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de Thierry de Faletans C, Misericordia M, Vallier JM, Duché P, Watelain E. Effects of dynamic visual feedback system on seasickness. APPLIED ERGONOMICS 2024; 119:104318. [PMID: 38797015 DOI: 10.1016/j.apergo.2024.104318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024]
Abstract
Motion sickness (MS) poses challenges for individuals affected, hindering their activities and travel. This study investigates the effect of a visual dynamic device, forming an artificial horizon plane, on symptoms and physiological changes induced by MS. This device consists of vertical light-emitting diodes whose illumination varies according to the boat's movements. Fifteen subjects with moderate-to-severe MS susceptibility were exposed to a seasickness simulator with and without the device. Symptoms were assessed immediately after exposure. Time spent in the simulator, heart rate, and temperature were also recorded. Symptom intensity at the end of the experience did not differ, but the time spent in the simulator was significantly longer with the device (+46%). Variations in heart rate were also observed. The device delays symptom onset and can be used as a tool against MS. Further research is needed to evaluate its effects, for example, during more prolonged exposure to MS-inducing stimuli.
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Affiliation(s)
- Camille de Thierry de Faletans
- Laboratory "Jeunesse - Activité Physique et Sportive- Santé" (J-AP2S), University of Toulon - CS 60584 - 83041 TOULON - Campus La Garde - France.
| | - Maxime Misericordia
- Laboratory "Jeunesse - Activité Physique et Sportive- Santé" (J-AP2S), University of Toulon - CS 60584 - 83041 TOULON - Campus La Garde - France
| | - Jean-Marc Vallier
- Laboratory "Jeunesse - Activité Physique et Sportive- Santé" (J-AP2S), University of Toulon - CS 60584 - 83041 TOULON - Campus La Garde - France
| | - Pascale Duché
- Laboratory "Jeunesse - Activité Physique et Sportive- Santé" (J-AP2S), University of Toulon - CS 60584 - 83041 TOULON - Campus La Garde - France
| | - Eric Watelain
- Laboratory "Jeunesse - Activité Physique et Sportive- Santé" (J-AP2S), University of Toulon - CS 60584 - 83041 TOULON - Campus La Garde - France
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2
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Allred AR, Clark TK. A computational model of motion sickness dynamics during passive self-motion in the dark. Exp Brain Res 2024; 242:1127-1148. [PMID: 38489025 DOI: 10.1007/s00221-024-06804-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/08/2024] [Indexed: 03/17/2024]
Abstract
Predicting the time course of motion sickness symptoms enables the evaluation of provocative stimuli and the development of countermeasures for reducing symptom severity. In pursuit of this goal, we present an Observer-driven model of motion sickness for passive motions in the dark. Constructed in two stages, this model predicts motion sickness symptoms by bridging sensory conflict (i.e., differences between actual and expected sensory signals) arising from the Observer model of spatial orientation perception (stage 1) to Oman's model of motion sickness symptom dynamics (stage 2; presented in 1982 and 1990) through a proposed "Normalized Innovation Squared" statistic. The model outputs the expected temporal development of human motion sickness symptom magnitudes (mapped to the Misery Scale) at a population level, due to arbitrary, 6-degree-of-freedom, self-motion stimuli. We trained model parameters using individual subject responses collected during fore-aft translations and off-vertical axis of rotation motions. Improving on prior efforts, we only used datasets with experimental conditions congruent with the perceptual stage (i.e., adequately provided passive motions without visual cues) to inform the model. We assessed model performance by predicting an unseen validation dataset, producing a Q2 value of 0.91. Demonstrating this model's broad applicability, we formulate predictions for a host of stimuli, including translations, earth-vertical rotations, and altered gravity, and we provide our implementation for other users. Finally, to guide future research efforts, we suggest how to rigorously advance this model (e.g., incorporating visual cues, active motion, responses to motion of different frequency, etc.).
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Affiliation(s)
- Aaron R Allred
- Smead Department of Aerospace Engineering Sciences, University of Colorado-Boulder, Boulder, CO, USA.
| | - Torin K Clark
- Smead Department of Aerospace Engineering Sciences, University of Colorado-Boulder, Boulder, CO, USA
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Bawa Z, McCartney D, Bedoya-Pérez M, Lau NS, Fox R, MacDougall H, McGregor IS. Effects of cannabidiol on psychosocial stress, situational anxiety and nausea in a virtual reality environment: a protocol for a single-centre randomised clinical trial. BMJ Open 2024; 14:e082927. [PMID: 38531572 DOI: 10.1136/bmjopen-2023-082927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION The non-intoxicating plant-derived cannabinoid, cannabidiol (CBD), has demonstrated therapeutic potential in a number of clinical conditions. Most successful clinical trials have used relatively high (≥300 mg) oral doses of CBD. Relatively few studies have investigated the efficacy of lower (<300 mg) oral doses, typical of those available in over-the-counter CBD products. METHODS We present a protocol for a randomised, double-blind, placebo-controlled, parallel-group clinical trial investigating the effects of a low oral dose (150 mg) of CBD on acute psychosocial stress, situational anxiety, motion sickness and cybersickness in healthy individuals. Participants (n=74) will receive 150 mg of CBD or a matched placebo 90 min before completing three virtual reality (VR) challenges (tasks) designed to induce transient stress and motion sickness: (a) a 15 min 'Public Speaking' task; (b) a 5 min 'Walk the Plank' task (above a sheer drop); and (c) a 5 min 'Rollercoaster Ride' task. The primary outcomes will be self-reported stress and nausea measured on 100 mm Visual Analogue Scales. Secondary outcomes will include salivary cortisol concentrations, skin conductance, heart rate and vomiting episodes (if any). Statistical analyses will test the hypothesis that CBD reduces nausea and attenuates subjective, endocrine and physiological responses to stress compared with placebo. This study will indicate whether low-dose oral CBD has positive effects in reducing acute psychosocial stress, situational anxiety, motion sickness and cybersickness. ETHICS AND DISSEMINATION The University of Sydney Human Research Ethics Committee has granted approval (2023/307, version 1.6, 16 February 2024). Study findings will be disseminated in a peer-reviewed journal and at academic conferences. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12623000872639).
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Affiliation(s)
- Zeeta Bawa
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- The Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Danielle McCartney
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- The Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Miguel Bedoya-Pérez
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- The Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Namson S Lau
- The Boden Initiative, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Richard Fox
- Yellow Dog Man Studios s.r.o, Ostrava-jih-Zábřeh, Czechia
| | - Hamish MacDougall
- RPA Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Iain S McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- The Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
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Bannigan GM, de Sousa AA, Scheller M, Finnegan DJ, Proulx MJ. Potential factors contributing to observed sex differences in virtual-reality-induced sickness. Exp Brain Res 2024; 242:463-475. [PMID: 38170233 PMCID: PMC10805816 DOI: 10.1007/s00221-023-06760-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024]
Abstract
Virtual reality (VR) technology has been widely adopted for several professional and recreational applications. Despite rapid innovation in hardware and software, one of the long prevailing issues for end users of VR is the experience of VR sickness. Females experience stronger VR sickness compared to males, and previous research has linked susceptibility to VR sickness to the menstrual cycle (Munafo et al., Exp Brain Res 235(3):889-901). Here we investigated the female versus male experience in VR sickness while playing an immersive VR game, comparing days of the menstrual cycle when hormones peak: day 15 (ovulation-peak estrogen) and day 22 (mid-luteal phase-peak progesterone). We found that immersion duration was greater in the second session than the first, and discomfort was lessened, suggesting a powerful adaptation with repeated exposure. Due to the estrogen levels changing along with the exposure, there was no clear independent impact of that; note, though, that there was a significant difference between self-report and physiological measures implying that GSR is potentially an unreliable measure of motion sickness. Although prior work found a delay over 2 days between session would not allow adaptation and habituation to reduce VR sickness susceptibility, we found that a week delay has potential success.
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Affiliation(s)
- Grainne M Bannigan
- Department of Psychology, University of Bath, Bath, UK
- School of Public Health Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Alexandra A de Sousa
- Department of Psychology, University of Bath, Bath, UK
- School of Sciences, Bath Spa University, Bath, UK
- Department of Computer Science, REVEAL Research Centre, University of Bath, Bath, UK
| | | | - Daniel J Finnegan
- School of Computer Science and Informatics, Cardiff University, Cardiff, UK.
| | - Michael J Proulx
- Department of Psychology, University of Bath, Bath, UK.
- Department of Computer Science, REVEAL Research Centre, University of Bath, Bath, UK.
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Ugur E. Investigation of the Correlation Between the Visually Induced Motion Sickness Susceptibility Questionnaire and the Turkish Motion Sickness Susceptibility Questionnaire. J Audiol Otol 2024; 28:36-43. [PMID: 37857370 PMCID: PMC10808388 DOI: 10.7874/jao.2023.00122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/19/2023] [Accepted: 06/26/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Visually induced motion sickness (VIMS) is a phenomenon similar to motion sickness frequently observed in users of visual technologies. The Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ), developed by Golding et al. (2006), is considered the most effective scale for assessing VIMS susceptibility levels. The main purpose of this study was to standardize the selection of participants for research conducted with virtual reality, especially motion sickness (MS) research. To achieve this, first, the Turkish version of the VIMSSQ was created to establish its validity and reliability, and subsequently, its correlation with the Turkish Motion Sickness Susceptibility Questionnaire Short form (HDDA), the expanded version of the Motion Sickness Susceptibility Questionnaire Short form (MSSQ), was examined. Subjects and. METHODS Linguistic equivalence assessment was obtained from ten experts by passing the VIMSSQ through the translation process. The VIMSSQ and the Turkish MSSQ forms were then administered to 49 subjects. This study statistically analyzed the validity and reliability of the VIMSSQ and its relationship with the MSSQ. RESULTS Results showed that the Turkish version of the original questionnaire is highly reliable (Cronbach alpha=0.843). There is a moderate statistically significant positive correlation between the total MSSQ scores and the subfactors of the VIMSSQ. CONCLUSIONS In this study, VIMSSQ was successfully adapted to Turkish, normative data demonstrated its validity, and all sub-factors were highly reliable. The Turkish version of the VIMSSQ can serve as a valuable tool for estimating individual susceptibility to VIMS.
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Affiliation(s)
- Emel Ugur
- Istanbul Aydin University Institute of Graduate Study-Health Sciences Audiology, Istanbul, Türkiye
- Acibadem Mehmet Ali Aydinlar University Vocational School of Health Sciences Audiometry, Istanbul, Türkiye
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Lagami D, Gutkovich YE, Jamison A, Fonar Y, Tal D. Seasickness susceptibility and the vestibular time constant: a prospective study. Exp Brain Res 2024; 242:267-274. [PMID: 38015244 DOI: 10.1007/s00221-023-06745-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
Human passive motion during boat, car or airplane travel may trigger motion sickness. Seasickness is the most provoking manifestation of motion sickness. It imposes major constraints on quality of life and human performance. Based on seasickness susceptibility the population is usually categorized into susceptible (S) and non-susceptible (NS). During repeated exposure some susceptible individuals undergo habituation and obtain symptoms relief, reflecting a third group of habituating (H) individuals. Recently, accumulative evidence suggests that the vestibular time constant (Tc) is associated with motion sickness susceptibility and attenuation of symptoms. These studies demonstrated that repeated passive motion stimuli lead to temporary short-term (days) changes in Tc, whereas sea sickness habituation process lasts 3 to 6 months. Therefore, the goal of the present study was to examine the behavior of Tc during the entire span of the seasickness habituation process between the H, S and NS groups to find an objective test for seasickness severity prediction. Tc of 30 subjects was prospectively evaluated pre, 3 and 6 months post exposure to sea environment using a computerized rotatory chair system protocol. Seasickness severity was evaluated by Wiker questionnaire. Significantly shorter Tc was found in the S group compared with the NS and H groups. Further analysis revealed lower maximal Slow Phase Velocity (mSPV) and nystagmus frequency (total number of beats/second) in the S group. Our results suggest that Tc, mSPV and nystagmus frequency might serve as a prediction for seasickness severity. This study was retrospectively registered on December 7th 2022 and assigned the identifier number NCT05640258.
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Affiliation(s)
- Daniel Lagami
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), IDF Medical Corps, Box 22, Rambam Health Care Campus, P.O. Box 9602, 3109601, Haifa, Israel
| | - Yoni Evgeni Gutkovich
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), IDF Medical Corps, Box 22, Rambam Health Care Campus, P.O. Box 9602, 3109601, Haifa, Israel
- Department of Otolaryngology - Head and Neck Surgery, HaEmek Medical Centre, Afula, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Anna Jamison
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), IDF Medical Corps, Box 22, Rambam Health Care Campus, P.O. Box 9602, 3109601, Haifa, Israel
| | - Yuri Fonar
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), IDF Medical Corps, Box 22, Rambam Health Care Campus, P.O. Box 9602, 3109601, Haifa, Israel
- Shalvata Mental Health Centre, Hod Hasharon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dror Tal
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), IDF Medical Corps, Box 22, Rambam Health Care Campus, P.O. Box 9602, 3109601, Haifa, Israel.
