Motion sickness susceptibility

Differential Gene Expression Profile in the Rat Caudal Vestibular Nucleus is Associated with Individual Differences in Motion Sickness Susceptibility

OBJECTIVE

To identify differentially expressed genes associated with motion sickness (MS) susceptibility in the rat caudal vestibular nucleus.

METHODS

We identified MS susceptible (MSS) and insusceptible (inMSS) rats by quantifying rotation-induced MS symptoms: defecation and spontaneous locomotion activity. Microarray analysis was used to screen differentially expressed genes in the caudal vestibular nucleus (CVN) after rotation. Plasma stress hormones were identified by radioimmunoassay. Candidate genes were selected by bioinformatics analysis and the microarray results were verified by real-time quantitative-PCR (RT-qPCR) methods. By using Elvax implantation, receptor antagonists or recombinant adenovirus targeting the candidate genes were applied to the CVN to evaluate their contribution to MS susceptibility variability. Validity of gene expression manipulation was verified by RT-qPCR and western blot analysis.

RESULTS

A total of 304 transcripts were differentially expressed in the MSS group compared with the inMSS group. RT-qPCR analysis verified the expression pattern of candidate genes, including nicotinic cholinergic receptor (nAchR) α3 subunit, 5-hydroxytryptamine receptor 4 (5-HT4R), tachykinin neurokinin-1 (NK1R), γ-aminobutyric acid A receptor (GABAAR) α6 subunit, olfactory receptor 81 (Olr81) and homology 2 domain-containing transforming protein 1 (Shc1). In MSS animals, the nAchR antagonist mecamylamine significantly alleviated rotation-induced MS symptoms and the plasma β-endorphin response. The NK1R antagonist CP99994 and Olr81 knock-down were effective for the defecation response, while the 5-HT4R antagonist RS39604 and Shc1 over-expression showed no therapeutic effect. In inMSS animals, rotation-induced changes in spontaneous locomotion activity and the plasma β-endorphin level occurred in the presence of the GABAAR antagonist gabazine.

CONCLUSION

Our findings suggested that the variability of the CVN gene expression profile after motion stimulation might be a putative molecular basis for individual differences in MS susceptibility and provide information for the development of new therapeutic strategies for MSS individuals.

The impact of vehicle motion during transport on animal welfare

Motion sickness is a common response in humans and some species of farm livestock during transport, but research on the impact of motion has been primarily focused on the use of animal models for humans. During livestock transportation, animals seek to minimise uncontrolled movements to reduce energy consumption and maintain posture. Road and sea transport of livestock can produce motion sickness and stress responses. Clinical signs are the result of autonomous nervous system activation. Studies conducted on road transportation effects in domestic animals showed several motion sickness behaviours including vomiting and, in ruminants, a reduction in rumination. However, there is a lack of knowledge on the impact of sea transport motion. Despite the paucity of data on livestock, there is sufficient evidence to believe that motion might affect animal welfare when animals are transported by road or sea.

Quantitative orientation preference and susceptibility to space motion sickness simulated in a virtual reality environment

Orientation preference should appear when variable weightings of spatial orientation cues are used between individuals. It is possible that astronauts' orientation preferences could be a potential predictor for susceptibility to space motion sickness (SMS). The present study was conducted to confirm this relationship on Earth by quantifying orientation preferences and simulating SMS in a virtual reality environment. Two tests were carried out. The first was to quantitatively determine one's orientation preference. Thirty-two participants' vision and body cue preferences were determined by measuring perceptual up (PU) orientations. The ratio of vision and body vector (ROVB) was used as the indicator of one's orientation preference. The second test was to visually induce motion sickness symptoms that represent similar sensory conflicts as SMS using a virtual reality environment. Relationships between ROVB values and motion sickness scores were analyzed, which revealed cubic functions by using optimal fits. According to ROVB level, participants were divided into three groups - body group, vision group, and confusion group - and the factor of gender was further considered as a covariate in the analysis. Consistent differences in motion sickness scores were observed between the three groups. Thus, orientation preference had a significant relationship with susceptibility to simulated SMS symptoms. This knowledge could assist with astronaut selection and might be a useful countermeasure when developing new preflight trainings.

Visually induced motion sickness can be alleviated by pleasant odors

Visually induced motion sickness (VIMS) is a common side effect in virtual environments and simulators. Several countermeasures against VIMS exist, but a reliable method to prevent or ease VIMS is unfortunately still missing. In the present study, we tested whether olfactory cues can alleviate VIMS. Sixty-two participants were exposed to a 15-min-long video showing a first-person-view bicycle ride that had successfully induced VIMS in previous studies. Participants were randomly assigned to one of three groups; the first group was exposed to a pleasant odor (rose) while watching the video, the second group was exposed to an unpleasant odor (leather), and the third group was not exposed to any odor. VIMS was measured using a verbal rating scale (0-20) and the Simulator Sickness Questionnaire. Results showed that only half of the participants who were exposed to the odor did notice it (n = 21), whereas the other half failed to detect the odor. However, among those participants who did notice the odor, the rose scent significantly reduced the severity of VIMS compared to the group that did not notice the odor. A moderate positive correlation between odor sensitivity and VIMS showed that participants with higher odor sensitivity also reported stronger VIMS. Our results demonstrate that olfaction can modulate VIMS and that a pleasant odor can potentially reduce VIMS. The relationship between olfactory perception, olfactory sensibility, and VIMS is discussed.

Childhood chronic nausea: is it just a queasy stomach?

Chronic nausea is an increasingly acknowledged complaint in children. It is commonly encountered in association with functional gastrointestinal (GI) disorders but can also occur in isolation. As such, there is no pediatric diagnostic classification for chronic idiopathic nausea. The pathophysiology appears complex, from foregut motor and sensory disturbances to autonomic imbalance and CNS influences. Also, there is scarcity of specific treatments that target this highly bothersome symptom. Treatment is mainly empiric or aimed at other functional complaints. Our retrospective data indicate a high prevalence of comorbid conditions in children with chronic nausea. These include migraines, autonomic disturbances, sleep problems, fatigue, and anxiety. Identifying specific features and targeting these therapeutically may be essential for improved treatment outcomes.

