What part of the brain controls equilibrium and balance, specifically the vestibular (vestibular) system?

From the Guidelines

The cerebellum, in conjunction with the vestibular system, is the primary part of the brain that controls balance. The vestibular system, which is defined as the sensory system within the inner ear that provides fundamental input to the brain regarding balance and spatial orientation 1, works closely with the cerebellum to maintain equilibrium. Located at the back of the brain beneath the cerebrum, the cerebellum coordinates movements and maintains equilibrium by processing sensory information from the inner ear, eyes, muscles, and joints.

Some key points to consider when evaluating balance and the brain include:

• The vestibular system in the inner ear contains fluid-filled canals that detect head movements and position relative to gravity 1.
• When you move your head, this fluid shifts, stimulating hair cells that send signals to the cerebellum.
• The cerebellum then processes this information and sends commands to muscles throughout your body to make the necessary adjustments to maintain balance.
• Other brain regions that contribute to balance include the brainstem, which contains nuclei that relay information between the cerebellum and spinal cord, and parts of the cerebral cortex that help with spatial awareness.
• Damage to the cerebellum or vestibular system can result in balance problems, dizziness, and coordination difficulties, as seen in conditions such as benign paroxysmal positional vertigo (BPPV) 1.

It's worth noting that BPPV is a disorder of the inner ear characterized by repeated episodes of positional vertigo, and it is most commonly diagnosed with the Dix-Hallpike test for posterior canal BPPV or the supine roll test for lateral canal BPPV 1. Treatment of BPPV, such as canalith repositioning procedures (CRPs), can result in improvement in quality of life 1.

From the Research

Brain Structures Involved in Balance

• The vestibular system, which includes the utricle, saccule, and semicircular canals in the inner ear, plays a crucial role in maintaining balance and equilibrium 2.
• The vestibular system sends sensory information to the brainstem and cerebellum, which process this information to coordinate vital reflexes, such as the vestibuloocular reflex and vestibulospinal reflex 2.
• The brainstem, cerebellum, and cerebral cortex work together to integrate sensory information from the vestibular system, visual system, and proprioceptive system to maintain proper balance and orientation 2.

Key Areas of the Brain

• The cerebellum is involved in the coordination of movements and maintenance of balance 2.
• The brainstem, which connects the cerebellum to the spinal cord, plays a critical role in processing sensory information from the vestibular system 2.
• The cerebral cortex, particularly the areas responsible for processing sensory information, is also involved in maintaining balance and equilibrium 2.

Vestibular System Function

• The vestibular system is responsible for detecting changes in head position and movement, and sending this information to the brain to maintain balance 2.
• The vestibular system works in conjunction with the visual and proprioceptive systems to maintain proper balance and orientation 2.
• Damage to the vestibular system can result in vertigo, dizziness, and balance disorders 3, 4, 5, 6.