A neuroscientific account of how vestibular disorders impair bodily self-consciousness.

Vestibular disorders are known to affect balance, eye movements, and the perception of self-motion, and more recent work links them to cognitive problems in spatial navigation and memory. Less commonly, these disorders can produce abnormal bodily perceptions such as distorted body image and body schema, out-of-body experiences, altered sense of agency, and feelings of depersonalization. The author proposes that vestibular disorders cause sensory conflict in multisensory brain regions, leading to perceptual incoherence and disrupted body and self perceptions. This hypothesis draws on functional mapping of the human vestibular cortex, which shows vestibular projections to somatosensory areas and multisensory regions essential for bodily self-consciousness.

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Abstract

The consequences of vestibular disorders on balance, oculomotor control, and self-motion perception have been extensively described in humans and animals. More recently, vestibular disorders have been related to cognitive deficits in spatial navigation and memory tasks. Less frequently, abnormal bodily perceptions have been described in patients with vestibular disorders. Altered forms of bodily self-consciousness include distorted body image and body schema, disembodied self-location (out-of-body experience), altered sense of agency, as well as more complex experiences of dissociation and detachment from the self (depersonalization). In this article, I suggest that vestibular disorders create sensory conflict or mismatch in multisensory brain regions, producing perceptual incoherence and abnormal body and self perceptions. This hypothesis is based on recent functional mapping of the human vestibular cortex, showing vestibular projections to the primary and secondary somatosensory cortex and in several multisensory areas found to be crucial for bodily self-consciousness.