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Lagami D, Shupak A, Jamison A, Tal D. The Vestibular Time Constant and Clinical Response to Antimotion Sickness Medication. Ear Hear 2023; 44:1404-1409. [PMID: 37221635 DOI: 10.1097/aud.0000000000001385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The therapeutic effects of antimotion sickness medications involve suppression of several components along the vestibular system. Scopolamine-based medications have proved to be the most effective anti-seasickness agents. However, there is high variability in individual responses. The vestibular nuclei, in which the vestibular time constant is modulated, contain acetylcholine receptors which are affected by scopolamine. The hypothesis of the study was that successful seasickness prevention by scopolamine requires vestibular suppression to be reflected by the shortening of the vestibular time constant. DESIGN Subjects were 30 naval crew members suffering from severe seasickness and were treated with oral scopolamine. The study participants were defined as responsive or non-responsive to the anti-seasickness medication according to the clinical outcome: successful response to scopolamine was defined as a reduction of seasickness severity from the highest score of 7 according to the Wiker scale to 4 or less. Scopolamine and placebo were assigned to each subject in a crossover, double-blind design. The horizontal semicircular canal time constant was evaluated by a computerized rotatory chair before, 1 and 2 hours after drug or placebo administration. RESULTS The vestibular time constant was significantly shortened from 16.01 ± 3.43 seconds to 12.55 ± 2.40 seconds ( p < 0.001) in the scopolamine-responsive group but not in the nonresponsive group. In contrast, vestibular time constant values were 13.73 ± 4.08 and 12.89 ± 4.48 for baseline and 2 hours measurements, respectively. This change was not statistically significant. CONCLUSIONS Reduction in the vestibular time constant after scopolamine administration can be used to predict whether motion sickness alleviation will occur. This will enable the administration of appropriate pharmaceutical treatment without the need for prior exposure to sea conditions.
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Affiliation(s)
- Daniel Lagami
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - Avi Shupak
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Unit of Otoneurology, Lin Medical Center, Haifa, Israel
- Department of Communication Science and Disorders, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Anna Jamison
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel
| | - Dror Tal
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Nunes CP, Rodrigues C, Suchmacher M, Esteves CR, Gonçalves K, Rzetelna H, Rodrigues RV, de Vasconcelos LR, Mezitis SG, Rabelo H, Kaufmann R, Schwarz F, Goldberg H, Sintoveter A, Geller M. A Combination of Gamma-Aminobutyric Acid, Glutamic Acid, Calcium, Thiamine, Pyridoxine, and Cyanocobalamin vs Ginger Extract in the Management of Chronic Motion Sickness: A Clinical Evaluation. CURRENT THERAPEUTIC RESEARCH 2023; 99:100719. [PMID: 38021267 PMCID: PMC10630771 DOI: 10.1016/j.curtheres.2023.100719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023]
Abstract
Background Motion sickness (kinetosis) is a common and temporarily incapacitant ailment, manageable with behavioral as well as pharmacological measures. Objective To assess the effectiveness and safety of a combination of gamma-aminobutyric acid, glutamic acid, calcium, thiamine, pyridoxine, and cyanocobalamin (Group A) (n = 170) and extract of Zingiber officinale (ginger) (Group B) (n = 165) in the management of chronic complaints consistent with motion sickness. Methods Both groups were tested according to the following end points, under self-paired as well as comparative study designs: reduction of ≥20 score points in the total motion sickness assessment questionnaire (MSAQ) score, percentage of patients presenting a reduction of the total MSAQ score, absolute MSAQ score reduction, physician's assessment scores, final overall assessment of study medication, and willingness to continue treatment. Safety was also evaluated. Results There was a statistically significant better performance under both study designs for Group A (P = 0.05 using different statistical tests) in all end points. Both regimens were safe, with different neurological and gastrointestinal tolerability outcomes. Conclusions Group A and Group B regimens were effective and safe in the management of chronic complaints consistent with motion sickness and the Group A regimen was more effective than Group B.
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Affiliation(s)
- Carlos P. Nunes
- Centro Universitário Serra Dos Órgãos, Rio de Janeiro, Brazil
| | | | - Mendel Suchmacher
- Instituto de Pós-graduação Médica Carlos Chagas, Rio de Janeiro, Brazil
| | | | | | - Hélio Rzetelna
- Universidade Estácio de Sá. Faculdade de Medicina, RJ, Rio de Janeiro, Brazil
| | | | | | | | - Heros Rabelo
- Instituto Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Renato Kaufmann
- Instituto Estadual de Cardiologia Aloysio de Carvalho, Rio de Janeiro, Brazil
| | | | | | | | - Mauro Geller
- Centro Universitário Serra Dos Órgãos, Rio de Janeiro, Brazil
- Instituto de Pós-graduação Médica Carlos Chagas, Rio de Janeiro, Brazil
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Benelli A, Neri F, Cinti A, Pasqualetti P, Romanella SM, Giannotta A, De Monte D, Mandalà M, Smeralda C, Prattichizzo D, Santarnecchi E, Rossi S. Frequency-Dependent Reduction of Cybersickness in Virtual Reality by Transcranial Oscillatory Stimulation of the Vestibular Cortex. Neurotherapeutics 2023; 20:1796-1807. [PMID: 37721646 PMCID: PMC10684476 DOI: 10.1007/s13311-023-01437-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 09/19/2023] Open
Abstract
Virtual reality (VR) applications are pervasive of everyday life, as in working, medical, and entertainment scenarios. There is yet no solution to cybersickness (CS), a disabling vestibular syndrome with nausea, dizziness, and general discomfort that most of VR users undergo, which results from an integration mismatch among visual, proprioceptive, and vestibular information. In a double-blind, controlled trial, we propose an innovative treatment for CS, consisting of online oscillatory imperceptible neuromodulation with transcranial alternating current stimulation (tACS) at 10 Hz, biophysically modelled to reach the vestibular cortex bilaterally. tACS significantly reduced CS nausea in 37 healthy subjects during a VR rollercoaster experience. The effect was frequency-dependent and placebo-insensitive. Subjective benefits were paralleled by galvanic skin response modulation in 25 subjects, addressing neurovegetative activity. Besides confirming the role of transcranially delivered oscillations in physiologically tuning the vestibular system function (and dysfunction), results open a new way to facilitate the use of VR in different scenarios and possibly to help treating also other vestibular dysfunctions.
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Affiliation(s)
- Alberto Benelli
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Francesco Neri
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- Oto-Neuro-Tech Conjoined Lab, Policlinico Le Scotte, University of Siena, Siena, Italy
| | - Alessandra Cinti
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | | | - Sara M Romanella
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- Precision Neuroscience & Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alessandro Giannotta
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - David De Monte
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Marco Mandalà
- Oto-Neuro-Tech Conjoined Lab, Policlinico Le Scotte, University of Siena, Siena, Italy
- Otolaryngology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Carmelo Smeralda
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Domenico Prattichizzo
- Oto-Neuro-Tech Conjoined Lab, Policlinico Le Scotte, University of Siena, Siena, Italy
- Siena Robotics and Systems (SiRS) Lab, Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | - Emiliano Santarnecchi
- Precision Neuroscience & Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Simone Rossi
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
- Oto-Neuro-Tech Conjoined Lab, Policlinico Le Scotte, University of Siena, Siena, Italy.
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10
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Özçelik P, Koçoğlu K, Halmágyi GM, Akdal G. Video head impulse and suppression head impulse test in vestibular migraine. Acta Otolaryngol 2023; 143:856-860. [PMID: 38071651 DOI: 10.1080/00016489.2023.2284877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/08/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Vestibular Migraine (VM) is a frequent cause of recurrent spontaneous vertigo. While some report a normal Video Head Impulse Test (vHIT) in VM, others observed abnormal results on this test. Whether or not methodological discrepancies could be the cause of these differences is not known. There are 2 vHIT methods: subjects fixating an earth-fixed target (HIMP paradigm) or a head-fixed target, the suppression head impulse test (SHIMP paradigm). OBJECTIVES The present study aimed to compare VM patients against healthy controls on both HIMP and SHIMP in order to unravel any differences between them. METHODS Forty-eight VM patients and 27 healthy controls tested with both the HIMP and SHIMP paradigm. Results: Our 48 VM patients showed mean VOR normal range gains in both the HIMP and SHIMP paradigms, although there were some VOR impairments in individual semicircular SCCs. VM patients with motion sickness had lower horizontal VOR gain than those without motion sickness, with the HIMP, but not the SHIMP paradigm. CONCLUSION VM patients have normal VOR gain with either vHIT paradigm. SIGNIFICANCE The clinical significance of this observation is that a definitely abnormal vHIT with either method is unlikely to be due to vestibular migraine and an alternative diagnosis should be sought.
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Affiliation(s)
- Pınar Özçelik
- Institute of Health Sciences, Department of Neurosciences, Dokuz Eylül University, Izmir, Türkiye
- Faculty of Medicine, Department of Neurology, Bezmialem Vakif University, Istanbul, Türkiye
| | - Koray Koçoğlu
- Institute of Health Sciences, Department of Neurosciences, Dokuz Eylül University, Izmir, Türkiye
| | - Gábor M Halmágyi
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
- Central Clinical School, University of Sydney, Sydney, Australia
| | - Gülden Akdal
- Institute of Health Sciences, Department of Neurosciences, Dokuz Eylül University, Izmir, Türkiye
- Faculty of Medicine, Department of Neurology, Dokuz Eylül University, Izmir, Türkiye
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Solomon D, Morka G, Wayessa ZJ. Determinants of hyperemesis gravidarum among pregnant women in public hospitals of Guji, West Guji, and Borana zones, Oromia, Ethiopia, 2022. SAGE Open Med 2023; 11:20503121231196713. [PMID: 37701795 PMCID: PMC10493065 DOI: 10.1177/20503121231196713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
Objectives Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy sufficiently enough to produce weight loss greater than 5%, dehydration, ketosis, alkalosis, and hypokalemia. Several studies have investigated risk factors for hyperemesis gravidarum in Ethiopia, but the studies have reported conflicting results attributed to study design, lack of proper sample size, and the selection of variables. This study aimed to assess the determinants of hyperemesis gravidarum among pregnant women in public hospitals of Guji, West Guji, and Borana zones, Southern Ethiopia, 2022. Methods An institutional-based case-control study design was conducted from April 15 to June 15, 2022 with a ratio of 1:2 (103 cases and 206 controls). Cases were all pregnant women admitted with a diagnosis of hyperemesis gravidarum by a clinician while controls were pregnant women who were visiting antenatal care services at the same time. Cases were selected consecutively until the required sample size is attained, while controls were selected by a simple random sampling technique. Data were collected using structured questionnaires with face-to-face interviews. The collected data were cleaned, coded, and entered into EpiData version 3.1, and then exported to SPSS version 25 for analysis. Frequency distribution for categorical variables, median, and interquartile range for continuous variables was computed. Backward stepwise logistic regression analyses were done. A significant association was declared with a 95% confidence interval at a p value less than 0.05. Results Those mothers who had antenatal follow-up (adjusted odds ratio = 0.082, 95% confidence interval: 0.037-0.180), pregnancy with multiple gestations (adjusted odds ratio = 3.557, 95% confidence interval: 1.387-9.126), previous history of hyperemesis gravidarum (adjusted odds ratio = 6.66, 95% confidence interval: 2.57-17.26), family history of hyperemesis gravidarum (adjusted odds ratio = 2.067, 95% confidence interval: 1.067-4.015), and those women had exercised before pregnancy (adjusted odds ratio = 0.352, 95% confidence interval: 0.194-0.639) were determinants of hyperemesis gravidarum. Conclusion Antenatal follow-up, number of the fetus, previous and family history of hyperemesis gravidarum, and exercise before pregnancy were significantly associated with outcome. Lifestyle modification, early treatment, and early ultrasound scans for pregnant women are crucial to reducing the burden of hyperemesis gravidarum.