Do mental workload and presence experienced when driving a real car predispose drivers to simulator sickness? An exploratory study

This study is aimed at determining whether the simulator sickness (SS) experienced by some drivers is influenced by psychological factors, such as cognitive solicitation, affective factors and a feeling of presence. We also wished to determine whether SS is caused by an individual reaction to the virtual environment (VE) itself or can be attributed to a more general personal predisposition. For this reason, we considered three conditions: driving a simulator, driving one's own vehicle and driving a school-owned vehicle. Fourteen expert drivers participated in the study. Each drove under a different experimental condition and then responded to various questionnaires (SSQ, NASA-TLX and QPF). Our results showed that it is possible to identify at least three sources of explanation of why some people are more liable to feel sick in a driving simulator.

Motion sickness prevalence in school children

This study aimed to determine the prevalence of motion sickness in schoolchildren and related the finding to the postural balance and quality of life. A population-based cross-sectional study was carried out with 831 children aged 7 to 12 years. The frequency of motion sickness was evaluated based on the Motion Sickness Susceptibility Questionnaire-Short (MSSQ-short). Postural balance was assessed using the Romberg test under different sensory conditions. The Dizziness Handicap Inventory was used in order to assess the quality of life. The statistical analyses were performed using the chi-square, Kruskal-Wallis, Mann-Whitney, and Spearman correlation tests. The prevalence of motion sickness was 43.4 % in car, 43.2 % on bus, 11.7 % on park swing, and 11.6 % on Ferris wheel. Mean unadjusted scores on the MSSQ-short ranged from 5.0 (SE = 0.5) for 10-year-olds to 6.8 (SE = 0.5) for 9-year-olds. The most prevalent symptoms following the balance tests were dizziness (89.2 %), vertigo (54.9 %), headache (10.6 %), and nausea (8.2 %). Significant correlations were found between the MSSQ-short score and all postural balance tests. Significant correlations were found between the MSSQ and modified DHI (Dizziness Handicap Inventory) at all ages.

CONCLUSION

The prevalence of motion sickness in schoolchildren is greater when in a car or on a bus. An association was found between motion sickness and postural balance tests and motion sickness and quality of life.

Assessment of otolith function using cervical and ocular vestibular evoked myogenic potentials in individuals with motion sickness

The involvement of otolith organs in motion sickness has long been debated; however, equivocal findings exist in literature. The present study thus aimed at evaluating the otolith functioning in individuals with motion sickness. Cervical and ocular vestibular evoked myogenic potentials were recorded from 30 individuals with motion sickness, 30 professional drivers and 30 healthy individuals. The results revealed no significant difference in latencies and amplitudes between the groups (p>0.05). Nonetheless, thresholds were significantly elevated and inter-aural asymmetry ratio significantly higher in motion sickness susceptible group (p < 0.001) for both the potentials. All the individuals in the motion sickness group had high asymmetry ratio at least on one of the two potentials. Thus, reduced response and/or asymmetric otolithic function seem the likely reasons behind motion sickness susceptibility.

Motion sickness: more than nausea and vomiting

Motion sickness is a complex syndrome that includes many features besides nausea and vomiting. This review describes some of these factors and points out that under normal circumstances, many cases of motion sickness go unrecognized. Motion sickness can occur during exposure to physical motion, visual motion, and virtual motion, and only those without a functioning vestibular system are fully immune. The range of vulnerability in the normal population varies about 10,000 to 1. Sleep deprivation can also enhance susceptibility. Systematic studies conducted in parabolic flight have identified velocity storage of semicircular canal signals-velocity integration-as being a key factor in both space motion sickness and terrestrial motion sickness. Adaptation procedures that have been developed to increase resistance to motion sickness reduce this time constant. A fully adequate theory of motion sickness is not presently available. Limitations of two popular theories, the evolutionary and the ecological, are described. A sensory conflict theory can explain many but not all aspects of motion sickness elicitation. However, extending the theory to include conflicts related to visceral afferent feedback elicited by voluntary and passive body motion greatly expands its explanatory range. Future goals should include determining why some conflicts are provocative and others are not but instead lead to perceptual reinterpretations of ongoing body motion. The contribution of visceral afferents in relation to vestibular and cerebellar signals in evoking sickness also deserves further exploration. Substantial progress is being made in identifying the physiological mechanisms underlying the evocation of nausea, vomiting, and anxiety, and a comprehensive understanding of motion sickness may soon be attainable. Adequate anti-motion sickness drugs without adverse side effects are not yet available.

Design, formulation and evaluation of green tea chewing gum

Background:

The main purpose of this study is to design, formulate and evaluate the green tea gums with a suitable taste and quality in order to produce an anti-oxidant chewing gum.

Materials and Methods:

Fresh green tea leaves obtained from Northern Iran for extraction. Maceration is the extraction method that is used in this study. The contents of caffeine, catechin and flavonoids of the hydro alcoholic extract were measured. Various formulations of the 120 mg green tea extract chewing gums with different sweeteners, flavoring agents and various gum bases were prepared afterward release pattern, content uniformity, organoleptic results and other properties were characterized.

Results:

The contents of caffeine, catechin and flavonoid of the hydro alcoholic extraction were 207.32 mg/g, 130.00 mg/g and 200.82 mg/g, respectively. Release pattern of green tea chewing gum with different gum base ratios and various sweeteners in phosphate buffer were prepared. A total of 60 persons who were 20-30 years of age, participated in our panel test for organoleptic properties such as taste, stiffness, stickiness, etc., Acceptable gum was the one with the same ratio of the used rubber bases. Cinnamon selected as the preferred taste by volunteers. Combination of aspartame, sugar and maltitol has appropriate taste. The effect of various sweetener on release pattern was negligible, on the other hand rubber bases ratio variation, changed the release pattern obviously.

Conclusion:

The green tea chewing gum with sugar, maltitol and aspartame sweeteners and cinnamon flavor, using the same rubber bases ratio may be a desirable antioxidant product.

