The cortical vestibular system: insights from EEG
File(s)
Published version
Author(s)
Bronstein, Adolfo
Mirdamadi, JL
Ellmers, Toby
Type
Journal Article
Abstract
Purpose of review
Although electroencephalography (EEG) is central to epilepsy diagnosis, its role in patients presenting with dizziness or balance disorders has historically been negligible. This review provides a timely synthesis of recent methodological and conceptual advances demonstrating how modern EEG analyses can probe cortical contributions to vestibular and balance function.
Recent findings
While vestibular epilepsy remains rare, EEG is increasingly being applied to investigate cortical dynamics during vestibular stimulation, postural control, and balance perturbations. Contemporary analytic techniques have revealed that alpha- and beta-band EEG activity reflect key aspects of vestibular perception, adaptation, and postural control. Findings in patients with higher-order vestibular dysfunction link symptoms to abnormal oscillatory patterns corresponding to disrupted sensory integration and maladaptive attentional engagement. Advances in mobile EEG approaches now permit reliable signal acquisition during movement and direct vestibular stimulation, allowing quantification of ecologically relevant cortical responses such as the perturbation-evoked potential.
Summary
EEG provides a powerful, accessible, and scalable tool to characterise cortical contributions to vestibular processing and balance. These developments highlight its emerging value for identifying neurophysiological biomarkers of vestibular dysfunction, improving diagnostic precision, and informing targeted rehabilitation strategies.
Although electroencephalography (EEG) is central to epilepsy diagnosis, its role in patients presenting with dizziness or balance disorders has historically been negligible. This review provides a timely synthesis of recent methodological and conceptual advances demonstrating how modern EEG analyses can probe cortical contributions to vestibular and balance function.
Recent findings
While vestibular epilepsy remains rare, EEG is increasingly being applied to investigate cortical dynamics during vestibular stimulation, postural control, and balance perturbations. Contemporary analytic techniques have revealed that alpha- and beta-band EEG activity reflect key aspects of vestibular perception, adaptation, and postural control. Findings in patients with higher-order vestibular dysfunction link symptoms to abnormal oscillatory patterns corresponding to disrupted sensory integration and maladaptive attentional engagement. Advances in mobile EEG approaches now permit reliable signal acquisition during movement and direct vestibular stimulation, allowing quantification of ecologically relevant cortical responses such as the perturbation-evoked potential.
Summary
EEG provides a powerful, accessible, and scalable tool to characterise cortical contributions to vestibular processing and balance. These developments highlight its emerging value for identifying neurophysiological biomarkers of vestibular dysfunction, improving diagnostic precision, and informing targeted rehabilitation strategies.
Date Issued
2026-02-01
Date Acceptance
2025-11-13
Citation
Current Opinion in Neurology, 2026, 39 (1), pp.92-98
ISSN
1350-7540
Publisher
Lippincott, Williams & Wilkins
Start Page
92
End Page
98
Journal / Book Title
Current Opinion in Neurology
Volume
39
Issue
1
Copyright Statement
© 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distri- bution, and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
10.1097/WCO.0000000000001448
Subjects
balance
cortical processing
electroencephalography
self-motion
vestibular perception
Publication Status
Published