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Affiliation(s)
- Demelash Solomon
- Department of Midwifery, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Geroma Morka
- Department of Nursing, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
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12
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Allred AR, Clark TK. A computational model of motion sickness dynamics during passive self-motion in the dark. Exp Brain Res 2023; 241:2311-2332. [PMID: 37589937 DOI: 10.1007/s00221-023-06684-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023]
Abstract
Predicting the time course of motion sickness symptoms enables the evaluation of provocative stimuli and the development of countermeasures for reducing symptom severity. In pursuit of this goal, we present an observer-driven model of motion sickness for passive motions in the dark. Constructed in two stages, this model predicts motion sickness symptoms by bridging sensory conflict (i.e., differences between actual and expected sensory signals) arising from the observer model of spatial orientation perception (stage 1) to Oman's model of motion sickness symptom dynamics (stage 2; presented in 1982 and 1990) through a proposed "Normalized innovation squared" statistic. The model outputs the expected temporal development of human motion sickness symptom magnitudes (mapped to the Misery Scale) at a population level, due to arbitrary, 6-degree-of-freedom, self-motion stimuli. We trained model parameters using individual subject responses collected during fore-aft translations and off-vertical axis of rotation motions. Improving on prior efforts, we only used datasets with experimental conditions congruent with the perceptual stage (i.e., adequately provided passive motions without visual cues) to inform the model. We assessed model performance by predicting an unseen validation dataset, producing a Q2 value of 0.86. Demonstrating this model's broad applicability, we formulate predictions for a host of stimuli, including translations, earth-vertical rotations, and altered gravity, and we provide our implementation for other users. Finally, to guide future research efforts, we suggest how to rigorously advance this model (e.g., incorporating visual cues, active motion, responses to motion of different frequency, etc.).
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Affiliation(s)
- Aaron R Allred
- Smead Department of Aerospace Engineering Sciences, University of Colorado-Boulder, Boulder, CO, USA.
| | - Torin K Clark
- Smead Department of Aerospace Engineering Sciences, University of Colorado-Boulder, Boulder, CO, USA
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13
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Lindström VS, Laitinen LM, Nurmi JMA, Koivisto MA, Polo‐Kantola P. Hyperemesis gravidarum: Associations with personal and family history of nausea. Acta Obstet Gynecol Scand 2023; 102:1176-1182. [PMID: 37431247 PMCID: PMC10407014 DOI: 10.1111/aogs.14629] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/13/2023] [Accepted: 06/18/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION The pathogenesis and risk factors for hyperemesis gravidarum, excessive nausea and vomiting of pregnancy, are not adequately recognized. In our previous study, we found that women with a personal history of nausea in different situations and a family history of nausea and vomiting of pregnancy (NVP) were more likely to have severe NVP. The present study focuses on these themes in association with hyperemesis gravidarum in a hospital setting. MATERIAL AND METHODS Women with hyperemesis gravidarum (n = 102) were recruited from among patients hospitalized due to hyperemesis gravidarum in Turku University Hospital, Finland. Our control group (Non-NVP group, n = 138) consisted of pregnant women with no NVP. Personal history of nausea in different situations was inquired about in relation to "motion sickness", "seasickness", "migraine", "other kind of headache", "after anesthesia", "during the use of contraception", and "other kinds of nausea". Relatives with NVP were divided into first-degree (mother and sisters) and second-degree (more distant) relatives. RESULTS In univariate analysis, a personal history of motion sickness, seasickness, nausea related to migraine, nausea with other headache and nausea in other situations were associated with hyperemesis gravidarum. After adjusting for age, parity, pre-pregnancy body mass index, marital status, and smoking, motion sickness (adjusted odds ratio [aOR] 5.24, 95% confidence interval [CI] 2.67-10.31, p < 0.0001), seasickness (aOR 4.82, 95% CI 2.32-10.03, p < 0.0001), nausea related to migraine (aOR 3.00, 95% CI 1.58-5.70, p < 0.001), and nausea in other situations (aOR 2.65, 95% CI 1.13-6.20, p = 0.025) remained significant. In multivariable analysis with all history of nausea variables, motion sickness (OR 2.76, 95% CI 1.29-5.89, p = 0.009) and nausea related to migraine (OR 3.10, 95% CI 1.40-6.86, p = 0.005) were associated with hyperemesis gravidarum. Having any affected relative (OR 3.51, 95%CI 1.84-6.73, p = 0.0002), especially a first-degree relative (OR 3.06, 95% CI 1.62-5.79, p = 0.0006), was also associated with hyperemesis gravidarum. Adjustment did not change the results. CONCLUSIONS Women with a personal history of nausea or a family history of NVP are more likely to suffer from hyperemesis gravidarum. These results are beneficial to better identify and help women at risk for hyperemesis gravidarum.
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Affiliation(s)
- Venla S. Lindström
- Department of Obstetrics and GynecologyTurku University Hospital and University of TurkuTurkuFinland
| | - Linda M. Laitinen
- University of TurkuTurkuFinland
- The Wellbeing Services County of Central Finland, Department of Obstetrics and GynecologyHospital Nova of Central FinlandJyväskyläFinland
| | | | | | - Päivi Polo‐Kantola
- Department of Obstetrics and GynecologyTurku University Hospital and University of TurkuTurkuFinland
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14
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Barrow J, Hurst W, Edman J, Ariesen N, Krampe C. Virtual reality for biochemistry education: the cellular factory. EDUCATION AND INFORMATION TECHNOLOGIES 2023:1-26. [PMID: 37361784 PMCID: PMC10182538 DOI: 10.1007/s10639-023-11826-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/11/2023] [Indexed: 06/28/2023]
Abstract
Virtual Reality (VR) involves the coupling of visual communication hardware and software. The technology is capable of offering transformative educational practice and is increasingly being adopted within the biochemistry domain to better understand complex biochemical processes. This article documents a pilot study for the efficacy of VR in biochemistry education at undergraduate university level, focusing on the citric acid cycle: a central process for extracting energy in most cellular life forms. 10 participants were equipped with a VR headset and electrodermal activity (EDA) sensors, then immersed within a digital environment where they were able to learn the 8 main steps of the citric acid cycle within a virtual lab by completing 8 levels of activity. Post and pre surveys were taken, along with EDA readings throughout the students' interaction with VR. Research findings support the hypothesis that VR increase students' understanding, particularly if students feel engaged, stimulated and intend to use the technology. Moreover, EDA analysis indicated that the majority of participants demonstrate enhanced engagement in the education-based VR-experience as measured by elevated levels of skin conductance, a marker for autonomic arousal and a measure of engagement in an activity.
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Affiliation(s)
- John Barrow
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, AB25 2ZD UK
| | - William Hurst
- Information Technology Group, Wageningen University and Research, Leeuwenborch, Hollandseweg 1, 6706 KN Wageningen, the Netherlands
| | - Joakim Edman
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, AB25 2ZD UK
| | - Natasja Ariesen
- Information Technology Group, Wageningen University and Research, Leeuwenborch, Hollandseweg 1, 6706 KN Wageningen, the Netherlands
| | - Caspar Krampe
- Marketing and Consumer Behaviour Group, Wageningen University and Research, Leeuwenborch, Hollandseweg 1, 6706 KN Wageningen, the Netherlands
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15
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Ramaioli C, Steinmetzer T, Brietzke A, Meyer P, Pham Xuan R, Schneider E, Gorges M. Assessment of vestibulo-ocular reflex and its adaptation during stop-and-go car rides in motion sickness susceptible passengers. Exp Brain Res 2023; 241:1523-1531. [PMID: 37097301 DOI: 10.1007/s00221-023-06619-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
Motion sickness is a physiological condition that negatively impacts a person's comfort and will be an emerging condition in autonomous vehicles without proper countermeasures. The vestibular system plays a key role in the origin of motion sickness. Understanding the susceptibility and (mal) adaptive mechanisms of the highly integrated vestibular system is a prerequisite for the development of countermeasures. We hypothesize a differential association between motion sickness and vestibular function in healthy individuals with and without susceptibility for motion sickness. We quantified vestibular function by measuring the high-frequency vestibulo-ocular reflex (VOR) using video head impulse testing (vHIT) in 17 healthy volunteers before and after a 11 min motion sickness-inducing naturalistic stop-and-go car ride on a test track (Dekra Test Oval, Klettwitz, Germany). The cohort was classified as motion sickness susceptible (n = 11) and non-susceptible (n = 6). Six (out of 11) susceptible participants developed nausea symptoms, while a total of nine participants were free of these symptoms. The VOR gain (1) did not differ significantly between participant groups with (n = 8) and without motion sickness symptoms (n = 9), (2) did not differ significantly in the factor time before and after the car ride, and showed no interaction between symptom groups and time, as indicated by a repeated measures ANOVA (F(1,15) = 2.19, p = 0.16. Bayesian inference confirmed that there was "anecdotal evidence" for equality of gain rather than difference across groups and time (BF10 < 0.77). Our results suggest that individual differences in VOR measures or adaptation to motion sickness provocative stimuli during naturalistic stop-and-go driving cannot predict motion sickness susceptibility or the likelihood of developing motion sickness.
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Affiliation(s)
- Cecilia Ramaioli
- Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany
| | - Tobias Steinmetzer
- Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany
| | - Adrian Brietzke
- Ergonomics and Innovation, Chemnitz University of Technology, Chemnitz, Germany
- Group Innovation, Volkswagen AG, Wolfsburg, Germany
| | - Paul Meyer
- Fraunhofer Institute for Ceramic Technologies and Systems, Dresden, Germany
| | | | - Erich Schneider
- Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany
| | - Martin Gorges
- Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany.
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16
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Varangot-Reille C, Sanger GJ, Andrews PLR, Herranz-Gomez A, Suso-Martí L, de la Nava J, Cuenca-Martínez F. Neural networks involved in nausea in adult humans: A systematic review. Auton Neurosci 2023; 245:103059. [PMID: 36580746 DOI: 10.1016/j.autneu.2022.103059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/20/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Nausea is a common clinical symptom, poorly managed with anti-emetic drugs. To identify potential brain regions which may be therapeutic targets we systematically reviewed brain imaging in subjects reporting nausea. The systematic review followed PRISMA statements with methodological quality (MINORS) and risk of bias (ROBINS-I) assessed. Irrespective of the nauseagenic stimulus the common (but not only) cortical structures activated were the inferior frontal gyrus (IFG), the anterior cingulate cortex (ACC) and the anterior insula (AIns) with some evidence for lateralization (Left-IFG, Right-AIns, Right-ACC). Basal ganglia structures (e.g., putamen) were also consistently activated. Inactivation was rarely reported but occurred mainly in the cerebellum and occipital lobe. During nausea, functional connectivity increased, mainly between the posterior and mid- cingulate cortex. Limitations include, a paucity of studies and stimuli, subject demographics, inconsistent definition and measurement of nausea. Structures implicated in nausea are discussed in the context of knowledge of central pathways for interoception, emotion and autonomic control. Comparisons are made between nausea and other aversive sensations as multimodal aversive conscious experiences.
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Affiliation(s)
- C Varangot-Reille
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - G J Sanger
- Center for Neuroscience, Surgery and Trauma, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - P L R Andrews
- Division of Biomedical Sciences, St George's University of London, London, United Kingdom
| | - A Herranz-Gomez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - L Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
| | - J de la Nava
- Faculty of Medicine, University of Granada, Granada, Spain
| | - F Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
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17
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de’Sperati C, Dalmasso V, Moretti M, Høeg ER, Baud-Bovy G, Cozzi R, Ippolito J. Enhancing Visual Exploration through Augmented Gaze: High Acceptance of Immersive Virtual Biking by Oldest Olds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1671. [PMID: 36767037 PMCID: PMC9914324 DOI: 10.3390/ijerph20031671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
The diffusion of virtual reality applications dedicated to aging urges us to appraise its acceptance by target populations, especially the oldest olds. We investigated whether immersive virtual biking, and specifically a visuomotor manipulation aimed at improving visual exploration (augmented gaze), was well accepted by elders living in assisted residences. Twenty participants (mean age 89.8 years, five males) performed three 9 min virtual biking sessions pedalling on a cycle ergometer while wearing a Head-Mounted Display which immersed them inside a 360-degree pre-recorded biking video. In the second and third sessions, the relationship between horizontal head rotation and contingent visual shift was experimentally manipulated (augmented gaze), the visual shift being twice (gain = 2.0) or thrice (gain = 3.0) the amount of head rotation. User experience, motion sickness and visual exploration were measured. We found (i) very high user experience ratings, regardless of the gain; (ii) no effect of gain on motion sickness; and (iii) increased visual exploration (slope = +46%) and decreased head rotation (slope = -18%) with augmented gaze. The improvement in visual exploration capacity, coupled with the lack of intolerance signs, suggests that augmented gaze can be a valuable tool to improve the "visual usability" of certain virtual reality applications for elders, including the oldest olds.
