Introduction So far, studies in animals as well as humans gave evidence that damage to the peripheral vestibular system leads deficits in spatial memory and navigation by neuronal changes in the hippocampus (atrophy) and a general reorganization of the vestibular cortex network (Brandt et al., 2005; Eulenburg et al., 2010). Pathology of the peripheral-vestibular endorgan causes a range of cognitive deficits, not only spatial, but also non-spatial, like object recognition memory (Zheng et al., 2009; Andersson et al., 2003). Patients with a chronic bilateral vestibular failure (BVF) complain to troubled in their abilities to sustain attention. Until now, only few studies have used complex cognitive tasks to examine this empirically. Aim of this study was to test patients with chronic unilateral vestibular failure (UVF) and BVF systematically in a series of attentionale tests and analyze which domains are especially affected. Methods All patients underwent a neurological examination and detailed vestibular testing and were diagnosed on-site. Eight patients with UVF (4 female, mean age 59years, 2 lesions left-sided) and 16 BVF (8 female, mean age 59) executed the TAP Alertness and Visual Scanning, the TVA whole and partial report, the Stroop Test (ST) and the Digit Span Test (DST).The Wechsler Memory Test (MWT) and the Mini Mental Status Test (MMST) were used additionally to exclude negative influences on performance due to other cognitive impairments. Standard values exist for all tests (except TVA) and the deviation from the population average was calculated accordingly, using a One-sample T -Test. A T -value or PR-value below 43 was considered pathological (Zimmermann and Fimm, 2009). Results MMST and MWT were within a normal range in all patients. The ST and the DST showed no anomaly, however the variance was high. There was a mild effect in the TAP Alertness and in the TAP Visual Scanning performance in BVF patients. Their reaction times were slightly decelerated. In the TVA test attentionale selectivity was strongly affected in UVF patients, their attention was shifted to one side, which did not correlate with the lesion side. In both patient groups, the information processing speed and the short term memory capacity were reduced. Conclusion We found a set of cognitive tasks affected by the peripheral deficits, i.e. short term memory, processing speed of information, and especially in UVF attentionale selectivity. These cognitive deficits might be explained by pathways from the vestibular nuclei to the limbic system, the neocortex and other areas that are likely linked to non-spatial memory, such as the perirhinal cortex (Liu et al., 2004). Accordingly, the vestibular afferents appear to be necessary for many cognitive operations. This rearrangement after damage probably, includes some cognitive compromises. Forward-looking, more complex behavioral tests have to be developed and combined with functional to increase the understanding of how the vestibular system is involved in cognitive tasks and how vestibular damage can impair cognitive function. Acknowledgements Supported by the Graduate School of Neuroscience, the GRK, the German Federal Ministry of Education and Research (BMBF: IFB), and the German Foundation for Neurology (DSN).