The role of the parasympathetic nervous system in visually induced motion sickness: systematic review and meta-analysis

The parasympathetic nervous system (PNS) has been implicated in the development of visually induced motion sickness. The objective of this study was to perform a systematic review and meta-analysis of the effect of visually induced motion sickness on validated parameters of PNS tone. Methods followed PRISMA recommendations. Controlled trials reporting validated measures of PNS tone in visually induced motion sickness in healthy adults were included. One reviewer performed the screening of articles and data extraction, and two reviewers independently performed methodological evaluation. Data were synthesised using standardised mean differences (SMDs) for all relevant outcomes using a random-effects model. Publication bias was assessed via funnel plots and Egger's test. The search strategy identified seven citations comprising 237 healthy individuals. The mean quality score was 4/10 (range 3-7). There was no difference between baseline PNS tone between individuals who developed visually induced motion sickness and those that did not. Visually induced motion sickness (VIMS)-sensitive individuals had a reduction in PNS tone, following exposure to the stimulus (mean weighted SMD = -0.45, 95% confidence interval -0.64 to -0.27, Z = -4.8, p < 0.0001). There was no evidence of heterogeneity or publication bias. These data suggest that baseline PNS parameters do not provide a useful measure of predicting the probability of developing visually induced motion sickness. However, a fall in PNS tone, as indicated by cardiac activity, is characteristic in sensitive individuals. Further work is needed to characterise these responses in clinical populations, in conjunction with improvements and standardisation in study design.

Pleasant music as a countermeasure against visually induced motion sickness

Visually induced motion sickness (VIMS) is a well-known side-effect in virtual environments or simulators. However, effective behavioral countermeasures against VIMS are still sparse. In this study, we tested whether music can reduce the severity of VIMS. Ninety-three volunteers were immersed in an approximately 14-minute-long video taken during a bicycle ride. Participants were randomly assigned to one of four experimental groups, either including relaxing music, neutral music, stressful music, or no music. Sickness scores were collected using the Fast Motion Sickness Scale and the Simulator Sickness Questionnaire. Results showed an overall trend for relaxing music to reduce the severity of VIMS. When factoring in the subjective pleasantness of the music, a significant reduction of VIMS occurred only when the presented music was perceived as pleasant, regardless of the music type. In addition, we found a gender effect with women reporting more sickness than men. We assume that the presentation of pleasant music can be an effective, low-cost, and easy-to-administer method to reduce VIMS.

Enhanced perceptions of control and predictability reduce motion-induced nausea and gastric dysrhythmia

Nausea is a debilitating condition that is typically accompanied by gastric dysrhythmia. The enhancement of perceived control and predictability has generally been found to attenuate the physiological stress response. The aim of the present study was to test the effect of these psychosocial variables in the context of nausea, motion sickness, and gastric dysrhythmia. A 2x2, independent-groups, factorial design was employed in which perceived control and predictability were each provided at high or low levels to 80 participants before exposure to a rotating optokinetic drum. Ratings of nausea were obtained throughout a 6-min baseline period and a 16-min drum rotation period. Noninvasive recordings of the electrical activity of the stomach called electrogastrograms were also obtained throughout the study. Nausea scores were significantly lower among participants with high control than among those with low control, and were significantly lower among participants with high predictability than among those with low predictability. Estimates of gastric dysrhythmia obtained from the EGG during drum rotation were significantly lower among participants with high predictability than among those with low predictability. A significant interaction effect of control and predictability on gastric dysrhythmia was also observed, such that high control was only effective for arresting the development of gastric dysrhythmia when high predictability was also available. Stronger perceptions of control and predictability may temper the development of nausea and gastric dysrhythmia during exposure to provocative motion. Psychosocial interventions in a variety of nausea contexts may represent an alternative means of symptom control.

Integration of vestibular and emetic gastrointestinal signals that produce nausea and vomiting: potential contributions to motion sickness

Vomiting and nausea can be elicited by a variety of stimuli, although there is considerable evidence that the same brainstem areas mediate these responses despite the triggering mechanism. A variety of experimental approaches showed that nucleus tractus solitarius, the dorsolateral reticular formation of the caudal medulla (lateral tegmental field), and the parabrachial nucleus play key roles in integrating signals that trigger nausea and vomiting. These brainstem areas presumably coordinate the contractions of the diaphragm and abdominal muscles that result in vomiting. However, it is unclear whether these regions also mediate the autonomic responses that precede and accompany vomiting, including alterations in gastrointestinal activity, sweating, and changes in blood flow to the skin. Recent studies showed that delivery of an emetic compound to the gastrointestinal system affects the processing of vestibular inputs in the lateral tegmental field and parabrachial nucleus, potentially altering susceptibility for vestibular-elicited vomiting. Findings from these studies suggested that multiple emetic inputs converge on the same brainstem neurons, such that delivery of one emetic stimulus affects the processing of another emetic signal. Despite the advances in understanding the neurobiology of nausea and vomiting, much is left to be learned. Additional neurophysiologic studies, particularly those conducted in conscious animals, will be crucial to discern the integrative processes in the brain stem that result in emesis.

Is there a relationship between odors and motion sickness?

The aim of this study was to evaluate the relationship between olfaction and motion sickness. A sample of 18 participants was recruited and submitted to three sessions of nauseogenic stimulations: off vertical axis rotation (OVAR), performed under conditions of olfactory stimulation with limonene (pleasant odor), petrol (unpleasant odor) or distilled water (as a control). Motion sickness was assessed before, during and after each OVAR session. In addition, participants were asked to evaluate the intensity and hedonic valence of four odors (geraniol, limonene, butanol, petrol) as well as distilled water (as a control) before and after each OVAR session. Our analysis showed that OVAR has consistently increased the induced-motion sickness. However the addition of an odor that is pleasant or unpleasant during the rotation did not affect the occurrence of motion sickness symptoms compared to the control condition. Our results also showed that intensity of odors was significantly increased after OVAR and the intensity was significantly higher for unpleasant odors than for pleasant one. For the hedonicity, OVAR made unpleasant odors more unpleasant (p<0.0001) while it made limonene odor slightly more pleasant (p<0.05). The present study highlighted the lack of influence of odors in motion-induced sickness but an impact of a nauseogenic test on olfactory perception.