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Affiliation(s)
- Claudio de’Sperati
- Laboratory of Action, Perception and Cognition, School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Vittorio Dalmasso
- Laboratory of Action, Perception and Cognition, School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Michela Moretti
- Laboratory of Action, Perception and Cognition, School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Emil Rosenlund Høeg
- Multisensory Experience Laboratory, Department of Architecture, Design and Media Technology, Aalborg University, 2450 Copenhagen, Denmark
| | - Gabriel Baud-Bovy
- Laboratory of Action, Perception and Cognition, School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Roberto Cozzi
- RSA San Giuseppe, Associazione Monte Tabor, 20132 Milan, Italy
| | - Jacopo Ippolito
- RSA San Giuseppe, Associazione Monte Tabor, 20132 Milan, Italy
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18
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Vestibular dysfunction amongst adolescents: what do we know? A review. J Laryngol Otol 2023; 137:2-6. [PMID: 35616060 DOI: 10.1017/s0022215122001268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Vestibular dysfunction in children is a debilitating condition that results in countless pernicious effects, such as motor development delay, poor academic performance and psychosocial impairment. Yet, research pertaining to vestibular and balance disorders amongst adolescents is still lacking and remains an enigma. METHODS This paper outlines novel emerging aetiological factors contributing to vestibular dysfunction amongst adolescents by appraising published articles through a narrative review. RESULTS Underlying aetiological factors of vestibular dysfunction can be identified among adolescents with thorough evaluation. Proper diagnostic evaluation of vestibular dysfunction is imperative in providing optimal care and guiding appropriate treatment strategies. The available literature demonstrated multifactorial aetiological factors that contribute to vestibular dysfunction in adolescents. CONCLUSION Outlining the underlying aetiological factors of vestibular dysfunction is vital to ensure that patients receive appropriate care and treatment.
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19
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Jakus G, Sodnik J, Miljković N. Electrogastrogram-Derived Features for Automated Sickness Detection in Driving Simulator. SENSORS (BASEL, SWITZERLAND) 2022; 22:8616. [PMID: 36433213 PMCID: PMC9694768 DOI: 10.3390/s22228616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/27/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
The rapid development of driving simulators for the evaluation of automated driving experience is constrained by the simulator sickness-related nausea. The electrogastrogram (EGG)-based approach may be promising for immediate, objective, and quantitative nausea assessment. Given the relatively high EGG sensitivity to noises associated with the relatively low amplitude and frequency spans, we introduce an automated procedure comprising statistical analysis and machine learning techniques for EGG-based nausea detection in relation to the noise contamination during automated driving simulation. We calculate the root mean square of EGG amplitude, median and dominant frequencies, magnitude of Power Spectral Density (PSD) at dominant frequency, crest factor of PSD, and spectral variation distribution along with newly introduced parameters: sample and spectral entropy, autocorrelation zero-crossing, and parameters derived from the Poincaré diagram of consecutive EGG samples. Results showed outstanding robustness of sample entropy with moderate robustness of autocorrelation zero-crossing, dominant frequency, and its median. Machine learning reached an accuracy of 88.2% and revealed sample entropy as one of the most relevant and robust parameters, while linear analysis highlighted spectral entropy, spectral variation distribution, and crest factor of PSD. This study clearly indicates the need for customized feature selection in noisy environments, as well as a complementary approach comprising machine learning and statistical analysis for efficient nausea detection.
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Affiliation(s)
- Grega Jakus
- Faculty of Electrical Engineering, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Jaka Sodnik
- Faculty of Electrical Engineering, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Nadica Miljković
- Faculty of Electrical Engineering, University of Ljubljana, 1000 Ljubljana, Slovenia
- School of Electrical Engineering, University of Belgrade, 11000 Belgrade, Serbia
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20
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Arnardottir NY, Jonsdottir SS, Petersen H. Seasickness among Icelandic seamen. PLoS One 2022; 17:e0273477. [PMID: 36018861 PMCID: PMC9416988 DOI: 10.1371/journal.pone.0273477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction The working environment abroad a ship is unique, with constant stimuli such as rolling of the vessel, noise, and vibration. Fishing industry is important for Icelandic economy, still the effect of seasickness-related symptoms on seamen´s health is not fully understood. Thus, the objective of this study is to explore the impact of seasickness-related symptoms, i.e., seasickness, seasickness symptoms and mal de débarquement on seaman´s health, and how their working environment may affect those factors. Methods Cross-sectional data was collected from 262 seamen answering questionnaire. Majority of the seamen participated while attending a compulsory course held by the Maritime Safety and Survival Training Centre. The majority of participants were men. A chi-square test was used to detect the difference between variables. Results The majority of seamen had experienced seasickness (87.8%) or mal de débarquement (85.8%). Having a history of tension headache (38.1%) and tinnitus (37.9%) was quite common. A total of 30.6% of the participants had been admitted to hospital once or more due to mishaps or accidents on land. Discussion Seasickness and seasickness symptoms together with mal de débarquement are common in Icelandic seamen. Working conditions at sea are demanding and seam to affect the seamen´s health both at sea and ashore, making further research needed.
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Affiliation(s)
| | | | - Hannes Petersen
- Department of Anatomy, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Surgery, Akureyri Hospital, Akureyri, Iceland
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21
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Yu J, Wan Y, Zhao J, Huang R, Wu P, Li W. Normative data for rotational chair considering motion susceptibility. Front Neurol 2022; 13:978442. [PMID: 36071903 PMCID: PMC9441918 DOI: 10.3389/fneur.2022.978442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
Objective Rotational Chair Test (RCT) is considered one of the most critical measures for vestibular functionality, which generally includes the sinusoidal harmonic acceleration test (SHAT), velocity step test (VST), and visual suppression (VS). The purpose of this study was to establish normal values for different age groups on the RCT and investigate whether motion susceptibility, such as with a history of motion sickness or migraine, has any effects on test metrics. Methods One hundred and nine subjects aged from 20 to 59 years who were free from neurotological and vestibular disorders were enrolled. According to the history of motion sickness or migraine, participants were divided into four groups: the motion sickness (MS) group (n = 13), the migraine group (n = 8), comorbidity group (n = 11), and the control group (n = 77). The 77 subjects without any history of MS and migraine were then further separated into four age groups: youth group (20–29 years), young and middle-aged group (30–39 years), middle-age group (40–49 years), and middle-age and elderly group (50–59 years). All participants underwent SHAT, VST, and VS, and a comprehensive set of metrics including gain, phase, asymmetry, time constant (TC), and Fixation Index were recorded. Results Regarding the VST and VS, no significant differences were observed either across the four groups (MS, migraine, comorbidity, and control group) or four age categories within the control group. For SHAT, VOR gain at the frequency of 0.01 Hz, VOR phase from 0.08 to 0.64 Hz, and asymmetry at 0.01, 0.16, and 0.64 Hz indicated significant differences among various age groups (P < 0.05 for all comparisons). The VOR phase lead was lower in the migraine and comorbidity group than that in the control group at 0.64 Hz (P = 0.027, P = 0.003, respectively). Conclusions Age slightly affects the result of SHAT, but not for VST and VS. VOR gain is more susceptible to aging at low frequency, while the phase is opposite. Subjects with both migraine and motion sickness show abnormal velocity storage mechanisms. Phase bias should be considered when assessing motion susceptibility with the RCT. SHAT is more sensitive than VST in terms of reflecting motion susceptibility.
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Affiliation(s)
- Jiaodan Yu
- Ear Nose Throat (ENT) Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Yi Wan
- Ear Nose Throat (ENT) Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Jieli Zhao
- Ear Nose Throat (ENT) Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Ruonan Huang
- Ear Nose Throat (ENT) Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Peixia Wu
- Ear Nose Throat (ENT) Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Nursing Department of Eye and ENT Hospital, Fudan University, Shanghai, China
- *Correspondence: Peixia Wu
| | - Wenyan Li
- Ear Nose Throat (ENT) Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- National Health Commission Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China
- Wenyan Li
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22
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An Immersive Virtual Reality Curriculum for Pediatric Hematology Clinicians on Shared Decision-making for Hydroxyurea in Sickle Cell Anemia. J Pediatr Hematol Oncol 2022; 44:e799-e803. [PMID: 35319512 PMCID: PMC8943226 DOI: 10.1097/mph.0000000000002289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/25/2021] [Indexed: 11/25/2022]
Abstract
Although hydroxyurea (HU) is an effective treatment for sickle cell anemia, uptake remains low. Shared decision-making (SDM) is a recommended strategy for HU initiation to elicit family preferences; however, clinicians lack SDM training. We implemented an immersive virtual reality (VR) curriculum at 8 pediatric institutions to train clinicians on SDM that included counseling virtual patients. Clinicians' self-reported confidence significantly improved following the VR simulations on all communication skills assessed, including asking open-ended questions, eliciting specific concerns, and confirming understanding (Ps≤0.01 for all). VR may be an effective method for educating clinicians to engage in SDM for HU.
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Double-blind randomized N-of-1 trial of transcranial alternating current stimulation for mal de débarquement syndrome. PLoS One 2022; 17:e0263558. [PMID: 35120184 PMCID: PMC8815977 DOI: 10.1371/journal.pone.0263558] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background Mal de Débarquement Syndrome (MdDS) is a medically refractory neurotological disorder characterized by persistent oscillating vertigo that follows a period of entrainment to oscillating motion such as experienced during sea or air travel. Fronto-occipital hypersynchrony may correlate with MdDS symptom severity. Materials and methods Individuals with treatment refractory MdDS lasting at least 6 months received single administrations of three fronto-occipital transcranial alternating current stimulation (tACS) protocols in an “n-of-1” double-blind randomized design: alpha frequency anti-phase, alpha-frequency in-phase, and gamma frequency control. Baseline assessments were made on Day 1. The treatment protocol that led to the most acute reduction in symptoms during a test session on Day 2 was administered for 10–12 stacked sessions given on Days 3 through 5 (20-minutes at 2-4mA). Pre to post symptom changes were assessed on Day 1 and Day 5. Participants who could clearly choose a preferred protocol on Day 2 did better on Day 5 than those who could not make a short-term determination on Day 2 and either chose a protocol based on minimized side effects or were randomized to one of the three protocols. In addition, weekly symptom assessments were made for four baseline and seven post stimulation points for the Dizziness Handicap Inventory (DHI), MdDS Balance Rating Scale (MBRS), and Hospital Anxiety and Depression Scale (HADS). Results Of 24 participants, 13 chose anti-phase, 7 chose in-phase, and 4 chose control stimulation. Compared to baseline, 10/24 completers noted ≥ 25% reduction, 5/24 ≥50% reduction, and 2/24 ≥75% reduction in oscillating vertigo intensity from Day 1 to Day 5. Stimulating at a frequency slightly higher than the individual alpha frequency (IAF) was better than stimulating at exactly the IAF, and slightly better than stimulating with a strategy of standardized stimulation at 10Hz. A one-way repeated measures ANOVA of weekly DHI, MBRS, and HADS measurements showed significant reductions immediately after treatment with improvement increasing through post-treatment week 6. Conclusion Fronto-occipital tACS may be effective in reducing the oscillating vertigo of MdDS and serve as a portable neuromodulation alternative for longer-term treatment. Stimulation frequency relative to the IAF may be important in determining the optimum treatment protocol [ClinicalTrials.gov study NCT02540616. https://clinicaltrials.gov/ct2/show/NCT02540616].
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Giacon TA, Bosco G, Vezzoli A, Dellanoce C, Cialoni D, Paganini M, Mrakic-Sposta S. Oxidative stress and motion sickness in one crew during competitive offshore sailing. Sci Rep 2022; 12:1142. [PMID: 35064225 PMCID: PMC8782845 DOI: 10.1038/s41598-022-05219-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/10/2022] [Indexed: 12/31/2022] Open
Abstract
Competitive Offshore Ocean Sailing is a highly demanding activity in which subjects are exposed to psychophysical stressors for a long time. To better define the physiological adaptations, we investigated the stress response of subjects exposed to 3-days long ocean navigation with disruption of circadian rhythms. 6 male subjects were involved in the study and provided urine and saliva samples before setting sail, during a single day of inshore sailing, during 3-days long ocean navigation, and at the arrival, to measure oxidative stress, cortisol, nitric oxide metabolites (NOx) and metabolic response. Motion Sickness questionnaires were also administered during the navigation. The crew suffered a mean weight loss of 1.58 kg. After the long navigation, a significant increase in ROS production and decrease in total antioxidant capacity and uric acid levels were observed. Lipid peroxidation, NO metabolites, ketones, creatinine, and neopterin levels were also increased. Furthermore, a significant increase in cortisol levels was measured. Finally, we found a correlation between motion sickness questionnaires with the increase of NOx, and no correlation with cortisol levels. Physical and psychological stress response derived from offshore sailing resulted in increased oxidative stress, nitric oxide metabolites, and cortisol levels, unbalanced redox status, transient renal function impairment, and ketosis. A direct correlation between motion sickness symptoms evaluated through questionnaires and NOx levels was also found.
