Vestibular-autonomic interactions: Beyond orthostatic dizziness

Jamie M. Bogle, Eduardo Benarroch, Paola Sandroni

Research output: Contribution to journalReview articlepeer-review


Purpose of review This review aims to summarize the current literature describing vestibular-autonomic interactions and to describe their putative role in various disorders' clinical presentations, including orthostatic dizziness and motion sensitivity. Recent findings The vestibular-autonomic reflexes have long been described as they relate to cardiovascular and respiratory function. Although orthostatic dizziness may be in part related to impaired vestibulo-sympathetic reflex (orthostatic hypotension), there are various conditions that may present similarly. A recent clinical classification aims to improve identification of individuals with hemodynamic orthostatic dizziness so that appropriate recommendations and management can be efficiently addressed. Researchers continue to improve understanding of the underlying vestibular-autonomic reflexes with recent studies noting the insular cortex as a cortical site for vestibular sensation and autonomic integration and modulation. Work has further expanded our understanding of the clinical presentation of abnormal vestibular-autonomic interactions that may occur in various conditions, such as aging, peripheral vestibular hypofunction, traumatic brain injury, and motion sensitivity. Summary The vestibular-autonomic reflexes affect various sympathetic and parasympathetic functions. Understanding these relationships will provide improved identification of underlying etiology and drive improved patient management.

Original languageEnglish (US)
Pages (from-to)126-134
Number of pages9
JournalCurrent opinion in neurology
Issue number1
StatePublished - Feb 1 2022


  • Autonomic nervous system
  • Motion sickness
  • Orthostatic hypotension
  • Vestibular system

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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