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To fill this knowledge gap, this cross\u2010sectional study investigates the relationship between age\u2010related variation in vestibular function and surface shape alterations of the frontal and sensorimotor cortices, considering age, intracranial volume, and sex. Data from 117 older adults (aged 60+) from the Baltimore Longitudinal Study of Aging, who underwent end\u2010organ\u2010specific vestibular tests (cVEMP for the saccule, oVEMP for the utricle, and vHIT for the horizontal canal) and T1\u2010weighted MRI scans on the same visit, were analyzed. We examined a subset of 10 frontal and sensorimotor brain structures in the broader, distributed vestibular network: the middle\u2010superior part of the prefrontal cortex (SFG_PFC), frontal pole (SFG_pole), and posterior pars of the superior frontal gyrus (SFG), the dorsal prefrontal cortex and posterior pars of middle frontal gyrus (MFG_DPFC, MFG), the pars opercularis, pars triangularis, and pars orbitalis of the inferior frontal gyrus, as well as the precentral gyrus and postcentral gyrus (PoCG) of the sensorimotor cortex. For each region of interest (ROI), shape descriptors were estimated as local compressions and expansions of the population average ROI surface using Large Deformation Diffeomorphic Metric Mapping (LDDMM) surface registration. Shape descriptors were linearly regressed onto standardized vestibular variables, age, intracranial volume, sex, and in follow\u2010up analyses, multisensory function (hearing, vision, proprioception). We found that lower utricular function was linked with surface compression in the left MFG and expansion in the bilateral SFG_pole and left SFG. Reduced canal function was associated with surface compression in the right SFG_PFC and SFG_pole and left SFG. Both reduced saccular and utricular function correlated with surface compression in the posterior medial part of the left MFG. Our findings illuminate the complexity of the relationship between vestibular end\u2010organ function and the focal morphology in aging in areas of the frontal and sensorimotor cortices relevant to executive ability, motor planning, and self\u2010motion perception. An improved understanding of these pathways could help in developing interventions to enhance the quality of life in aging and populations with cognitive impairment.<\/jats:p>","DOI":"10.1002\/hbm.70251","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T15:28:50Z","timestamp":1752074930000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Reduced Vestibular Function is Associated With Cortical Surface Shape Changes in the Frontal Cortex"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4972-0036","authenticated-orcid":false,"given":"Dominic","family":"Padova","sequence":"first","affiliation":[{"name":"Center for Imaging Science, Department of Biomedical Engineering Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Tilak","family":"Ratnanather","sequence":"additional","affiliation":[{"name":"Center for Imaging Science and Institute for Computational Medicine, Department of Biomedical Engineering Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1673-002X","authenticated-orcid":false,"given":"Andreia V.","family":"Faria","sequence":"additional","affiliation":[{"name":"Department of Radiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318295313c"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3182995227"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2018.12.016"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/aud.0000000000000619"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2010.12.049"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780195139822.001.0001","volume-title":"Clinical Neurophysiology of the Vestibular System","author":"Baloh R. 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