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Affiliation(s)
- Tommaso Antonio Giacon
- Department of Biomedical Sciences, Environmental and Respiratory Physiology, University of Padova, Via Marzolo 3, 35131, Padua, Italy.
| | - Gerardo Bosco
- Department of Biomedical Sciences, Environmental and Respiratory Physiology, University of Padova, Via Marzolo 3, 35131, Padua, Italy.
| | - Alessandra Vezzoli
- Institute of Clinical Physiology, National Research Council (CNR), Milan, Italy
| | - Cinzia Dellanoce
- Institute of Clinical Physiology, National Research Council (CNR), Milan, Italy
| | - Danilo Cialoni
- Department of Biomedical Sciences, Environmental and Respiratory Physiology, University of Padova, Via Marzolo 3, 35131, Padua, Italy
| | - Matteo Paganini
- Department of Biomedical Sciences, Environmental and Respiratory Physiology, University of Padova, Via Marzolo 3, 35131, Padua, Italy
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Zhao Q, Ning BF, Zhou JY, Wang J, Yao YJ, Peng ZY, Yuan ZL, Chen JD, Xie WF. Transcutaneous Electrical Acustimulation Ameliorates Motion Sickness Induced by Rotary Chair in Healthy Subjects: A Prospective Randomized Crossover Study. Neuromodulation 2022; 25:1421-1430. [DOI: 10.1016/j.neurom.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/25/2021] [Accepted: 08/16/2021] [Indexed: 11/28/2022]
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26
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Lee C, Sinha AK, Henry K, Walbaum AW, Crooks PA, Holt JC. Characterizing the Access of Cholinergic Antagonists to Efferent Synapses in the Inner Ear. Front Neurosci 2022; 15:754585. [PMID: 34970112 PMCID: PMC8712681 DOI: 10.3389/fnins.2021.754585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Stimulation of cholinergic efferent neurons innervating the inner ear has profound, well-characterized effects on vestibular and auditory physiology, after activating distinct ACh receptors (AChRs) on afferents and hair cells in peripheral endorgans. Efferent-mediated fast and slow excitation of vestibular afferents are mediated by α4β2*-containing nicotinic AChRs (nAChRs) and muscarinic AChRs (mAChRs), respectively. On the auditory side, efferent-mediated suppression of distortion product otoacoustic emissions (DPOAEs) is mediated by α9α10nAChRs. Previous characterization of these synaptic mechanisms utilized cholinergic drugs, that when systemically administered, also reach the CNS, which may limit their utility in probing efferent function without also considering central effects. Use of peripherally-acting cholinergic drugs with local application strategies may be useful, but this approach has remained relatively unexplored. Using multiple administration routes, we performed a combination of vestibular afferent and DPOAE recordings during efferent stimulation in mouse and turtle to determine whether charged mAChR or α9α10nAChR antagonists, with little CNS entry, can still engage efferent synaptic targets in the inner ear. The charged mAChR antagonists glycopyrrolate and methscopolamine blocked efferent-mediated slow excitation of mouse vestibular afferents following intraperitoneal, middle ear, or direct perilymphatic administration. Both mAChR antagonists were effective when delivered to the middle ear, contralateral to the side of afferent recordings, suggesting they gain vascular access after first entering the perilymphatic compartment. In contrast, charged α9α10nAChR antagonists blocked efferent-mediated suppression of DPOAEs only upon direct perilymphatic application, but failed to reach efferent synapses when systemically administered. These data show that efferent mechanisms are viable targets for further characterizing drug access in the inner ear.
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Affiliation(s)
- Choongheon Lee
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States
| | - Anjali K Sinha
- Department of Neuroscience, University of Rochester, Rochester, NY, United States
| | - Kenneth Henry
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States.,Department of Neuroscience, University of Rochester, Rochester, NY, United States
| | - Anqi W Walbaum
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Peter A Crooks
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Joseph C Holt
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States.,Department of Neuroscience, University of Rochester, Rochester, NY, United States.,Department of Pharmacology & Physiology, University of Rochester, Rochester, NY, United States
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27
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Effect of Standardized Yelling on Subjective Perception and Autonomic Nervous System Activity in Motion Sickness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312854. [PMID: 34886576 PMCID: PMC8657713 DOI: 10.3390/ijerph182312854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 12/23/2022]
Abstract
This study investigated the effects of yelling intervention on symptoms and autonomic responses in motion sickness. Forty-two healthy participants were recruited, and they participated in Coriolis stimulation, a technique for inducing motion sickness. The experimental procedure comprised five 1-min rotating stimuli with 1-min rest after each stimulus. Then, the symptom severity was assessed using the Motion Sickness Symptom Rating (MSSR). The d2 Test of Attention scores and cardiovascular responses were recorded before and after Coriolis stimulation. The electrocardiogram results were documented to analyze heart rate variability (HRV). During Coriolis stimulus, the participants were required to yell 5–8 times in the experimental trial, and to keep quiet for each minute of rotation in the control trial. The yelling intervention significantly reduced the MSSR score (p < 0.001). Nevertheless, it did not significantly affect the d2 Test of Attention scores. Yelling while rotating did not significantly affect the heart rate nor blood pressure. However, it decreased the normalized low frequency of HRV (p = 0.036). Moreover, it improved motion sickness, but its effect on attention was not evident. Motion sickness could significantly affect cardiovascular responses and HRV. However, yelling did not affect cardiovascular response, and it reduced sympathetic nervous system activity.
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28
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Nürnberger M, Klingner C, Witte OW, Brodoehl S. Mismatch of Visual-Vestibular Information in Virtual Reality: Is Motion Sickness Part of the Brains Attempt to Reduce the Prediction Error? Front Hum Neurosci 2021; 15:757735. [PMID: 34776909 PMCID: PMC8586552 DOI: 10.3389/fnhum.2021.757735] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
Visually induced motion sickness (VIMS) is a relevant limiting factor in the use of virtual reality (VR) devices. Understanding the origin of this problem might help to develop strategies to circumvent this limitation. Previous studies have attributed VIMS to a mismatch between visual, and vestibular information, causing ambiguity of the position of the body in relation to its surrounding. Studies using EEG have shown a shift of the power spectrum to lower frequencies while VIMS is experienced. However, little is known about the relationship between the intensity of the VIMS and the changes in these power spectra. Moreover, the effect of different varieties of VIMS on the causal relationship between brain areas is largely unknown. Here, we used EEG to study 14 healthy subjects in a VR environment who were exposed to increasing levels of mismatch between vestibular and visual information. The frequency power and the bivariate transfer entropy as a measure for the information transfer were calculated. We found a direct association between increasing mismatch levels and subjective VIMS. With increasing VIMS, the proportion of slow EEG waves (especially 1–10 Hz) increases, especially in temporo-occipital regions. Furthermore, we found a general decrease in the information flow in most brain areas but especially in brain areas involved in the processing of vestibular signals and the detection of self-motion. We hypothesize that the general shift of frequency power and the decrease in information flow while experiencing high intensity VIMS represent a brain state of a reduced ability to receive, transmit and process information. We further hypothesize that the mechanism of reduced information flow is a general reaction of the brain to an unresolvable mismatch of information. This reaction aims on transforming a currently unstable model with a high prediction error into a stable model in an environment of minimal contradictory information.
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Affiliation(s)
- Matthias Nürnberger
- Hans Berger Department of Neurology, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.,Biomagnetic Center, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - Carsten Klingner
- Hans Berger Department of Neurology, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.,Biomagnetic Center, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - Otto W Witte
- Hans Berger Department of Neurology, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - Stefan Brodoehl
- Hans Berger Department of Neurology, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.,Biomagnetic Center, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
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29
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Gutkovich YE, Lagami D, Jamison A, Fonar Y, Tal D. Galvanic vestibular stimulation as a novel treatment for seasickness. Exp Brain Res 2021; 240:429-437. [PMID: 34782915 DOI: 10.1007/s00221-021-06263-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/29/2021] [Indexed: 11/24/2022]
Abstract
Motion sickness is the cause of major physical discomfort and impaired performance in many susceptible individuals. Some habituate to sea conditions, whereas others remain chronically susceptible, requiring lifelong pharmaceutical treatment. The present study sets out to investigate whether galvanic vestibular stimulation (GVS) coupled with rotatory chair stimulation could mimic sea conditions and alleviate motion sickness symptoms in individuals deemed chronically susceptible. Thirty seasickness susceptible subjects, after at least six months of regular sailing, were enrolled in a prospective, single-blind, randomised controlled study. The treatment group underwent GVS coupled with inverse phase rotatory chair impulse in sinusoidal harmonic acceleration protocol. The control group underwent a sham procedure. All subjects performed repeated velocity step tests to determine the vestibular time constant (Tc) and completed a seasickness questionnaire. The GVS rotatory chair procedure decreased the prevalence of severe seasickness. The number of motion sickness clinic visits and anti-motion sickness drug consumption were reduced in the treatment group three-month post intervention as compared to control. In addition, there was significant reduction of Tc in the treatment group. GVS coupled with rotatory chair impulse could decrease motion sickness severity, induce neurophysiological learning processes and promote habituation to seasickness in chronic susceptible subjects. This is a novel and promising non-pharmacological method to treat motion sickness susceptible individuals. Furthermore, the investigation demonstrated that adaptation to sea conditions may take place even after years of susceptibility to seasickness. This study was retrospectively registered on August 10th 2021 and assigned the identifier number NCT05004818.
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Affiliation(s)
- Yoni Evgeni Gutkovich
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), Rambam Health Care Campus, P.O. Box 22, 3109601, Haifa, Israel.,Department of Otolaryngology - Head and Neck Surgery, Haemek Medical Centre, Afula, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Daniel Lagami
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), Rambam Health Care Campus, P.O. Box 22, 3109601, Haifa, Israel
| | - Anna Jamison
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), Rambam Health Care Campus, P.O. Box 22, 3109601, Haifa, Israel
| | - Yuri Fonar
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), Rambam Health Care Campus, P.O. Box 22, 3109601, Haifa, Israel.,Shalvata Mental Health Centre, Hod Hasharon, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dror Tal
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute (INMI), Rambam Health Care Campus, P.O. Box 22, 3109601, Haifa, Israel.
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30
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Cha YH, Baloh RW, Cho C, Magnusson M, Song JJ, Strupp M, Wuyts F, Staab JP. Mal de débarquement syndrome diagnostic criteria: Consensus document of the Classification Committee of the Bárány Society. J Vestib Res 2021; 30:285-293. [PMID: 32986636 PMCID: PMC9249277 DOI: 10.3233/ves-200714] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We present diagnostic criteria for mal de débarquement syndrome (MdDS) for inclusion into the International Classification of Vestibular Disorders. The criteria include the following: 1] Non-spinning vertigo characterized by an oscillatory perception (‘rocking,’ ‘bobbing,’ or ‘swaying’) present continuously or for most of the day; 2] Onset occurs within 48 hours after the end of exposure to passive motion, 3] Symptoms temporarily reduce with exposure to passive motion (e.g. driving), and 4] Symptoms persist for >48 hours. MdDS may be designated as “in evolution,” if symptoms are ongoing but the observation period has been less than 1 month; “transient,” if symptoms resolve at or before 1 month and the observation period extends at least to the resolution point; or “persistent” if symptoms last for more than 1 month. Individuals with MdDS may develop co-existing symptoms of spatial disorientation, visual motion intolerance, fatigue, and exacerbation of headaches or anxiety. Features that distinguish MdDS from vestibular migraine, motion sickness, and persistent postural perceptual dizziness (PPPD) are reviewed. Motion-moderated oscillatory vertigo can also occur without a motion trigger, typically following another vestibular disorder, a medical illness, heightened psychological stress, or metabolic disturbance. Terminology for this non-motion triggered presentation has been varied as it has features of both MdDS and PPPD. Further research is needed into its phenomenological and biological relationship to MdDS, PPPD, and other vestibular disorders.
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Affiliation(s)
- Yoon-Hee Cha
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Robert W Baloh
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Catherine Cho
- Department of Neurology and Otolaryngology-Head and Neck Surgery, NYU Grossman School of Medicine, NY, USA
| | - Måns Magnusson
- Department of Otorhinolaryngology, Lund University, Lund, Sweden
| | - Jae-Jin Song
- Department of Otorhinolaryngology Head-and-Neck Surgery, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Michael Strupp
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany
| | - Floris Wuyts
- Lab for Equilibrium Investigations and Aerospace (LEIA), University of Antwerp, Antwerp, Belgium
| | - Jeffrey P Staab
- Departments of Psychiatry and Psychology and Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN., USA
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31
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Skuladottir AT, Bjornsdottir G, Nawaz MS, Petersen H, Rognvaldsson S, Moore KHS, Olafsson PI, Magnusson SH, Bjornsdottir A, Sveinsson OA, Sigurdardottir GR, Saevarsdottir S, Ivarsdottir EV, Stefansdottir L, Gunnarsson B, Muhlestein JB, Knowlton KU, Jones DA, Nadauld LD, Hartmann AM, Rujescu D, Strupp M, Walters GB, Thorgeirsson TE, Jonsdottir I, Holm H, Thorleifsson G, Gudbjartsson DF, Sulem P, Stefansson H, Stefansson K. A genome-wide meta-analysis uncovers six sequence variants conferring risk of vertigo. Commun Biol 2021; 4:1148. [PMID: 34620984 PMCID: PMC8497462 DOI: 10.1038/s42003-021-02673-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022] Open
Abstract
Vertigo is the leading symptom of vestibular disorders and a major risk factor for falls. In a genome-wide association study of vertigo (Ncases = 48,072, Ncontrols = 894,541), we uncovered an association with six common sequence variants in individuals of European ancestry, including missense variants in ZNF91, OTOG, OTOGL, and TECTA, and a cis-eQTL for ARMC9. The association of variants in ZNF91, OTOGL, and OTOP1 was driven by an association with benign paroxysmal positional vertigo. Using previous reports of sequence variants associating with age-related hearing impairment and motion sickness, we found eight additional variants that associate with vertigo. Although disorders of the auditory and the vestibular system may co-occur, none of the six genome-wide significant vertigo variants were associated with hearing loss and only one was associated with age-related hearing impairment. Our results uncovered sequence variants associating with vertigo in a genome-wide association study and implicated genes with known roles in inner ear development, maintenance, and disease.
