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Fortunately, the vestibular system\u2019s well-defined peripheral structure and well-understood encoding strategies offer unique opportunities for developing sensory prostheses to restore vestibular function. While these devices show promising results in both animal models and implanted patients, substantial room for improvement remains. Research from an engineering perspective has largely focused on optimizing stimulation protocol to improve outcomes. However, this approach has often been pursued in isolation from research in neuroscience that has enriched our understanding of neural responses at the synaptic, cellular, and circuit levels. Accordingly, this review bridges the domains of neuroscience and engineering to consider recent progress and challenges in vestibular prosthesis development. We advocate for interdisciplinary approaches that leverage studies of neural circuits at the population level, especially in light of recent advancement in large-scale recording technology, to identify impediments still to overcome and to develop more naturalistic stimulation strategies. Fully integrating neuroscience and engineering in the context of prosthesis development will help advance the field forward and ultimately improve patient outcomes.<\/jats:p>","DOI":"10.7554\/elife.99516","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T04:15:07Z","timestamp":1733372107000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.99516","source":"Crossref","is-referenced-by-count":8,"title":["Restoring vestibular function during natural self-motion: Progress and challenges"],"prefix":"10.7554","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-9718","authenticated-orcid":true,"given":"Kantapon Pum","family":"Wiboonsaksakul","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biomedical Engineering, Johns Hopkins University School of Medicine","place":["Baltimore, United States"]},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Kavli Neuroscience Discovery Institute, Johns Hopkins University","place":["Baltimore, United States"]}],"role":[{"role":"author","vocabulary":"crossref"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-1249","authenticated-orcid":true,"given":"Olivia ME","family":"Leavitt Brown","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biomedical Engineering, Johns Hopkins University School of Medicine","place":["Baltimore, United States"]}],"role":[{"role":"author","vocabulary":"crossref"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9348-0933","authenticated-orcid":true,"given":"Kathleen E","family":"Cullen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biomedical Engineering, Johns Hopkins University School of Medicine","place":["Baltimore, United States"]},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Kavli Neuroscience Discovery Institute, Johns Hopkins University","place":["Baltimore, United States"]},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine","place":["Baltimore, United States"]},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Neuroscience, Johns Hopkins University School of Medicine","place":["Baltimore, United States"]}],"role":[{"role":"author","vocabulary":"crossref"},{"role":"corresponding-author","vocabulary":"crossref"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"4374","published-online":{"date-parts":[[2024,12,17]]},"reference":[{"key":"bib1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1146\/annurev.neuro.31.060407.125555","type":"journal-article","article-title":"Vestibular system: the many facets of a multimodal sense","volume":"31","author":"Angelaki","year":"2008","journal-title":"Annual Review of Neuroscience"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2019.00379","type":"journal-article","article-title":"Implantable direct current neural modulation: theory, feasibility, and efficacy","volume":"13","author":"Aplin","year":"2019","journal-title":"Frontiers in Neuroscience"},{"key":"bib3","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1109\/TBME.2018.2856698","type":"journal-article","article-title":"Ionic Direct current modulation for combined inhibition\/excitation of the vestibular system","volume":"66","author":"Aplin","year":"2019","journal-title":"IEEE Transactions on Bio-Medical Engineering"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.3233\/VES-220211","type":"conference-paper","article-title":"Modulating vestibular implant stimulation using angular head velocity and acceleration","author":"Ayiotis","year":"2022","unstructured":"Ayiotis AI, Chow MR, Fernandez Brillet C, Lane KE, Schoo DP, Carey JP, Della Santina CC. 2022. 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