Cognitive-vestibular interactions: a review of patient difficulties and possible mechanisms

Cognitive deficits such as poor concentration and short-term memory loss are known by clinicians to occur frequently among patients with vestibular abnormalities. Although direct scientific study of such deficits has been limited, several types of investigations do lend weight to the existence of vestibular-cognitive effects. In this article we review a wide range of studies indicating a vestibular influence on the ability to perform certain cognitive functions. In addition to tests of vestibular patient abilities, these studies include dual-task studies of cognitive and balance functions, studies of vestibular contribution to spatial perception and memory, and works demonstrating a vestibular influence on oculomotor and motor coordination abilities that are involved in the performance of everyday cognitive tasks. A growing literature on the physiology of the vestibular system has demonstrated the existence of projections from the vestibular nuclei to the cerebral cortex. The goals of this review are to both raise awareness of the cognitive effects of vestibular disease and to focus scientific attention on aspects of cognitive-vestibular interactions indicated by a wide range of results in the literature.