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Affiliation(s)
| | | | - Muhammad Sulaman Nawaz
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Hannes Petersen
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Akureyri Hospital, Akureyri, Iceland
| | | | | | | | | | | | - Olafur A Sveinsson
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Saedis Saevarsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | | | | | | | - Joseph B Muhlestein
- Intermountain Medical Center, Intermountain Heart Institute, Salt Lake City, UT, USA
- University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - Kirk U Knowlton
- Intermountain Medical Center, Intermountain Heart Institute, Salt Lake City, UT, USA
- University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - David A Jones
- Precision Genomics, Intermountain Healthcare, Saint George, UT, USA
| | - Lincoln D Nadauld
- Precision Genomics, Intermountain Healthcare, Saint George, UT, USA
- Stanford University, School of Medicine, Stanford, CA, USA
| | - Annette M Hartmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Michael Strupp
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany
| | - G Bragi Walters
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Ingileif Jonsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
| | | | | | | | | | - Kari Stefansson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland.
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
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Besnard S, Bois J, Hitier M, Vogt J, Laforet P, Golding JF. Motion Sickness Lessons from the Southern Ocean. Aerosp Med Hum Perform 2021; 92:720-727. [PMID: 34645552 DOI: 10.3357/amhp.5696.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: The objectives were to assess the prevalence, severity, and medication taken, and to look for predictive factors in order to better identify characteristics of passengers at risk of motion sickness during transport from Hobart in Tasmania to the French polar stations in Antarctica. METHODS: There were 239 passengers who were surveyed over 4 yr with 4 round trips per year using the Motion Sickness Susceptibility Questionnaire (MSSQ), Simulator Sickness Questionnaire (SSQ), state-trait anxiety test (STAI-Trait and STAI-State), and general parameters (age, gender, number of trips, jet-lag, direction of the trip), medication, calculation of the distance of each passengers cabin to the center of gravity (CoG). RESULTS: While the passengers had a low intrinsic sensitivity to motion sickness (MSSQ), 94 reported at least one SSQ symptom of motion sickness, and 38 vomited. Five associated factors were discovered: greater initial sensitivity (MSSQ), anticipation of being ill, younger age, higher level of anxiety at midtrip, and greater distance from the CoG. Of the passengers, there were 54 who took anti-motion sickness medication at different times of the trip, however, these passengers experienced more nausea. This could be due to self-selection since they were more sensitive to motion sickness. CONCLUSION: We identified three predictive factors of motion sickness (greater intrinsic susceptibility, younger age, and greater cabin distance from the CoG). For preventive purposes, two associated factors of MS (anticipation of being ill, MSSQ score) were determined to classify three groups of risk of MS to improve passenger care during the trip. Besnard S, Bois J, Hitier M, Vogt J, Laforet P, Golding JF. Motion sickness lessons from the Southern Ocean. Aerosp Med Hum Perform. 2021; 92(9):720727.
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Abstract
PURPOSE OF REVIEW Determining the etiology of disorders that manifest with chronic dizziness can seem a daunting task, but extracting some basic elements of the patient's history can reduce the differential diagnosis significantly. This includes determining initial triggers, timing of symptoms, associated features, and exacerbating factors. This article covers distinct causes of chronic dizziness including persistent postural perceptual dizziness, mal de débarquement syndrome, motion sickness and visually induced motion sickness, bilateral vestibulopathy, and persistent dizziness after mild concussion. RECENT FINDINGS To date, none of the disorders above has a cure but are considered chronic syndromes with fluctuations that are both innate and driven by environmental stressors. As such, the mainstay of therapy for chronic disorders of dizziness involves managing factors that exacerbate symptoms and adding vestibular rehabilitation or cognitive-behavioral therapy alone or in combination, as appropriate. These therapies are supplemented by serotonergic antidepressants that modulate sensory gating and reduce anxiety. Besides expectation management, ruling out concurrent disorders and recognizing behavioral and lifestyle factors that affect symptom severity are critical issues in reducing morbidity for each disorder. SUMMARY Many syndromes of chronic dizziness can be diagnosed by recognition of key features, although many symptoms overlap between these groups. Symptoms may be manageable and improve with time, but they are often incompletely relieved.
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34
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Recenti M, Ricciardi C, Aubonnet R, Picone I, Jacob D, Svansson HÁR, Agnarsdóttir S, Karlsson GH, Baeringsdóttir V, Petersen H, Gargiulo P. Toward Predicting Motion Sickness Using Virtual Reality and a Moving Platform Assessing Brain, Muscles, and Heart Signals. Front Bioeng Biotechnol 2021; 9:635661. [PMID: 33869153 PMCID: PMC8047066 DOI: 10.3389/fbioe.2021.635661] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/05/2021] [Indexed: 01/15/2023] Open
Abstract
Motion sickness (MS) and postural control (PC) conditions are common complaints among those who passively travel. Many theories explaining a probable cause for MS have been proposed but the most prominent is the sensory conflict theory, stating that a mismatch between vestibular and visual signals causes MS. Few measurements have been made to understand and quantify the interplay between muscle activation, brain activity, and heart behavior during this condition. We introduce here a novel multimetric system called BioVRSea based on virtual reality (VR), a mechanical platform and several biomedical sensors to study the physiology associated with MS and seasickness. This study reports the results from 28 individuals: the subjects stand on the platform wearing VR goggles, a 64-channel EEG dry-electrode cap, two EMG sensors on the gastrocnemius muscles, and a sensor on the chest that captures the heart rate (HR). The virtual environment shows a boat surrounded by waves whose frequency and amplitude are synchronized with the platform movement. Three measurement protocols are performed by each subject, after each of which they answer the Motion Sickness Susceptibility Questionnaire. Nineteen parameters are extracted from the biomedical sensors (5 from EEG, 12 from EMG and, 2 from HR) and 13 from the questionnaire. Eight binary indexes are computed to quantify the symptoms combining all of them in the Motion Sickness Index (I MS ). These parameters create the MS database composed of 83 measurements. All indexes undergo univariate statistical analysis, with EMG parameters being most significant, in contrast to EEG parameters. Machine learning (ML) gives good results in the classification of the binary indexes, finding random forest to be the best algorithm (accuracy of 74.7 for I MS ). The feature importance analysis showed that muscle parameters are the most relevant, and for EEG analysis, beta wave results were the most important. The present work serves as the first step in identifying the key physiological factors that differentiate those who suffer from MS from those who do not using the novel BioVRSea system. Coupled with ML, BioVRSea is of value in the evaluation of PC disruptions, which are among the most disturbing and costly health conditions affecting humans.
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Affiliation(s)
- Marco Recenti
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland
| | - Carlo Ricciardi
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland.,Department of Advanced Biomedical Sciences, University Hospital of Naples "Federico II", Naples, Italy
| | - Romain Aubonnet
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland
| | - Ilaria Picone
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland.,Department of Advanced Biomedical Sciences, University Hospital of Naples "Federico II", Naples, Italy
| | - Deborah Jacob
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland
| | - Halldór Á R Svansson
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland
| | - Sólveig Agnarsdóttir
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland
| | - Gunnar H Karlsson
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland
| | - Valdís Baeringsdóttir
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland
| | - Hannes Petersen
- Department of Anatomy, University of Iceland, Reykjavík, Iceland.,Akureyri Hospital, Akureyri, Iceland
| | - Paolo Gargiulo
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavík, Iceland.,Department of Science, Landspitali University Hospital, Reykjavík, Iceland
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Becker-Bense S, Huppert D. [Less common, but clinically important episodic vertigo syndromes]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 89:221-232. [PMID: 33652478 DOI: 10.1055/a-1353-4893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ZusammenfassungDie Differentialdiagnostik der selteneren, episodischen Schwindelsyndrome kann im klinischen Alltag eine Herausforderung darstellen, insbesondere wenn sie keine im Intervall messbaren Befunde in der neuro-ophthalmologischen oder -otologischen Routinediagnostik hinterlassen. Ursächlich für diese episodischen Schwindelsyndrome können physiologische Reaktionen aufgrund intersensorischer Inkongruenzen oder angeborene bzw. erworbene neuroanatomische/neurophysiologische Varianten sein, die zu vestibulären Reizsyndromen führen. In dieser Übersicht fokussieren wir auf die folgenden, aus unserer Sicht wichtigen vestibulären Syndrome: Bewegungskrankheit, Mal de Debarquement Syndrom, Visuelle Höhenintoleranz, Vestibularisparoxysmie, Zervikaler Schwindel, Episodische Ataxie Typ II und Syndrome eines dritten mobilen Fensters wie das Syndrom der Dehiszenz des superioren Bogengangs. Die Ausprägung reicht von milden Symptomen mit geringer Belastung bis hin zu schweren Krankheitsbildern mit relevanter Alltagseinschränkung. Sie können vom Kindes- oder Jugendalter bis ins Senium auftreten, teilweise mit abweichender Symptomatik. Durch gezielte Anamnese und ggf. erweiterte vestibuläre Diagnostik in einem spezialisierten Zentrum lassen sich diese Syndrome oft klar herausarbeiten und einer erfolgreichen Therapie zuführen.
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Affiliation(s)
- Sandra Becker-Bense
- Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ), Ludwig-Maximilians-Universität München Deutschland
| | - Doreen Huppert
- Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ), Ludwig-Maximilians-Universität München Deutschland
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Cha YH, Golding J, Keshavarz B, Furman J, Kim JS, Lopez-Escamez JA, Magnusson M, Yates BJ, Lawson BD, Staab J, Bisdorff A. Motion sickness diagnostic criteria: Consensus document of the classification committee of the Bárány society. J Vestib Res 2021; 31:327-344. [PMID: 33646187 PMCID: PMC9249300 DOI: 10.3233/ves-200005] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present diagnostic criteria for motion sickness, visually induced motion sickness (VIMS), motion sickness disorder (MSD), and VIMS disorder (VIMSD) to be included in the International Classification of Vestibular Disorders. Motion sickness and VIMS are normal physiological responses that can be elicited in almost all people, but susceptibility and severity can be high enough for the response to be considered a disorder in some cases. This report provides guidelines for evaluating signs and symptoms caused by physical motion or visual motion and for diagnosing an individual as having a response that is severe enough to constitute a disorder. The diagnostic criteria for motion sickness and VIMS include adverse reactions elicited during exposure to physical motion or visual motion leading to observable signs or symptoms of greater than minimal severity in the following domains: nausea and/or gastrointestinal disturbance, thermoregulatory disruption, alterations in arousal, dizziness and/or vertigo, headache and/or ocular strain. These signs and/or symptoms occur during the motion exposure, build as the exposure is prolonged, and eventually stop after the motion ends. Motion sickness disorder and VIMSD are diagnosed when recurrent episodes of motion sickness or VIMS are reliably triggered by the same or similar stimuli, severity does not significantly decrease after repeated exposure, and signs/symptoms lead to activity modification, avoidance behavior, or aversive emotional responses. Motion sickness/MSD and VIMS/VIMSD can occur separately or together. Severity of symptoms in reaction to physical motion or visual motion stimuli varies widely and can change within an individual due to aging, adaptation, and comorbid disorders. We discuss the main methods for measuring motion sickness symptoms, the situations conducive to motion sickness and VIMS, and the individual traits associated with increased susceptibility. These additional considerations will improve diagnosis by fostering accurate measurement and understanding of the situational and personal factors associated with MSD and VIMSD.
