorganized after vestibular dysfunctions. Subliminal galvanic vestibular stimulation (GVS) induces long-term reduction of hemispatial neglect and improves vertical perception in stroke patients, but the underlying mechanisms remain to be identified. Healthy volunteer research suggests that GVS and caloric vestibular stimulation (CVS) modulate visual and somatosensory processing and that beneficial effects of GVS/CVS in stroke patients are not limited to merely rebalancing brain hemispheric activity. Another mechanism would be that GVS/CVS anchors the self to the body, thus promoting an egocentric frame of reference.

Summary In addition to ‘balancing the body’, the vestibular cortical network contributes to modulate space, body and self-awareness. Emerging evidence suggests that the vestibular network expands into dimensions of emotion processing, mental health, and social cognition. Here, the importance of connecting vestibular physiology, affective neuroscience, and social neuroscience to better understand the psychological aspects of vertigo in otoneurology is discussed.

Aix Marseille Université, CNRS, NIA UMR 7260, Marseille, France

Correspondence to Christophe Lopez, Laboratoire de Neurosciences Intégratives et Adaptatives – UMR 7260, Centre National de la Recherche Scientifique (CNRS) and Aix-Marseille Université, Centre Saint Charles, Fédération de Recherche 3C – Case B, 3, Place Victor Hugo, 13331 Marseille Cedex 03, France. Tel: +33 4 13 55 08 41; fax: +33 4 13 55 08 44; e-mail:

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