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An exciting body of information has developed over the last 15 years that substantially improve our understanding of the basic mechanisms that underlie vestibular function and disease. Many of these studies, however, have not yet been widely disseminated to the vestibular and oculomotor scientific and ...

An exciting body of information has developed over the last 15 years that substantially improve our understanding of the basic mechanisms that underlie vestibular function and disease. Many of these studies, however, have not yet been widely disseminated to the vestibular and oculomotor scientific and clinical communities. This Research Topic proposes to report, in a concise and accessible manner, many of these new scientific and clinical advances in the vestibular field.

This Research Topic is organized into the following sections: Vestibular anatomy and physiology, Vestibular pathophysiology, Treatment of vestibular disorders, Vestibulo-autonomic function and dysfunction, and Motion sickness: a vestibulo-autonomic disorder. This Research Topic begins with an overview of the latest developments in the understanding of normal vestibular function, followed by new evidence for mechanisms of central and peripheral disorders and then new approaches to treatment of vestibular disorders. The treatment section highlights new forms of therapy for the Mal de Debarquement Syndrome (MdDS), a disorder that has remained poorly understood and resistant to treatment modalities in the past. The final section focuses on the enormous advances in the understanding of vestibular-autonomic interactions and includes a description of a potential new treatment modality for vasovagal syncope, described in a rat model. Motion sickness, a ubiquitous problem that remains poorly understood, is also dissected in terms of its mechanistic underpinnings and relation to the vestibule-autonomic system.

Other papers that represent significant new advances include the organization of the vestibular nuclei; the development and organization of velocity storage considered from an evolutionary point of view and also with regard to its contribution to clinical disorders such as MdDS; and diagnostic procedures to determine individual canal dysfunction. Vestibulo-autonomic function is highlighted in a number of papers from both the scientific and clinical perspectives. Macefield and colleagues have emphasized that there are two inputs to the sympathetic nervous system, a glutamatergic input that activates the cardiovascular system to produce changes in muscle sympathetic nerve activity (MSNA) and BP, but generally not HR – the process that appears to underlie orthostasis and vasovagal responses. A new model of the interaction of the Vestibulo-Sympathetic Response (VSR) provides new insights into the interaction of the VSR and the baroreflex. Additionally, causes of nausea are elegantly described and their anatomic basis is discussed in terms of vestibular inputs and for a genetic condition in which there is a loss of afferent input.

Overall, we are confident that this Research Topic in vestibular science and disease will provide important insights to both the scientists and clinicians who deal with these fascinating areas of sensori-motor physiology and pathophysiology.

Keywords: vestibular, eye movements, perception, autonomic, motion sickness


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