Top-down approach to vestibular compensation: Translational lessons from vestibular rehabilitation

Carey D. Balaban, Michael E. Hoffer, Kim R. Gottshall

Research output: Contribution to journalReview articlepeer-review

37 Scopus citations


This review examines vestibular compensation and vestibular rehabilitation from a unified translational research perspective. Laboratory studies illustrate neurobiological principles of vestibular compensation at the molecular, cellular and systems levels in animal models that inform vestibular rehabilitation practice. However, basic research has been hampered by an emphasis on 'naturalistic' recovery, with time after insult and drug interventions as primary dependent variables. The vestibular rehabilitation literature, on the other hand, provides information on how the degree of compensation can be shaped by specific activity regimens. The milestones of the early spontaneous static compensation mark the re-establishment of static gaze stability, which provides a common coordinate frame for the brain to interpret residual vestibular information in the context of visual, somatosensory and visceral signals that convey gravitoinertial information. Stabilization of the head orientation and the eye orientation (suppression of spontaneous nystagmus) appear to be necessary by not sufficient conditions for successful rehabilitation, and define a baseline for initiating retraining. The lessons from vestibular rehabilitation in animal models offer the possibility of shaping the recovery trajectory to identify molecular and genetic factors that can improve vestibular compensation.

Original languageEnglish (US)
Pages (from-to)101-111
Number of pages11
JournalBrain research
StatePublished - Oct 30 2012
Externally publishedYes


  • Gaze control
  • Head control
  • Locomotion
  • Vestibular compensation
  • Vestibular rehabilitation therapy

ASJC Scopus subject areas

  • Neuroscience(all)
  • Molecular Biology
  • Clinical Neurology
  • Developmental Biology


Dive into the research topics of 'Top-down approach to vestibular compensation: Translational lessons from vestibular rehabilitation'. Together they form a unique fingerprint.

Cite this