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Objective   We investigated the changes of the vestibulospinal tract (VST) and parietoinsular vestibular cortex (PIVC) using diffusion tensor imaging (DTI) and relation to balance between old and young healthy adults.Methods   This study recruited eleven old adults (6 males, 5 females; mean age 63.36 ± 4.25 years) and 12 young adults (7 males, 5 females; mean age 28.42 ± 4.40 years). The lateral and medial VST and PIVC were reconstructed using DTI. Fractional anisotropy (FA), mean diffusivity (MD), and tract volume were measured. The six-minute walk test (6-MWT), the timed up and go test (TUG), and the Berg balance scale (BBS) were conducted. Spatiotemporal parameters during tandem gait and values of sway during one-leg standing using the wearable sensors were measured. All parameters between two groups were analyzed by the Mann-Whitney  U  test and independent  t -test.Results   Statistically significant decrease in old adults was detected in the tract volume of lateral ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST ( p  = 0.005) and medial VST (    Conclusion   The results suggested that there was a relationship between DTI parameters in the vestibular neural pathway and balance according to aging.

Associations between Age-Related Changes in the Core Vestibular Projection Pathway and Balance Ability: A Diffusion Tensor Imaging Study