The comparison of sensitivity of motion sickness between retinal degeneration fast mice and normal mice

Recent studies report that a conflict between information from the visual system and vestibular system is one of the main reasons for induction of motion sickness (MS). We may be able to clarify the integration mechanism of visual and vestibular information using an animal model with a visual defect, the retinal degeneration fast (rdf) mouse, and the role of vestibular information in the pathogenesis of MS. The rdf mice and wild-type Kunming mice were subjected to rotary stimulation to induce MS. Conditioned taste anorexia to saccharin solution and behavior score were used to observe the differences in MS sensitivity between two types of mice. The decrease in intake of saccharin solution and the behavior score in rdf mice were greater than those in normal mice. After rotatory stimulation, the reduction of intake mass and the behavior score were greater in rdf mice compared to those of normal mice. The rdf mice were more sensitive to rotation than normal mice. We conclude that visual information plays a role in the pathogenesis of MS. Visual information and vestibular information impact each other and integrate through certain channels in the central nervous system in mice.

The expression of calcitonin gene-related Peptide and acetylcholine in the vestibular-related nucleus population of wild-type mice and retinal degeneration fast mice after rotary stimulation

Due to the lack of an appropriate animal model, few studies have addressed the integration of visual and vestibular information in the visual system. Using a mouse model with a visual defect (retinal degeneration fast, rdf), we have verified that the prepositus hypoglossal nucleus (PrH) and the Kooy cap of the inferior olive medial nucleus (IOK) are key regions in which visual and vestibular information integrate. Although the integration regions were identified, the precise mechanisms of integration require further investigation. The rdf mice and wild-type Kunming mice were randomly assigned to experimental and control subgroups, respectively. Mice in the experimental groups were exposed to rotary motion for 30 min three times at 24-h intervals, whereas mice in the control groups were not exposed to rotary motion. Differences in the number of calcitonin gene-related peptide positive (CGRP-positive) and choline acetyltransferase positive (ChAT-positive) neurons in the vestibular-related nucleus populations of two types of mice were determined. After rotatory stimulus, the number of CGRP-positive and ChAT-positive neurons in the PrH and the IOK was significantly less in rdf mice compared with that in wild-type mice. There were differences in the number of CGRP-positive and ChAT-positive neurons in the other vestibular-related regions, but the differences were not significant, except the difference in the number of ChAT-positive neurons in the medial vestibular nucleus. The expression patterns of CGRP and ChAT were similar to that of Fos in the vestibular-related regions in the two types of mice after rotatory stimulus. The number of CGRP-positive and ChAT-positive neurons and the number of active nerve cells were consistent in those regions in the two types of mice after rotary stimulus. Therefore, we speculated that CGRP and Ach generated and released by neurons in the PrH and the IOK may play roles in the sensory integration of visual and vestibular information in mice.

Oxidative stress is not involved in motion sickness in mice

AIMS

Some indirect evidences indicate a possible correlation between oxidative stress and motion sickness. The aim of this research was to investigate whether oxidative stress contributing to motion sickness in mice or not.

METHODS

We examined the mRNA levels of peroxiredoxin 6 (PRDX6), catalase, and enzyme superoxide dismutase 1 (SOD1); reactive oxygen species (ROS); and total antioxidant capacity and SOD activity in different brain regions after rotary stimulation. Mice motion sickness index was recorded after rotation when pretreated with paraquat, vitamin C, or vitamin E.

RESULTS

The ROS level and antioxidant capacity were both increased in cerebellum plus brainstem (CB) after rotation, a critical region determines motion sickness. However, manipulation of oxidants or antioxidants using pharmacological method in vivo had no influence on motion sickness index in mice.

CONCLUSION

Oxidative stress is not involved in the development of motion sickness in mice.

Simultaneous transcutaneous electrical nerve stimulation mitigates simulator sickness symptoms in healthy adults: a crossover study

Background

Flight simulators have been used to train pilots to experience and recognize spatial disorientation, a condition in which pilots incorrectly perceive the position, location, and movement of their aircrafts. However, during or after simulator training, simulator sickness (SS) may develop. Spatial disorientation and SS share common symptoms and signs and may involve a similar mechanism of dys-synchronization of neural inputs from the vestibular, visual, and proprioceptive systems. Transcutaneous electrical nerve stimulation (TENS), a maneuver used for pain control, was found to influence autonomic cardiovascular responses and enhance visuospatial abilities, postural control, and cognitive function. The purpose of present study was to investigate the protective effects of TENS on SS.

Methods

Fifteen healthy young men (age: 28.6 ± 0.9 years, height: 172.5 ± 1.4 cm, body weight: 69.3 ± 1.3 kg, body mass index: 23.4 ± 1.8 kg/m²) participated in this within-subject crossover study. SS was induced by a flight simulator. TENS treatment involved 30 minutes simultaneous electrical stimulation of the posterior neck and the right Zusanli acupoint. Each subject completed 4 sessions (control, SS, TENS, and TENS + SS) in a randomized order. Outcome indicators included SS symptom severity and cognitive function, evaluated with the Simulator Sickness Questionnaire (SSQ) and d2 test of attention, respectively. Sleepiness was rated using the Visual Analogue Scales for Sleepiness Symptoms (VAS-SS). Autonomic and stress responses were evaluated by heart rate, heart rate variability (HRV) and salivary stress biomarkers (salivary alpha-amylase activity and salivary cortisol concentration).

Results

Simulator exposure increased SS symptoms (SSQ and VAS-SS scores) and decreased the task response speed and concentration. The heart rate, salivary stress biomarker levels, and the sympathetic parameter of HRV increased with simulator exposure, but parasympathetic parameters decreased (p < 0.05). After TENS treatment, SS symptom severity significantly decreased and the subjects were more able to concentrate and made fewer cognitive test errors (p < 0.05).

Conclusions

Sympathetic activity increased and parasympathetic activity decreased after simulator exposure. TENS was effective in reducing SS symptoms and alleviating cognitive impairment.

