Distorted own-body representations in patients with dizziness and during caloric vestibular stimulation

There is increasing evidence that vestibular disorders evoke deficits reaching far beyond imbalance, oscillopsia and spatial cognition. Yet, how vestibular disorders affect own-body representations, in particular the perceived body shape and size, has been overlooked. Here, we explored vestibular contributions to own-body representations using two approaches. Study 1 measured the occurrence and severity of distorted own-body representations in 60 patients with dizziness and 60 healthy controls using six items from the Cambridge Depersonalization Scale. 12% of the patients have experienced distorted own-body representations (their hands or feet felt larger or smaller), 37% reported abnormal sense of agency, 35% reported disownership for the body, and 22% reported disembodiment. These proportions were larger in patients than controls. Study 2 aimed at testing whether artificial stimulation of the vestibular apparatus produced comparable distortions of own-body representations in healthy volunteers. We compared the effects of right-warm/left-cold caloric vestibular stimulation (CVS), left-warm/right-cold CVS and sham CVS on internal models of the left and right hands using a pointing task. The perceived length of the dorsum of the hand was increased specifically during left-warm/right-cold CVS, and this effect was found for both hands. Our studies show a vestibular contribution to own-body representations and should help understand the complex symptomatology of patients with dizziness.