The Elusive Primary Vestibular Cortex – What Do We Really Know?
09-12, 16:30–17:00 (Europe/Istanbul), Equlibirium 1

This session’s header image
<p>Description: This keynote revisits the question of a primary vestibular cortex in humans. Through a PET paradigm based on natural vestibular stimulation, consistent activation in medial Heschl’s gyrus has been demonstrated, challenging the longstanding belief that vestibular input is only processed in multimodal association areas. Limitations of fMRI in vestibular research will also be addressed, including magnetic field-induced vestibular stimulation and gradient noise, which may confound signal interpretation. Finally, a double dissociation study using the same PET methodology is presented, comparing cortical activation in individuals with bilateral vestibular loss and normal hearing versus those with profound hearing loss and preserved vestibular function. This classical neuroimaging approach strengthens the case for functional separation of auditory and vestibular processing.</p> <p>Outcome Objectives:</p> <p>After this session, participants will be able to:</p> <p>1. Summarize PET-based evidence for vestibular-related activity in medial Heschl’s gyrus<br>2. Reflect on the overlap and distinction between auditory and vestibular cortical networks<br>3. Recognize the impact of scanner-related vestibular stimulation on fMRI interpretations<br>4. Understand the rationale behind double dissociation paradigms in sensory neuroscience<br>5. Consider methodological and conceptual implications for future vestibular research</p> <p>Structure of the Session (30 min):</p> <p>5 min: Introduction – the vestibular paradox and historical context</p> <p>10 min: PET findings – natural stimulation and cortical response</p> <p>10 min: fMRI limitations – field effects and interpretative constraints</p> <p>5 min: Perspectives – dissociation data and future directions</p> <p>Key References:</p> <p>1. Devantier L, Hansen AK, Mølby-Henriksen JJ, Christensen CB, Pedersen M, Magnusson M, Ovesen T, Borghammer P. PET visualized stimulation of the vestibular organ is localized in Heschl’s gyrus. Hum Brain Mapp. 2020;41(1):185–193.<br>2. Devantier L, Hansen AK, Mølby-Henriksen JJ, Christensen CB, Lildal T, Pedersen M, Magnusson M, Borghammer P, Ovesen T. PET visualized stimulation of the vestibular organ in Menière’s disease. Front Neurol. 2020 Jan 28;12:00019.<br>3. Devantier L, Hansen AK, Mølby-Henriksen JJ, Pedersen M, Borghammer P, Ovesen T, Magnusson M. Cortical activity during an attack of Menière’s disease. Front Neurol. 2021 Jul 22;12:669390.<br>4. Horsager J, Knudsen K, Sommerauer M, et al. Mapping cholinergic synaptic loss in Parkinson’s disease: an 18F-FEOBV PET case–control study. Brain. 2022;145(5):1690–1704.<br>5. Devantier L et al. Dissociating auditory and vestibular cortical responses: a PET study using a double dissociation design.(unpublished, 2025)<br>6. Devantier L et al. Magnetic field-induced vestibular stimulation in fMRI: methodological implications for vestibular neuroimaging.(unpublished, 2025)</p> <p>Background: The vestibular system has traditionally been considered unique among the senses for lacking a defined primary cortical area. Using PET imaging during natural vestibular stimulation, metabolic activity has been observed in medial Heschl’s gyrus. To disentangle auditory and vestibular contributions, a double dissociation design was applied: one group with bilateral vestibular loss and intact hearing, and another with profound hearing loss but preserved vestibular function. This allows for sensory-specific mapping of cortical activation. Additionally, methodological data from fMRI highlight how scanner-related vestibular stimulation may influence results. Reduced cholinergic activity in Heschl’s gyrus, as reported in Parkinson’s disease, may further support the clinical relevance of this area in balance processing.</p>
<p>To present novel neuroimaging findings that challenge established models of vestibular cortical organization and encourage a reevaluation of current assumptions in cortical vestibular research.</p>
Session Chair Session Chair
Burak Ömür Çakır
Speaker Speaker
Louise Devantier
Louise Devantier
<p>Dr. Louise Devantier is a board-certified ENT specialist and Associate Professor in Otolaryngology. She leads the Vestibular Clinic at the Department of Otolaryngology, Aarhus University Hospital, where she combines clinical work with research in balance disorders.</p> <p>Her research focuses on vestibular function, hearing loss, inner ear diseases, cochlear implantation, and balance in Parkinson’s disease. Ongoing projects include a methodological fMRI study on magnetic field-induced vestibular stimulation, a PET study using a double dissociation design to explore auditory and vestibular activation patterns, and collaborative work investigating vestibular function in patients with Parkinson’s disease.</p> <p>Dr. Devantier is Postgraduate Clinical Lecturer at Aalborg University and serves as Chair of the Danish Society for Vestibulology. She collaborates with national and international research groups in neuro-otology and audiology.</p>
This speaker also appears in:
Burak Ömür Çakır
<p></p>
This speaker also appears in: