Asymmetrical perception of body rotation after unilateral injury to human vestibular cortex

Vestibular information plays a key role in many perceptual and cognitive functions, but surprisingly little is known about how vestibular signals are processed at the cortical level in humans. To address this issue, we tested the ability of two patients, with damage to key components of the vestibular network in either the left or right hemisphere, to perceive passive whole-body rotations (25-125 degrees) about the yaw axis. In both patients, the posterior insula, hippocampus, putamen, and thalamus were extensively damaged. The patients' responses were compared with those of nine age- and sex-matched neurologically intact participants. The body rotations were conducted without vision and the peak angular velocities ranged from 40 degrees to 90 degrees per second. Perceived rotation was assessed by open-loop manual pointing. The right hemisphere patient exhibited poor sensitivity for body rotations toward the contralesional (left) hemispace and generally underestimated the rotations. By contrast, his judgments of rotations toward the ipsilesional (right) hemispace greatly overestimated the physical rotation by 50-70 degrees for all tested magnitudes. The left hemisphere patient's responses were more appropriately scaled for both rotation directions, falling in the low-normal range. These findings suggest that there is some degree of hemispheric specialization in the cortical processing of dynamic head rotations in the yaw plane. In this view, right hemisphere structures play a dominant role, processing rotations in both directions, while left hemisphere structures process rotations only toward the contralesional hemispace.