Trial registration number

Australia and New Zealand Clinical Trials Register: http://ACTRN12612001172897

Prospective study on the efficacy of optokinetic training in the treatment of seasickness

OBJECTIVES

Seasickness corresponds to all of the clinical symptoms experienced by a subject at sea related to boat movements. The objective of this study was to evaluate the efficacy of optokinetic training versus placebo in the treatment of seasickness.

MATERIAL AND METHODS

Fifteen subjects were randomized to either an optokinetic training arm or a placebo arm. The impact of seasickness was evaluated for each subject before and after optokinetic training using the Graybiel scale.

RESULTS

Among the trained subjects, 71.4% were improved by optokinetic training versus 12.5% of control subjects. A significant difference was observed for Graybiel scores before and after optokinetic training in the training arm.

CONCLUSION

Optokinetic training appears to be an effective modality for the management of disabling seasickness. This training can be further improved by more global patient management.

Are there side effects to watching 3D movies? A prospective crossover observational study on visually induced motion sickness

Background

The increasing popularity of commercial movies showing three dimensional (3D) images has raised concern about possible adverse side effects on viewers.

Methods and Findings

A prospective carryover observational study was designed to assess the effect of exposure (3D vs. 2D movie views) on self reported symptoms of visually induced motion sickness. The standardized Simulator Sickness Questionnaire (SSQ) was self administered on a convenience sample of 497 healthy adult volunteers before and after the vision of 2D and 3D movies. Viewers reporting some sickness (SSQ total score>15) were 54.8% of the total sample after the 3D movie compared to 14.1% of total sample after the 2D movie. Symptom intensity was 8.8 times higher than baseline after exposure to 3D movie (compared to the increase of 2 times the baseline after the 2D movie). Multivariate modeling of visually induced motion sickness as response variables pointed out the significant effects of exposure to 3D movie, history of car sickness and headache, after adjusting for gender, age, self reported anxiety level, attention to the movie and show time.

Conclusions

Seeing 3D movies can increase rating of symptoms of nausea, oculomotor and disorientation, especially in women with susceptible visual-vestibular system. Confirmatory studies which include examination of clinical signs on viewers are needed to pursue a conclusive evidence on the 3D vision effects on spectators.

Processing of vestibular inputs by the medullary lateral tegmental field of conscious cats: implications for generation of motion sickness

The dorsolateral reticular formation of the caudal medulla, the lateral tegmental field (LTF), participates in generating vomiting. LTF neurons exhibited complex responses to vestibular stimulation in decerebrate cats, indicating that they received converging inputs from a variety of labyrinthine receptors. Such a convergence pattern of vestibular inputs is appropriate for a brain region that participates in generating motion sickness. Since responses of brainstem neurons to vestibular stimulation can differ between decerebrate and conscious animals, the current study examined the effects of whole-body rotations in vertical planes on the activity of LTF neurons in conscious felines. Wobble stimuli, fixed-amplitude tilts, the direction of which moves around the animal at a constant speed, were used to determine the response vector orientation, and also to ascertain whether neurons had spatial-temporal convergence (STC) behavior (which is due to the convergence of vestibular inputs with different spatial and temporal properties). The proportion of LTF neurons with STC behavior in conscious animals (25 %) was similar to that in decerebrate cats. Far fewer neurons in other regions of the feline brainstem had STC behavior, confirming findings that many LTF neurons receive converging inputs from a variety of labyrinthine receptors. However, responses to vertical plane vestibular stimulation were considerably different in decerebrate and conscious felines for LTF neurons lacking STC behavior. In decerebrate cats, most LTF neurons had graviceptive responses to rotations, similar to those of otolith organ afferents. However, in conscious animals, the response properties were similar to those of semicircular canal afferents. These differences show that higher centers of the brain that are removed during decerebration regulate the labyrinthine inputs relayed to the LTF, either by gating connections in the brainstem or by conveying vestibular inputs directly to the region.

Using virtual reality to assess user experience

OBJECTIVE

The aim of this article is to discuss how user experience (UX) evaluation can benefit from the use of virtual reality (VR).

BACKGROUND

UX is usually evaluated in laboratory settings. However, considering that UX occurs as a consequence of the interaction between the product, the user, and the context of use, the assessment of UX can benefit from a more ecological test setting. VR provides the means to develop realistic-looking virtual environments with the advantage of allowing greater control of the experimental conditions while granting good ecological validity.

METHOD

The methods used to evaluate UX, as well as their main limitations, are identified.The currentVR equipment and its potential applications (as well as its limitations and drawbacks) to overcome some of the limitations in the assessment of UX are highlighted.

RESULTS

The relevance of VR for UX studies is discussed, and a VR-based framework for evaluating UX is presented.

CONCLUSION

UX research may benefit from a VR-based methodology in the scopes of user research (e.g., assessment of users' expectations derived from their lifestyles) and human-product interaction (e.g., assessment of users' emotions since the first moment of contact with the product and then during the interaction).

APPLICATION

This article provides knowledge to researchers and professionals engaged in the design of technological interfaces about the usefulness of VR in the evaluation of UX.

Vestibular stimulation on a motion-simulator impacts on mood States

We are familiar with both pleasant and unpleasant psychotropic effects of movements associated with vestibular stimulation. However, there has been no attempt to scientifically explore the impact of different kinds of vestibular stimulation on mood states and biomarkers. A sample of 23 healthy volunteers were subjected to a random sequence of three different passive rotational (yaw, pitch, roll) and translational (heave, sway, surge) vestibular stimulation paradigms using a motion-simulator (hexapod). Mood states were measured by means of questionnaires and visual analog scales. In addition, saliva cortisol and α-amylase samples were taken. Compared to a subliminal control paradigm all rotational and two translational stimulations produced significant changes in mood states: Yaw rotation was associated with feeling more comfortable, pitch rotation with feeling more alert and energetic, and roll rotation with feeling less comfortable. Heave translation was associated with feeling more alert, less relaxed, and less comfortable and surge translation with feeling more alert. Biomarkers were not affected. In conclusion, we provide first experimental evidence that passive rotational and translational movements may influence mood states on a short-term basis and that the quality of these psychotropic effects may depend on the plane and axis of the respective movements.

