Reaching with the sixth sense: Vestibular contributions to voluntary motor control in the human right parietal cortex

The vestibular system constitutes the silent sixth sense: It automatically triggers a variety of vital reflexes to maintain postural and visual stability. Beyond their role in reflexive behavior, vestibular afferents contribute to several perceptual and cognitive functions and also support voluntary control of movements by complementing the other senses to accomplish the movement goal. Investigations into the neural correlates of vestibular contribution to voluntary action in humans are challenging and have progressed far less than research on corresponding visual and proprioceptive involvement. Here, we demonstrate for the first time with event-related TMS that the posterior part of the right medial intraparietal sulcus processes vestibular signals during a goal-directed reaching task with the dominant right hand. This finding suggests a qualitative difference between the processing of vestibular vs. visual and proprioceptive signals for controlling voluntary movements, which are pre-dominantly processed in the left posterior parietal cortex. Furthermore, this study reveals a neural pathway for vestibular input that might be distinct from the processing for reflexive or cognitive functions, and opens a window into their investigation in humans.