Vestibular Cognition in Audiology and Otology: Hearing, Balance, and Brain Function

The inner ear has long been viewed through two separate lenses: the cochlea as the organ of hearing, and the vestibular labyrinth as the organ of balance. Biologically and clinically, however, the two function as one integrated unit. They share the same sensory organ, project to overlapping cortical and subcortical networks, and together shape higher-order brain functions including spatial navigation, attention, memory, executive function, and emotional processing.On the vestibular side, the labyrinth was first misunderstood as an organ of hearing before it was shown to mediate a hidden “sixth” sense: the sense of head motion. Beyond the reflexes that stabilize gaze and posture, thalamocortical projections from the vestibular nuclei feed a distributed network involved in cognition and affect. Patients with disorders such as unilateral and bilateral vestibulopathy, Meniere’s disease, vestibular migraine, and persistent postural-perceptual dizziness (PPPD) report not only dizziness but also impaired concentration, spatial disorientation, mental fatigue, and mood disturbance.In parallel, hearing loss has been linked to reduced cognitive reserve, accelerated cognitive decline, and increased dementia risk, affecting attentional resources, working memory, and social cognition. The two systems also interact directly: audiovestibular signals are integrated during cognitive processing, and combined dysfunction may carry a cumulative cognitive burden greater than either alone. A possible link between presbyvestibulopathy, age-related hearing loss, and cognitive impairment suggests inner ear function may explain some of the otherwise unexplained variation in clinical outcomes. Yet auditory and vestibular contributions to cognition have largely been studied in isolation, and the mechanisms remain incompletely understood.GoalThis Research Topic brings together basic science and clinical research on how the inner ear, across both its auditory and vestibular functions, shapes cognition and brain health. By uniting audiology, otology, neurotology, cognitive neuroscience, neuropsychology, and rehabilitation medicine, we aim to: Advance understanding of the neural mechanisms linking auditory and vestibular signals to cognition. Explore how dysfunction in either or both inner ear systems contributes to cognitive impairment across the lifespan. Characterize audiovestibular interactions and the cumulative cognitive impact of combined dysfunction. Promote cross-disciplinary dialogue between the hearing and vestibular research communities around shared cognitive outcomes. Support assessment tools and rehabilitation strategies that account for the full cognitive burden of inner ear disorders.Ultimately, this collection seeks to establish a more unified framework for how hearing and balance interact with brain function, opening new avenues for research, diagnosis, and care.ScopeWe welcome contributions that explore, but are not limited to, the following themes:o Neural mechanisms of vestibular cognition, including cortical networks, hippocampal function, and multisensory integrationo Cognitive and affective profiles of patients with peripheral and central vestibular disorderso Spatial navigation, body representation, and mental rotation in vestibular populationso The relationship between hearing loss and cognitive decline, dementia risk, and cognitive reserveo Auditory processing, working memory, and attentional load in individuals with hearing losso Audiovestibular interactions in cognitive processing and their neural substrateso Cognitive outcomes of hearing rehabilitation, including hearing aids and cochlear implantso Cognitive outcomes of vestibular rehabilitation, including conventional, virtual reality based, and gamified protocolso Combined auditory and vestibular dysfunction and its cumulative cognitive impacto Presbyvestibulopathy, age-related hearing loss, and links to cognitive aging and fall risko Neuroimaging, electrophysiological, and biomarker approaches to inner ear cognitiono Development and validation of cognitive assessment tools for auditory and vestibular populationso Pediatric perspectives on auditory and vestibular contributions to cognitive developmento Patient-reported outcomes and qualitative research on the cognitive and emotional burden of inner ear disorders Topic editors: Qadeer Arshad, Richard Ibitoye Source: https://www.frontiersin.org/research-topics/82200/vestibular-cognition-in-audiology-and-otology-hearing-balance-and-brain-function