Self-adjustments may account for the contradictory correlations between HRV and motion-sickness severity

This study investigates the relationship between heart rate variability (HRV) and the level of motion sickness (MS) induced by simulated tunnel driving. The HRV indices, normalized low frequency (NLF, 0.04-0.15 Hz), normalized high frequency (NHF, 0.15-0.4 Hz), and LF/HF ratio were correlated with the subjectively and continuously rated MS levels of 20 participants. The experimental results showed that for 13 of the subjects, the MS levels positively correlated with the NLF and the LF/HF ratio and negatively correlated with the NHF. The remaining seven subjects had negative correlations between the MS levels and the NLF and the LF/HF ratio and a positive correlation between the MS levels and the NHF. To clarify this contradiction, this study also inspected the effects of subjects' self-adjustments on the correlations between the MS levels and the HRV indices and showed that the variations in the relationship might be attributed to the subjects' self-adjustments, which they used to relieve the discomfort of MS.

Expression of calcitonin gene-related peptide in efferent vestibular system and vestibular nucleus in rats with motion sickness

Motion sickness presents a challenge due to its high incidence and unknown pathogenesis although it is a known fact that a functioning vestibular system is essential for the perception of motion sickness. Recent studies show that the efferent vestibular neurons contain calcitonin gene-related peptide (CGRP). It is a possibility that the CGRP immunoreactivity (CGRPi) fibers of the efferent vestibular system modulate primary afferent input into the central nervous system; thus, making it likely that CGRP plays a key role in motion sickness. To elucidate the relationship between motion sickness and CGRP, the effects of CGRP on the vestibular efferent nucleus and the vestibular nucleus were investigated in rats with motion sickness.

A survey of visually induced symptoms and associated factors in spectators of three dimensional stereoscopic movies

BACKGROUND

The increasing popularity of commercial movies showing three dimensional (3D) computer generated images has raised concern about image safety and possible side effects on population health.This study aims to (1) quantify the occurrence of visually induced symptoms suffered by the spectators during and after viewing a commercial 3D movie and (2) to assess individual and environmental factors associated to those symptoms.

METHODS

A cross-sectional survey was carried out using a paper based, self administered questionnaire. The questionnaire includes individual and movie characteristics and selected visually induced symptoms (tired eyes, double vision, headache, dizziness, nausea and palpitations). Symptoms were queried at 3 different times: during, right after and after 2 hours from the movie.

RESULTS

We collected 953 questionnaires. In our sample, 539 (60.4%) individuals reported 1 or more symptoms during the movie, 392 (43.2%) right after and 139 (15.3%) at 2 hours from the movie. The most frequently reported symptoms were tired eyes (during the movie by 34.8%, right after by 24.0%, after 2 hours by 5.7% of individuals) and headache (during the movie by 13.7%, right after by 16.8%, after 2 hours by 8.3% of individuals). Individual history for frequent headache was associated with tired eyes (OR = 1.34, 95%CI = 1.01-1.79), double vision (OR = 1.96; 95%CI = 1.13-3.41), headache (OR = 2.09; 95%CI = 1.41-3.10) during the movie and of headache after the movie (OR = 1.64; 95%CI = 1.16-2.32). Individual susceptibility to car sickness, dizziness, anxiety level, movie show time, animation 3D movie were also associated to several other symptoms.

CONCLUSIONS

The high occurrence of visually induced symptoms resulting from this survey suggests the need of raising public awareness on possible discomfort that susceptible individuals may suffer during and after the vision of 3D movies.

Effects of transcutaneous electrical nerve stimulation on motion sickness induced by rotary chair: a crossover study

OBJECTIVES

Motion sickness (MS) is evoked by the conflict among somatosensory, visual, and vestibular input. Some of the MS symptoms and signs are mediated by activation of the autonomic nervous system (ANS). Transcutaneous electrical nerve stimulation (TENS), a maneuver used for pain control, was found to influence cardiovascular responses through ANS reflex, and to enhance motor function, visuospatial abilities, postural control, and cognitive function. The purpose of the present study is to investigate the effects of TENS on MS.

SUBJECTS AND DESIGN

Fifteen (15) healthy young men participated in a within-subjects crossover study. Each completed four test sessions (control, rotation, TENS, TENS+rotation) in randomized order. Rotary chair (120°/s) combined with pitch movement of the subject's head was used as a model to provoke MS. Whole rotation protocol consisted of 5 1-minute rotations, each separated by a 1-minute rest period. TENS protocol involved simultaneous electrical stimulation of posterior neck and Zusanli acupoint.

OUTCOME MEASURES

Motion sickness susceptibility was rated on a standardized questionnaire (Motion Sickness Susceptibility Questionnaire). Motion sickness symptoms, blood pressure (BP), skin temperature, heart rate (HR), and heart rate variability (HRV) were measured. Saliva samples were collected to analyze the level of stress markers. Cognitive function was evaluated with d2 test prior to and after MS provocation.

RESULTS

Spinning by itself significantly decreased task response speed and contraction. MS symptom scores, BP, as well as the sympathetic parameter of HRV increased progressively with MS provocation (p<0.05), but skin temperature decreased (p=0.023). Severity of MS symptoms significantly decreased with TENS intervention (p<0.05). After TENS treatment, subjects were able to concentrate better and showed fewer errors in a cognitive test. Salivary cortisol concentration significant decreased after TENS treatment.

CONCLUSIONS

Sympathetic activity increased but parasympathetic activity decreased during MS. TENS was effective in reducing MS symptoms as well as alleviating cognitive impairment.

Bitter taster status predicts susceptibility to vection-induced motion sickness and nausea

BACKGROUND

Sensitivity to bitter taste and susceptibility to nausea are both protective mechanisms that guard against toxin ingestion, and both these traits vary within and between populations. Thus, we postulated that they may have co-evolved, such that they are associated.