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Affiliation(s)
- Yoon-Hee Cha
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - John Golding
- Psychology, School for Social Sciences, University of Westminster, London UK
| | - Behrang Keshavarz
- Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada; Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Joseph Furman
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ji-Soo Kim
- Department of Neurology Seoul National University, Seoul, Republic of Korea
| | - Jose A Lopez-Escamez
- Department of Surgery, Division of Otolaryngology, Universidad de Granada, Granada, Spain.,Otology and Neurotology Group CTS495, Department of Genomic Medicine, Centre for Genomics and Oncology Research - Pfizer/Univ. de Granada/Junta de Andalucía (GENyO), PTS, Granada, Spain.,Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs. GRANADA Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Måns Magnusson
- Department of Otorhinolaryngology, Lund University, Lund, Sweden
| | - Bill J Yates
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ben D Lawson
- Naval Submarine Medical Research Laboratory, Naval Submarine Base New London, Groton CT, USA
| | - Jeffrey Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Alexandre Bisdorff
- Department of Neurology, Centre Hospitalier Emile Mayrisch, L-4005 Esch-sur-Alzette, Luxembourg
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Gruden T, Popović NB, Stojmenova K, Jakus G, Miljković N, Tomažič S, Sodnik J. Electrogastrography in Autonomous Vehicles-An Objective Method for Assessment of Motion Sickness in Simulated Driving Environments. SENSORS 2021; 21:s21020550. [PMID: 33466805 PMCID: PMC7830998 DOI: 10.3390/s21020550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 11/29/2022]
Abstract
Autonomous vehicles are expected to take complete control of the driving process, enabling the former drivers to act as passengers only. This could lead to increased sickness as they can be engaged in tasks other than driving. Adopting different sickness mitigation techniques gives us unique types of motion sickness in autonomous vehicles to be studied. In this paper, we report on a study where we explored the possibilities of assessing motion sickness with electrogastrography (EGG), a non-invasive method used to measure the myoelectric activity of the stomach, and its potential usage in autonomous vehicles (AVs). The study was conducted in a high-fidelity driving simulator with a virtual reality (VR) headset. There separate EGG measurements were performed: before, during and after the driving AV simulation video in VR. During the driving, the participants encountered two driving environments: a straight and less dynamic highway road and a highly dynamic and curvy countryside road. The EGG signal was recorded with a proprietary 3-channel recording device and Ag/AgCl cutaneous electrodes. In addition, participants were asked to signalize whenever they felt uncomfortable and nauseated by pressing a special button. After the drive they completed also the Simulator Sickness Questionnaire (SSQ) and reported on their overall subjective perception of sickness symptoms. The EGG results showed a significant increase of the dominant frequency (DF) and the percentage of the high power spectrum density (FSD) as well as a significant decrease of the power spectrum density Crest factor (CF) during the AV simulation. The vast majority of participants reported nausea during more dynamic conditions, accompanied by an increase in the amplitude and the RMS value of EGG. Reported nausea occurred simultaneously with the increase in EGG amplitude. Based on the results, we conclude that EGG could be used for assessment of motion sickness in autonomous vehicles. DF, CF and FSD can be used as overall sickness indicators, while the relative increase in amplitude of EGG signal and duration of that increase can be used as short-term sickness indicators where the driving environment may affect the driver.
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Affiliation(s)
- Timotej Gruden
- Faculty of Electrical Engineering, University of Ljubljana, Tržaška c. 25, 1000 Ljubljana, Slovenia; (T.G.); (K.S.); (G.J.); (S.T.)
| | - Nenad B. Popović
- School of Electrical Engineering, University of Belgrade, B. kralja Aleksandra 73, 11000 Belgrade, Serbia; (N.B.P.); (N.M.)
| | - Kristina Stojmenova
- Faculty of Electrical Engineering, University of Ljubljana, Tržaška c. 25, 1000 Ljubljana, Slovenia; (T.G.); (K.S.); (G.J.); (S.T.)
| | - Grega Jakus
- Faculty of Electrical Engineering, University of Ljubljana, Tržaška c. 25, 1000 Ljubljana, Slovenia; (T.G.); (K.S.); (G.J.); (S.T.)
| | - Nadica Miljković
- School of Electrical Engineering, University of Belgrade, B. kralja Aleksandra 73, 11000 Belgrade, Serbia; (N.B.P.); (N.M.)
| | - Sašo Tomažič
- Faculty of Electrical Engineering, University of Ljubljana, Tržaška c. 25, 1000 Ljubljana, Slovenia; (T.G.); (K.S.); (G.J.); (S.T.)
| | - Jaka Sodnik
- Faculty of Electrical Engineering, University of Ljubljana, Tržaška c. 25, 1000 Ljubljana, Slovenia; (T.G.); (K.S.); (G.J.); (S.T.)
- Correspondence: ; Tel.: +386-14768-494
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The mammalian efferent vestibular system utilizes cholinergic mechanisms to excite primary vestibular afferents. Sci Rep 2021; 11:1231. [PMID: 33441862 PMCID: PMC7806594 DOI: 10.1038/s41598-020-80367-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/18/2020] [Indexed: 02/06/2023] Open
Abstract
Electrical stimulation of the mammalian efferent vestibular system (EVS) predominantly excites primary vestibular afferents along two distinct time scales. Although roles for acetylcholine (ACh) have been demonstrated in other vertebrates, synaptic mechanisms underlying mammalian EVS actions are not well-characterized. To determine if activation of ACh receptors account for efferent-mediated afferent excitation in mammals, we recorded afferent activity from the superior vestibular nerve of anesthetized C57BL/6 mice while stimulating EVS neurons in the brainstem, before and after administration of cholinergic antagonists. Using a normalized coefficient of variation (CV*), we broadly classified vestibular afferents as regularly- (CV* < 0.1) or irregularly-discharging (CV* > 0.1) and characterized their responses to midline or ipsilateral EVS stimulation. Afferent responses to efferent stimulation were predominantly excitatory, grew in amplitude with increasing CV*, and consisted of fast and slow components that could be identified by differences in rise time and post-stimulus duration. Both efferent-mediated excitatory components were larger in irregular afferents with ipsilateral EVS stimulation. Our pharmacological data show, for the first time in mammals, that muscarinic AChR antagonists block efferent-mediated slow excitation whereas the nicotinic AChR antagonist DHβE selectively blocks efferent-mediated fast excitation, while leaving the efferent-mediated slow component intact. These data confirm that mammalian EVS actions are predominantly cholinergic.
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Intractable airsickness associated with COVID-19: A case report. VACUNAS (ENGLISH EDITION) 2021. [PMCID: PMC7882910 DOI: 10.1016/j.vacune.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A 29-yr-old male Melicopter co-pilot with high flight hours in air transport missions of the patients with COVID-19 tested positive for his RT-PCR due to clinical suspicion. With the diagnosis of SARS-CoV-2, he was treated based on the national protocol and stayed in the home quarantine for two weeks. Having been released for flying, he faced nausea, vomiting, facial cold sweat and pallor, dizziness, and imbalance that eventually caused flying avoidance during the three first flights. He has never had a similar problem or any predisposing factors during his pilot's training and afterwards. All the probable reasons ruled out after a complete assessment. Following the diagnosis of moderate airsickness, he was abstained from flying and treated with different prevention and rehabilitation techniques. None of them had enough clinical efficacies, applying the United States Air Force Preventive Airsickness Protocol as the last choice. Despite the three separate consecutive therapeutic courses, no significant clinical improvement was observed, and could not return to fly, yet. That is the first reported case of intractable airsickness in a flight crew that may be associated with SARS-CoV-2 infection.
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Talebi Bezmin Abadi H, Abadi ATB, Farahani AA, Darvishi M. Intractable airsickness associated with COVID-19: A case report. ACTA ACUST UNITED AC 2020; 22:52-55. [PMID: 33262681 PMCID: PMC7688289 DOI: 10.1016/j.vacun.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/06/2020] [Indexed: 12/15/2022]
Abstract
A 29-yr-old male Melicopter co-pilot with high flight hours in air transport missions of the patients with COVID-19 tested positive for his RT-PCR due to clinical suspicion. With the diagnosis of SARS-CoV-2, he was treated based on the national protocol and stayed in the home quarantine for two weeks. Having been released for flying, he faced nausea, vomiting, facial cold sweat and pallor, dizziness, and imbalance that eventually caused flying avoidance during the three first flights. He has never had a similar problem or any predisposing factors during his pilot's training and afterwards. All the probable reasons ruled out after a complete assessment. Following the diagnosis of moderate airsickness, he was abstained from flying and treated with different prevention and rehabilitation techniques. None of them had enough clinical efficacies, applying the United States Air Force Preventive Airsickness Protocol as the last choice. Despite the three separate consecutive therapeutic courses, no significant clinical improvement was observed, and could not return to fly, yet. That is the first reported case of intractable airsickness in a flight crew that may be associated with SARS-CoV-2 infection.
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Affiliation(s)
- H Talebi Bezmin Abadi
- Aerospace and Sub-Aquatic Medical Faculty, Aja University of Medical Sciences, Tehran, Iran
| | - A T B Abadi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - A A Farahani
- Department of Medical Pathology, Medical Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - M Darvishi
- Infectious Diseases and Tropical Medicine Research Center (IDTMRC), Aerospace and Sub-Aquatic Medical Faculty, Aja University of Medical Sciences, Tehran, Iran
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Satar B, Akin Ocal FC, Karacayli C, Coban VK. Routine Vestibular Tests May Point Out Vestibular Subtype of Seasickness Only. Aerosp Med Hum Perform 2020; 91:852-860. [PMID: 33334405 DOI: 10.3357/amhp.5675.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: The vestibular system is important in the pathogenesis of seasickness. Our objective is to investigate whether routine vestibular tests detect seasickness.METHODS: Included were 17 professional naval personnel (mean age of 29.76 4.73 yr) diagnosed as having seasickness and 29 healthy age- and gender-matched controls. Cervical (c) vestibular evoked myogenic potentials (VEMP) and ocular (o) VEMP and bithermal caloric tests were performed after ear, nose, and throat examination, pure tone audiometry, and magnetic resonance imaging. Severity of seasickness was evaluated based on the Graybiel scale. P1 latency, N1 latency, P1N1 amplitude, and interaural asymmetry ratios (IAR) of cVEMP and oVEMP were compared between the patients and control groups. Abnormal findings in the caloric test were noted. Presence of an abnormality in any of the three vestibular tests (cVEMP, oVEMP, or caloric test) was accepted as a positive vestibular finding.RESULTS: According to the Graybiel Scale, severe malaise and frank sickness were observed in 3 patients (18.7%) and 13 patients (81.3%), respectively. Graybiel scoring could not be performed in one patient due to general discomfort and bad general condition. In the caloric test, each of three patients (17.65%) showed canal paresis, an incomplete test because of severe nausea, and vomiting and hyperactive response. There were no significant differences in P1 latency, N1 latency, P1N1 amplitude, or IAR of cVEMP and oVEMP (P > 0.05). There were three patients (17.65%) and two patients (11.76%) who had abnormal IAR for cVEMP and oVEMP, respectively.CONCLUSION: Routine vestibular tests may detect some findings in only a minority of patients with seasickness.Satar B, Akin Ocal FC, Karacayli C, Coban VK. Routine vestibular tests may point out vestibular subtype of seasickness only. Aerosp Med Hum Perform. 2020; 91(11):852860.
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Lipson S, Wang A, Corcoran M, Zhou G, Brodsky JR. Severe motion sickness in infants and children. Eur J Paediatr Neurol 2020; 28:176-179. [PMID: 32682672 DOI: 10.1016/j.ejpn.2020.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/21/2020] [Accepted: 06/21/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Susceptibility to severe motion sickness has not been well described in the pediatric population, particularly in very young children. This study aimed to describe and evaluate risk factors and treatment responses in a group of children with severe motion sickness, including infants and toddlers. METHODS We conducted a retrospective review of patients less than 18 years of age seen in our pediatric vestibular program for evaluation of motion sickness over a 6-year period. RESULTS A total of 23 patients with motion sickness were identified. Age of onset ranged from 0 to 15 years old, with a mean age of 6.6 ± 4.2 years. Eleven patients (47.8%) were diagnosed with a migraine variant. Vestibular deficits were identified in four out of 17 patients (23.5%) who underwent formal vestibular testing. Other frequent comorbid conditions included recurrent/chronic otitis media (n = 9; 39.1%) and a history of motor delay (n = 7; 30.4%). A high proportion of patients reported symptom improvement when treated with meclizine, ondansetron, cyproheptadine, or vestibular rehabilitation. DISCUSSION Motion sickness can impact children even in infancy. Common comorbid conditions that may contribute to pediatric motion sickness include migraine disorders, vestibular impairment, otitis media, and motor delay. Treatments such as cyproheptadine and vestibular rehabilitation may be helpful but require further study.
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Affiliation(s)
- Sophie Lipson
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Alicia Wang
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Meghan Corcoran
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Guangwei Zhou
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA; Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
| | - Jacob R Brodsky
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA; Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.
