A few years after their bilateral vestibular loss, patients usually show a motor repertoire that is almost back to normal. This recovery is thought to involve an up-regulation of the visual and proprioceptive information that compensates for the lack of vestibular information. Here, we investigated whether plantar tactile inputs, which provide body information relative to the ground and to the Earth-vertical, contribute to this compensation. More specifically, we tested the hypothesis that somatosensory cortex response to electric stimulation of the plantar sole in standing adults will be greater in humans (n = 10) with bilateral vestibular hypofunction (VH) than in an age-matched healthy group (n = 10). Showing significantly greater somatosensory evoked potentials (i.e., P1N1) in VH than in controls, the electroencephalographic recordings supported this hypothesis. Furthermore, we found evidence that increasing the differential pressure between both feet, by adding a 1 kg mass at each pendant wrist, enhanced the internal representation of body orientation and motion relative to a gravitational reference frame. The large decrease in alpha power in the right posterior parietal cortex (and not in the left) is in line with this assumption. Finally, behavioral analyses showed that trunk oscillations were smaller than head oscillations in VH and showed a reverse pattern for healthy participants. These findings are consistent with a tactile-based postural control strategy in the absence of vestibular input, and a vestibular-based control strategy in healthy participants where the head serves as a reference for balance control.

A few years after their bilateral vestibular loss, individuals usually show a motor repertoire that is almost back to normal. This recovery is thought to involve an up-regulation of the visual and proprioceptive information that compensates for the lack of vestibular information. Here, we investigated whether plantar tactile inputs, which provide body information relative to the ground and to the Earth-vertical, contribute to this compensation. More specifically, we tested the hypothesis that somatosensory cortex response to electric stimulation of the plantar sole in standing adults will be greater in patients (n = 10) with bilateral vestibular loss than in an aged-matched healthy group (n = 10). Showing significant greater somatosensory evoked potentials (i.e., P1N1) in patients than in controls, the electroencephalographic recordings supported this hypothesis. Furthermore, we found evidence that increasing the differential pressure between both feet, by adding a 1 kg mass at each pending wrist, enhanced the internal representation of body orientation and motion relative to a gravitational reference frame. The large decreased in alpha/beta power in the right posterior parietal cortex (and not in the left) is in line with this assumption. Finally, our behavioral analyses showed smaller body sway oscillations for patients, likely originated from a tactile-based control strategy. Conversely, healthy subjects showed smaller head oscillations suggesting a vestibular-based control strategy, the head serving as a reference for balance control.HighlightsSomatosensory cortex excitability is greater in patients with bilateral vestibular loss than in aged-matched healthy individualsTo control balance, healthy individuals “locked” the head while vestibular patients “locked” their pelvisFor vestibular patients, increasing loading/unloading mechanism enhances the internal representation of body state in the posterior parietal cortex