Vestibular insights into cognition and psychiatry

Abstract

The vestibular system has traditionally been thought of as a balance apparatus; however, accumulating research suggests an association between vestibular function and psychiatric and cognitive symptoms, even when balance is measurably unaffected. There are several brain regions that are implicated in both vestibular pathways and psychiatric disorders. The present review examines the anatomical associations between the vestibular system and various psychiatric disorders. Despite the lack of direct evidence for vestibular pathology in the key psychiatric disorders selected for this review, there is a substantial body of literature implicating the vestibular system in each of the selected psychiatric disorders. The second part of this review provides complimentary evidence showing the link between vestibular dysfunction and vestibular stimulation upon cognitive and psychiatric symptoms. In summary, emerging research suggests the vestibular system can be considered a potential window for exploring brain function beyond that of maintenance of balance, and into areas of cognitive, affective and psychiatric symptomology. Given the paucity of biological and diagnostic markers in psychiatry, novel avenues to explore brain function in psychiatric disorders are of particular interest and warrant further exploration.

Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey

“…Unfortunately, this avoidance behaviour can actually worsen dizziness and psychological symptoms 20 24 25 36 37. The mechanism that links psychological distress and symptoms of dizziness or vertigo is still unclear, but several authors hypothesise it is related to the substantial overlap of neuroanatomical regions and neurotransmitters involved in the vestibular system and pathways implicated in emotional states 21 38…”

Personality traits modulate subcortical and cortical vestibular and anxiety responses to sound-evoked otolithic receptor stimulation

“…Animal studies provided evidence about important neural connections between subcortical anxiety and vestibular systems [21][22][23][24][25][26]. Information about head motion is conveyed from vestibular labyrinths to vestibular nuclei, and then to pathways that control oculomotor and spinal reflexes, modulated by loops through the cerebellum.…”

The vestibular system

“…Future neuroimaging studies should precisely identify brain structures where vestibular stimulation modulates emotion processing. Potential candidates are the parabrachial nuclei, amygdala, insula, hippocampus, anterior cingulate cortex, and prefrontal cortex [118].…”