METHODS

Bitter taster status was determined in 40 subjects (13 men, 27 women) by measuring the differential perceived taste intensity between salt and n-propylthiouracil using a labeled magnitude scale; susceptibility to vection-induced motion sickness and nausea was assessed using an optokinetic drum, a validated multi-symptom scoring scale, and electrogastrography.

KEY RESULTS

Taster status distribution was 25% non-tasters (NT), 40% tasters (T), and 35% supertasters (ST). Gender had no impact on this distribution, but females had a higher mean maximum symptom score than males (12.4 ± 1.4 vs 7.3 ± 2.0). Non-tasters displayed a faster and larger increase in mean symptom scores, had a higher percentage of subjects with high maximum symptom scores, and had a higher mean maximum score than T or ST, (14.8 ± 2.6 vs 7.1 ± 1.8, vs 9.8 ± 2.0). Taster status did not affect the gastric myoelectric frequency response to vection.

CONCLUSIONS & INFERENCES

Non-tasters are more susceptible to vection-induced motion sickness and nausea than T or ST, suggesting these two traits may have co-evolved in a reciprocal manner: in environments where the NT trait conferred an evolutionary advantage by enabling intake of fruits and vegetables containing bitter, yet beneficial, phytonutrients, increased nausea susceptibility may have arisen to maintain protection against ingested toxins.

[Relationships between constitutional types of traditional Chinese medicine and motion sickness in 145 ocean sailors]

OBJECTIVE

To investigate the relationships between constitutional types of traditional Chinese medicine (TCM) and motion sickness.

METHODS

A survey of TCM constitutions in ocean sailors participating in a voyage was performed by using the TCM Constitution Questionnaire developed by Beijing University of Traditional Chinese Medicine, while the survey of motion sickness was operated by Graybiel's diagnostic criteria. The incidences of motion sickness among sailors with different types of constitutions were compared.

RESULTS

Prior to the voyage, 50.3% of sailors exhibited a gentleness constitution, 14.5% were of dampness-heat constitution, 10.3% were of qi-stagnation constitution, whereas the percentages of qi-deficiency, yang-deficiency, yin-deficiency, blood-stasis and special diathesis constitutions were 6.2%, 7.6%, 6.2%, 4.1% and 0.7%, respectively. None exhibited a phlegm-dampness constitution. By the end of the 176-day voyage, the percentages of gentleness, dampness-heat, qi-depression, qi-deficiency, yang-deficiency, yin-deficiency, blood-stasis, special diathesis and phlegm-dampness constitutions were 33.8%, 13.8%, 13.1%, 11.0%, 6.9%, 9.7%, 4.1%, 0.7% and 6.9%, respectively. The incidence of motion sickness was 69.7% (101 sailors) during this voyage. The incidences of motion sickness among sailors with different types of constitutions before the voyage showed significant difference (P<0.001). The incidence of motion sickness was higher in the sailors with dampness-heat constitution than in those with gentleness constitution.

CONCLUSION

Types of Chinese medical constitution can be related to susceptibility to motion sickness. Furthermore, ocean voyage may have an effect or influence on the type of Chinese medical constitution of sailors involved.

Decreased Fos protein expression in rat caudal vestibular nucleus is associated with motion sickness habituation

We investigated the temporal change of Fos protein expression in the caudal vestibular nucleus of rats exposed to daily 2-h Ferris-wheel like (FWL) rotation. Repeated rotation (2h daily for 14 consecutive days) caused an initial increase in defecation, followed by a gradual decline back to the baseline level after 8 rotation sessions. Unlike defecation, the Kaolin consumption of rats showed a bitonic function during the daily rotation sessions (2h daily for 33 consecutive days) and finally recovered to the baseline after about 31 sessions. Immunohistochemistry study revealed increased Fos immunolabeled (Fos-LI) neurons in the medial vestibular nucleus and spinal vestibular nucleus during the initial 7 rotation sessions, and it decreased to the baseline level after 10 rotation sessions. There was a strong linear relationship between the amount of Fos-LI neurons and rat defecation level throughout the whole rotation sessions. These results suggest that the change of neuronal plasticity in the caudal vestibular nucleus might contribute to attenuation of gastrointestinal symptoms during motion sickness habituation process.

Mal de debarquement

Mal de debarquement (MdD), the "sickness of disembarkment," occurs when habituation to background rhythmic movement becomes resistant to readaption to stable conditions and results in a phantom perception of self motion typically described as rocking, bobbing, or swaying. Although several studies have shown that brief periods of MdD are common in healthy individuals, this otherwise natural phenomenon can become persistent in some individuals and lead to severe balance problems. Increased recognition of MdD in a persistent pathological form occurred after the publication of a case series of six patients by Brown and Baloh in 1987. Over 20 years later, although more is known about the clinical syndrome of persistent MdD, little is known about what leads to this persistence. This review addresses the clinical features of MdD, the associated symptoms in the persistent form, theories on pathogenesis, experience with treatment, and future directions for research.

Integrated evaluation of visually induced motion sickness in terms of autonomic nervous regulation

To evaluate visually-induced motion sickness, we integrated subjective and objective responses in terms of autonomic nervous regulation. Twenty-seven subjects viewed a 2-min-long first-person-view video section five times (total 10 min) continuously. Measured biosignals, the RR interval, respiration, and blood pressure, were used to estimate the indices related to autonomic nervous activity (ANA). Then we determined the trigger points and some sensation sections based on the time-varying behavior of ANA-related indices. We found that there was a suitable combination of biosignals to present the symptoms of visually-induced motion sickness. Based on the suitable combination, integrating trigger points and subjective scores allowed us to represent the time-distribution of subjective responses during visual exposure, and helps us to understand what types of camera motions will cause visually-induced motion sickness.

Gender and the nocebo response following conditioning and expectancy

OBJECTIVE

To investigate the role of Pavlovian conditioning and expectancy and of gender on the nocebo effects.

