Evidence for cognitive impairment in patients with vestibular disorders

Objective: Extensive animal research has shown that vestibular damage can be associated with cognitive deficits. More recently, new evidence has emerged linking vestibular disorders to cognitive impairment in humans. Herein, we review contemporary research on the pathophysiology of cognitive-vestibular interactions and discuss its emerging clinical relevance.

Data sources: PubMed, Embase, and Cochrane databases.

Review methods: A systematic literature search was performed with combinations of search terms: "cognition," "cognitive impairment," "chronic fatigue," "brain fog," "spatial navigation," "attention," "memory," "executive function," "processing speed," and "vestibular hypofunction." Relevant articles were considered for inclusion, including basic and clinical studies, case series, and major reviews.

Conclusions: Patients with vestibular disorders can demonstrate long-term deficits in both spatial and nonspatial cognitive domains. The underlying mechanism(s) linking the vestibular system to cognitive function is not well characterized, but several neuro-biologic correlates have been identified. Additional screening tools are required to identify individuals at risk for cognitive impairment, and further research is needed to determine whether treatment of vestibular dysfunction has the capacity to improve cognitive function.

Implications for practice: Physicians should be aware of emerging data supporting the presence of cognitive deficits in patients with vestibular disorders. Prevention and treatment of long-term cognitive deficits may be possible through screening and rehabilitation.