Imaging cortical activity after vestibular lesions

In this article we will discuss our current knowledge of multisensory vestibular structures and their functions in the human cortex. Most of it derives from brain activation studies with PET and fMRI in humans conducted over the last decade. They have confirmed the existence of several separate and distinct cortical areas that were identified earlier by tracer and electrophysiological studies in animals, especially in monkeys. The patterns of activations and deactivations during vestibular stimulations in healthy subjects have been compared with those in patients with acute and chronic peripheral and central vestibular disorders. The following reviews what is presently known about the interconnections of vestibular structures, their activations and interactions with other sensory modalities, the correlations of perceptual and motor functions in normal humans, and the changes that result from strategic unilateral peripheral and central vestibular lesions such as vestibular neuritis and bilateral vestibular failure, on the one hand, and central vestibular nucleus lesions due to ischemic infarctions of the lateral medulla (Wallenberg's syndrome), on the other.