METHODS

Conditioning experiment: Forty-eight healthy male and female volunteers were investigated for 3 days using a standard rotation procedure. Subjects in the experimental group received a salient oral stimulus prior to rotation; subjects in the control group received the stimulus 12 h after rotations on Days 1 and 2; on Day 3, all subjects received the stimulus prior to rotation. Expectancy experiment: Another 48 healthy subjects were rotated 5 x 1 min once only. All subjects received the same oral stimulus immediately prior to rotation; subjects in the experimental group were told that the symptoms might worsen with the stimulus; controls did not receive additional information. In both experiments, symptom rating (SR) and rotation tolerance (RT) were determined.

RESULTS

Conditioning significantly reduced RT (P=.015) and increased SR (P=.024). For both RT and SR, a significant "day x group x gender" effect was found (P=.044; SR: P=.011) indicating that conditioning was more effective in women. Expectancies lowered RT (P=.085) without affecting SR. There was a significant "rotation x gender" interaction on RT (P=.005) indicating that the expectancy was more effective in men.

CONCLUSION

Women responded stronger to conditioning while men responded to expectancies, but to a lesser degree. It needs to be determined whether this is restricted to nausea-specific conditions or can be generalized across clinical and experimental conditions.

Cortisol levels predict motion sickness tolerance in women but not in men

A variety of intrinsic and extrinsic factors contribute to motion sickness severity in a stressful motion environment. The interplay of all these factors may partially explain the high inter-subject variability of motion sickness susceptibility found in many studies as well as some of the contradictory findings between studies regarding the modulating influence of single factors. We investigated the role of endogenous cortisol levels, gender and repetitive experience for motion sickness susceptibility. Motion sickness was induced in 32 healthy, but motion-sickness susceptible volunteers (16:16 males:females), by means of a vection drum. Subjects were investigated between 8:00 am (high cortisol) and 11:00 am (low cortisol), and on five consecutive days. Tolerance to rotation (RT) of the drum, motion sickness symptom ratings (SR) and salivary cortisol levels were assessed. Baseline cortisol levels correlated positively with RT in women, but not in men. RT showed a gender-specific time course across days, with higher values in males than in females on day 1, and sensitization on day 3 only in men. SR and cortisol levels following rotation did not differ between males and females, or between testing days. Gender differences in motion sickness susceptibility appear to be linked to a different role of basal cortisol levels for motion sickness tolerance. Results clearly indicate the need to control for gender, day time and cortisol levels in studies of motion sickness.

Could sound be used as a strategy for reducing symptoms of perceived motion sickness?

BACKGROUND

Working while exposed to motions, physically and psychologically affects a person. Traditionally, motion sickness symptom reduction has implied use of medication, which can lead to detrimental effects on performance. Non-pharmaceutical strategies, in turn, often require cognitive and perceptual attention. Hence, for people working in high demand environments where it is impossible to reallocate focus of attention, other strategies are called upon. The aim of the study was to investigate possible impact of a mitigation strategy on perceived motion sickness and psychophysiological responses, based on an artificial sound horizon compared with a non-positioned sound source.

METHODS

Twenty-three healthy subjects were seated on a motion platform in an artificial sound horizon or in non-positioned sound, in random order with one week interval between the trials. Perceived motion sickness (Mal), maximum duration of exposure (ST), skin conductance, blood volume pulse, temperature, respiration rate, eye movements and heart rate were measured continuously throughout the trials.

RESULTS

Mal scores increased over time in both sound conditions, but the artificial sound horizon, applied as a mitigation strategy for perceived motion sickness, showed no significant effect on Mal scores or ST. The number of fixations increased with time in the non-positioned sound condition. Moreover, fixation time was longer in the non-positioned sound condition compared with sound horizon, indicating that the subjects used more time to fixate and, hence, assumingly made fewer saccades.

CONCLUSION

A subliminally presented artificial sound horizon did not significantly affect perceived motion sickness, psychophysiological variables or the time the subjects endured the motion sickness triggering stimuli. The number of fixations and fixation times increased over time in the non-positioned sound condition.

Effects of vestibular and neck proprioceptive stimulation on posture as a function of hypnotizability

Previous studies on the role of hypnotizability in postural control indicate that the body sway of subjects with high or low hypnotizability to hypnosis is differentially modulated by eye closure. The aim of this study was to investigate whether hypnotizability also modulates the postural response to electrical vestibular stimulation and to head rotation in nonhypnotized individuals. The center of pressure (CoP) displacements were monitored in highs and lows standing on a stabilometric platform with closed eyes during basal conditions and electrical vestibular stimulation in 3 different positions of the head. Results showed that the CoP stimulus-locked displacements as well as the CoP mean position, area, and mean velocity were similar in highs and lows, but only in lows did the head position modulate the mean velocity. This finding might reflect a difference in sensory-motor integration between the 2 groups.

The effect of the 5-HT1A receptor agonist, 8-OH-DPAT, on motion-induced emesis in Suncus murinus

In the present study we evaluated the role of 5-HT(1A) receptors in mediating the inhibitory action of 8-OH-DPAT, a 5-HT(1A) receptor agonist, in motion sickness in Suncus murinus. 8-OH-DPAT (0.1 mg/kg, i. p) attenuated motion-induced emesis which was associated with an increase in the latency of the onset to the first emetic episode. Pre-treatment with methysergide (a 5-HT(1/2/7) receptor antagonist, 1.0 mg/kg, i. p.), WAY-100635 (a 5-HT(1A) receptor antagonist, 1.0 mg/kg, i. p.), SB269970A (a 5-HT(7) receptor antagonist, 1.0 and 5.0 mg/kg, i. p.), ondansetron (a 5-HT(3) receptor antagonist, 1.0 mg/kg, i. p) or GR13808 (a 5-HT(4) receptor antagonist, 0.5 mg/kg, i. p) failed to modify the inhibitory action of 8-OH-DPAT on motion sickness. Furthermore, the application of either methysergide, WAY-100635, SB269970A, ondansetron or GR13808 alone had no effect on motion sickness in its own right. These data indicate that neither 5-HT(1A) nor any 5-HT(2) receptor subtypes, 5-HT(3), 5-HT(4) and 5-HT(7) receptors are likely to be involved in the inhibition of motion-induced emesis mediated by 8-OH-DPAT.