Personality changes in patients with vestibular dysfunction.

The vestibular system, which detects head motion and gravitational orientation, not only controls eye movements and posture but also influences cognition, emotion, and the sense of self. Vestibular dysfunction can cause depersonalization and derealization—feelings of being "spaced out" or not in control of one's body—suggesting that vestibular signals contribute to self-awareness. This review proposes that the vestibular system supports the concept of self by providing information about self-motion and self-location to brain regions like the temporo-parietal junction.

Study at a glance

Abstract

The vestibular system is a sensory system that has evolved to detect linear and angular acceleration of the head in all planes so that the brain is not predominantly reliant on visual information to determine self-motion. Since the vestibular system first evolved in invertebrate species in order to detect gravitational vertical, it is likely that the central nervous system has developed a special dependence upon vestibular input. In addition to the deficits in eye movement and postural reflexes that occur following vestibular dysfunction, there is convincing evidence that vestibular loss also causes cognitive and emotional disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and neocortex play in the sense of spatial orientation. Beyond this, however, patients with vestibular disorders have been reported to experience other personality changes that suggest that vestibular sensation is implicated in the sense of self. These are depersonalization and derealization symptoms such as feeling "spaced out", "body feeling strange" and "not feeling in control of self". We propose in this review that these symptoms suggest that the vestibular system may make a unique contribution to the concept of self through information regarding self-motion and self-location that it transmits, albeit indirectly, to areas of the brain such as the temporo-parietal junction (TPJ).