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Nunes CP, Rodrigues CDC, Cardoso CAF, Cytrynbaum N, Kaufman R, Rzetelna H, Goldwasser G, Santos A, Oliveira L, Geller M. Clinical Evaluation of the Use of Ginger Extract in the Preventive Management of Motion Sickness. Curr Ther Res Clin Exp 2020; 92:100591. [PMID: 32714473 PMCID: PMC7378854 DOI: 10.1016/j.curtheres.2020.100591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 12/30/2022] Open
Abstract
Background Motion sickness can be triggered in a variety of situations and is characterized primarily by nausea and vomiting. Ginger is widely used in treating conditions including chemotherapy-associated gastrointestinal symptoms, morning sickness, postoperative nausea, and motion sickness. Objectives The primary study objective was to evaluate Zingiber officinale extract in the treatment of motion sickness. Secondary objectives were to evaluate treatment effect on Motion Sickness Assessment Questionnaire (MSAQ) score and subscores before and after treatment, and to evaluate treatment tolerability. Methods Open-label, single-arm study assessing motion sickness outcomes with and without pre-travel oral treatment with Zingiber officinale 160 mg extract (containing 8 mg gingerols). All patients answered the MSAQ on 4 separate occasions following a trip of at least 15 minutes in duration: Trip 1 (pretreatment) and Trips 2, 3, and 4 (after oral treatment with study medication). The primary end point was percentage of patients presenting improvement ≥20 score points on the MSAQ during Trip 2, Trip 3, and Trip 4 in comparison to pretreatment score (Trip 1). Secondary end points included percentage of patients presenting improvement in MSAQ subscores during Trips 2, 3, and 4; percentage of patients presenting treatment-related adverse events; and pre- and posttreatment physician assessment scores. Results One hundred eighty-four patients were included and 174 completed treatment. A reduction of ≥20 points in total MSAQ score points occurred in 26.52%, 29.89%, and 29.31% of patients from Trips 2, 3, and 4, respectively. There was no significant difference at Trips 2, 3, and 4 in number of patients presenting improvement ≥20 score points (P = 0.9579). There was a significant reduction in total MSAQ scores from Trips 2, 3, and 4 (P < 0.0001) compared with Trip 1. Total MSAQ scores did not vary at each trip taken under treatment (P = 0.28). There were significant (P < .001) improvements in all domain subscores from Trips 2, 3, and 4 in relation to scores from Trip 1. There was a significant improvement in physician assessment scores at Visit 2 (P < .0001). Adverse events were reported among 31 patients, mainly affecting the gastrointestinal system. Twenty-four patients (13.04%) reported 39 adverse events considered related to treatment. No significant change in physical exam was noted at Visit 2 in relation to Visit 1. Conclusions These open label, historically controlled study results suggest the need for randomized, blinded, placebo and active substance controlled clinical trials. (Curr Ther Res Clin Exp. 2020; 81:XXX–XXX)
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Affiliation(s)
| | | | | | - Natasha Cytrynbaum
- Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renato Kaufman
- Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Helio Rzetelna
- Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gerson Goldwasser
- Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alessandra Santos
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lisa Oliveira
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauro Geller
- Centro Universitário Serra dos Órgãos, Teresópolis, Rio de Janeiro, Brazil
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Address correspondence to: Centro Universitário Serra dos Órgãos, Teresópolis, Rio de Janeiro, Brazil.
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Methodological Considerations Concerning Motion Sickness Investigations during Automated Driving. INFORMATION 2020. [DOI: 10.3390/info11050265] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Automated driving vehicles will allow all occupants to spend their time with various non-driving related tasks like relaxing, working, or reading during the journey. However, a significant percentage of people is susceptible to motion sickness, which limits the comfort of engaging in those tasks during automated driving. Therefore, it is necessary to investigate the phenomenon of motion sickness during automated driving and to develop countermeasures. As most existing studies concerning motion sickness are fundamental research studies, a methodology for driving studies is yet missing. This paper discusses methodological aspects for investigating motion sickness in the context of driving including measurement tools, test environments, sample, and ethical restrictions. Additionally, methodological considerations guided by different underlying research questions and hypotheses are provided. Selected results from own studies concerning motion sickness during automated driving which were conducted in a motion-based driving simulation and a real vehicle are used to support the discussion.
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Weech S, Wall T, Barnett-Cowan M. Reduction of cybersickness during and immediately following noisy galvanic vestibular stimulation. Exp Brain Res 2020; 238:427-437. [PMID: 31938844 DOI: 10.1007/s00221-019-05718-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/27/2019] [Indexed: 11/26/2022]
Abstract
The mechanism underlying cybersickness during virtual reality (VR) exposure is still poorly understood, although research has highlighted a causal role for visual-vestibular sensory conflict. Recently established methods for reducing cybersickness include galvanic vestibular stimulation (GVS) to mimic absent vestibular cues in VR, or vibration of the vestibular organs to add noise to the sensory modality. Here, we examined if applying noise to the vestibular system using noisy-current GVS affects sickness severity in VR. Participants were exposed to one of the two VR games that were classified as either moderately or intensely nauseogenic. The VR content lasted for 50 min and was broken down into three blocks: 30 min of gameplay during exposure to either noisy GVS (± 1750 μA) or sham stimulation (0 μA), and 10 min of gameplay before and after this block. We characterized the effects of noisy GVS in terms of post-minus-pre-exposure cybersickness scores. In the intense VR condition, we found a main effect of noisy vestibular stimulation on a verbal cybersickness scale, but not for questionnaire measures of cybersickness. Participants reported lower cybersickness scores during and directly after exposure to GVS. However, this difference was quickly extinguished (~ 3-6 min) after further VR exposure, indicating that sensory adaptation did not persist after stimulation was terminated. In contrast, there were no differences between the sham and GVS group for the moderate VR content. The results show the potential for reducing cybersickness with non-invasive sensory stimulation. We address possible mechanisms for the observed effects, including noise-induced sensory re-weighting.
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Affiliation(s)
- Séamas Weech
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
| | - Travis Wall
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
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Abstract
Our research described in this article was motivated by the puzzling finding of the Skylab M131 experiments: head movements made while rotating that are nauseogenic and disorienting on Earth are innocuous in a weightless, 0-g environment. We describe a series of parabolic flight experiments that directly addressed this puzzle and discovered the gravity-dependent responses to semicircular canal stimulation, consistent with the principles of velocity storage. We describe a line of research that started in a different direction, investigating dynamic balancing, but ended up pointing to the gravity dependence of angular velocity-to-position integration of semicircular canal signals. Together, these lines of research and the theoretical framework of velocity storage provide an answer to at least part of the M131 puzzle. We also describe recently discovered neural circuits by which active, dynamic vestibular, multisensory, and motor signals are interpreted as either appropriate for action and orientation or as conflicts evoking motion sickness and disorientation.
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Affiliation(s)
- James R Lackner
- Ashton Graybiel Spatial Orientation Laboratory, Brandeis University, Waltham, Massachusetts
| | - Paul DiZio
- Ashton Graybiel Spatial Orientation Laboratory, Brandeis University, Waltham, Massachusetts
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Leung AK, Hon KL. Motion sickness: an overview. Drugs Context 2019; 8:dic-2019-9-4. [PMID: 32158479 PMCID: PMC7048153 DOI: 10.7573/dic.2019-9-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/18/2022] Open
Abstract
Background Motion sickness is a common phenomenon that affects almost everybody at some point in their lifetime. Clinicians should be familiar with the proper management of this condition. Objective To provide an update on the current understanding of the pathophysiology and management of motion sickness. Methods A PubMed search was performed with Clinical Queries using the key term ‘motion sickness.’ The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. The information retrieved from the earlier search was used in the compilation of the present article. Results Motion sickness is typically triggered by low-frequency vertical, lateral, angular, rotary motion, or virtual stimulator motion, to which an individual has not adapted. Sine qua non for developing motion sickness is when the brain receives conflicting information from different sensors about real body movements or virtual environment. The principal sensors are the eyes, the vestibular apparatus, and proprioceptive receptors. The conflicting information is judged in relation to a pattern of expected associations formed under normal or experienced conditions stored in the brain. Motion sickness typically presents with malaise, anorexia, nausea, yawning, sighing, increased salivation, burping, headache, blurred vision, non-vertiginous dizziness, drowsiness, spatial disorientation, difficulty concentrating, and sometimes vomiting. Simple behavioral and environmental modifications can be effective in the prevention of motion sickness. Medications that are effective in the prophylaxis and/or treatment of motion sickness include anticholinergics, antihistamines, and sympathomimetics. Conclusion In most cases, motion sickness can be prevented by behavioral and environmental modifications (avoidance, habituation, and minimization of motion stimuli). Pharmacotherapy should be considered in the prevention and/or treatment of more severe motion sickness and for patients who do not respond to conservative measures. Medications are most effective when combined with behavioral and environmental modifications. Drugs that are effective in the prophylaxis and/or treatment of motion sickness include anticholinergic agents and antihistamines.
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Affiliation(s)
- Alexander Kc Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong
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Abstract
Although motion of the head and body has been suspected or known as the provocative cause for the production of motion sickness for centuries, it is only within the last 20 yr that the source of the signal generating motion sickness and its neural basis has been firmly established. Here, we briefly review the source of the conflicts that cause the body to generate the autonomic signs and symptoms that constitute motion sickness and provide a summary of the experimental data that have led to an understanding of how motion sickness is generated and can be controlled. Activity and structures that produce motion sickness include vestibular input through the semicircular canals, the otolith organs, and the velocity storage integrator in the vestibular nuclei. Velocity storage is produced through activity of vestibular-only (VO) neurons under control of neural structures in the nodulus of the vestibulo-cerebellum. Separate groups of nodular neurons sense orientation to gravity, roll/tilt, and translation, which provide strong inhibitory control of the VO neurons. Additionally, there are acetylcholinergic projections from the nodulus to the stomach, which along with other serotonergic inputs from the vestibular nuclei, could induce nausea and vomiting. Major inhibition is produced by the GABAB receptors, which modulate and suppress activity in the velocity storage integrator. Ingestion of the GABAB agonist baclofen causes suppression of motion sickness. Hopefully, a better understanding of the source of sensory conflict will lead to better ways to avoid and treat the autonomic signs and symptoms that constitute the syndrome.
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Affiliation(s)
- Bernard Cohen
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, New York.,Department of Neurology, New York University, New York
| | - Mingjia Dai
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, New York.,Department of Neurology, New York University, New York
| | - Sergei B Yakushin
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, New York.,Department of Neurology, New York University, New York
| | - Catherine Cho
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, New York.,Department of Neurology, New York University, New York
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Luo H, Cao C, Zhong J, Chen J, Cen Y. Adjunctive virtual reality for procedural pain management of burn patients during dressing change or physical therapy: A systematic review and meta-analysis of randomized controlled trials. Wound Repair Regen 2018; 27:90-101. [PMID: 30480854 DOI: 10.1111/wrr.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 08/21/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Huaxiu Luo
- Department of Burn and Plastic Surgery; West China Hospital, Sichuan University; Chengdu China
| | - Chang Cao
- Department of Burn and Plastic Surgery; West China Hospital, Sichuan University; Chengdu China
| | - Jian Zhong
- Department of Orthopaedics; West China Hospital, Sichuan University; Chengdu China
| | - Junjie Chen
- Department of Burn and Plastic Surgery; West China Hospital, Sichuan University; Chengdu China
| | - Ying Cen
- Department of Burn and Plastic Surgery; West China Hospital, Sichuan University; Chengdu China
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Koch A, Cascorbi I, Westhofen M, Dafotakis M, Klapa S, Peter Kuhtz-Buschbeck J. The Neurophysiology and Treatment of Motion Sickness. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:687-696. [PMID: 30406755 PMCID: PMC6241144 DOI: 10.3238/arztebl.2018.0687] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 03/28/2018] [Accepted: 08/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Seasickness and travel sickness are classic types of motion illness. Modern simulation systems and virtual reality representations can also induce comparable symptoms. Such manifestations can be alleviated or prevented by various measures. METHODS This review is based on pertinent publications retrieved by a PubMed search, with special attention to clinical trials and review articles. RESULTS Individuals vary in their susceptibility to autonomic symptoms, ranging from fatigue to massive vomiting, induced by passive movement at relatively low frequencies (0.2 to 0.4 Hz) in situations without any visual reference to the horizontal plane. Younger persons and women are considered more susceptible, and twin studies have revealed a genetic component as well. The various types of motion sickness are adequately explained by the intersensory conflict model, incorporating the vestibular, visual, and proprioceptive systems and extended to include consideration of postural instability and asymmetry of the otolith organs. Scopolamine and H1-antihistamines, such as dimenhydrinate and cinnarizine, can be used as pharmacotherapy. The symptoms can also be alleviated by habituation through long exposure or by the diminution of vestibular stimuli. CONCLUSION The various types of motion sickness can be treated with general measures to lessen the intersensory conflict, behavioral changes, and drugs.
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Affiliation(s)
- Andreas Koch
- Naval Institute of Maritime Medicine, Kronshagen, Institute of Experimental Medicine, Section Maritime Medicine Christian-Albrechts-Universität, Kiel
| | - Ingolf Cascorbi
- Institute of Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, Campus Kiel
| | - Martin Westhofen
- Clinic for Otorhinolaryngology and Plastic Surgery of the Head and Throat, RWTH Aachen
| | | | - Sebastian Klapa
- Naval Institute of Maritime Medicine, Kronshagen, Institute of Experimental Medicine, Section Maritime Medicine Christian-Albrechts-Universität, Kiel
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