Recent advances in the pharmacology of the vestibulo-ocular reflex system

Recent advances in the pharmacology of the vestibulo-ocular reflex have had a major impact on our understanding of the vestibular system, the sensory system primarily concerned with the stabilization of gaze and posture during head movement. Increasing evidence suggests that afferent transmission from the receptor hair cells in the vestibular labyrinth to the vestibular nerve probably involves glutamate acting on a number of excitatory amino acid receptor subtypes. Furthermore, hair-cell sensitivity appears to be regulated by cholinergic, GABA-mediated and, possibly, peptide-mediated efferent feedback from the CNS. Likewise, it seems clear that an excitatory amino acid, probably glutamate, is the major transmitter used by the vestibular nerve in its synapses with neurones of the brainstem vestibular nucleus. In this review, Paul Smith and Cynthia Darlington discuss the large number of receptor subtypes that have been identified in the vestibular nucleus, including receptors for several peptides that may have a role in co-transmission.