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Zhang FX, Xie XH, Guo ZX, Wang HD, Li H, Wu KLK, Chan YS, Li YQ. Evaluating proxies for motion sickness in rodent. IBRO Neurosci Rep 2023; 15:107-115. [PMID: 38204574 PMCID: PMC10776324 DOI: 10.1016/j.ibneur.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/29/2023] [Indexed: 01/12/2024] Open
Abstract
Motions sickness (MS) occurs when the brain receives conflicting sensory signals from vestibular, visual and proprioceptive systems about a person's ongoing position and/or motion in relation to space. MS is typified by symptoms such as nausea and emesis and implicates complex physiological aspects of sensations and sensorimotor reflexes. Use of animal models has been integral to unraveling the physiological causality of MS. The commonly used rodents (rat and mouse), albeit lacking vomiting reflex, reliably display phenotypic behaviors of pica (eating of non-nutritive substance) and conditioned taste aversion (CTAver) or avoidance (CTAvoi) which utilize neural substrates with pathways that cause gastrointestinal malaise akin to nausea/emesis. As such, rodent pica and CTAver/CTAvoi have been widely used as proxies for nausea/emesis in studies dealing with neural mechanisms of nausea/emesis and MS, as well as for evaluating therapeutics. This review presents the rationale and experimental evidence that support the use of pica and CTAver/CTAvoi as indices for nausea and emesis. Key experimental steps and cautions required when using rodent MS models are also discussed. Finally, future directions are suggested for studying MS with rodent pica and CTAver/CTAvoi models.
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Affiliation(s)
- Fu-Xing Zhang
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Xiao-Hang Xie
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Zi-Xin Guo
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Hao-Dong Wang
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Hui Li
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Kenneth Lap Kei Wu
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ying-Shing Chan
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Yun-Qing Li
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
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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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Woo YS, Jang KM, Nam SG, Kwon M, Lim HK. Recovery time from VR sickness due to susceptibility: Objective and quantitative evaluation using electroencephalography. Heliyon 2023; 9:e14792. [PMID: 37095971 PMCID: PMC10121634 DOI: 10.1016/j.heliyon.2023.e14792] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/02/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
With the increasing use of virtual reality (VR) devices, interest in reducing their negative effects, such as VR sickness, is also increasing. This study used electroencephalography (EEG) to investigate participants' VR sickness recovery time after watching a VR video. We tested 40 participants in advance using a motion sickness susceptibility questionnaire (MSSQ). We classified the participants into two groups (sensitive group/non-sensitive group) depending on their MSSQ scores. We used a simulator sickness questionnaire (SSQ) and EEG to evaluate VR sickness. The SSQ score increased significantly after watching the VR sickness-inducing video (VR video) in both groups (p < 0.001). The recovery time based on the SSQ was 11.3 ± 6.6 min for the sensitive group and 9.1 ± 5.2 min for the non-sensitive group. The difference in recovery time between the two groups was not significant (p > 0.05). EEG results showed that recovery time took an average of 11.5 ± 7.1 min in both groups. The EEG data showed that the delta wave increased significantly across all brain areas (p < 0.01). There was no statistical difference between groups in recovering VR sickness depending on individual characteristics. However, we confirmed that subjective and objective VR recovery required at least 11.5 min. This finding can inform recommendations regarding the VR sickness recovery times.
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Affiliation(s)
- Ye Shin Woo
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
| | - Kyoung-Mi Jang
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
| | - Sun Gu Nam
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
- Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Moonyoung Kwon
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
| | - Hyun Kyoon Lim
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
- University of Science and Technology, Daejeon, Republic of Korea
- Corresponding author. Korea Research Institute of Standards and Science, Daejeon, Republic of Korea.
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Mian A, Aamir Mian M. Space Medicine: Inspiring a new generation of physicians. Postgrad Med J 2022:7150864. [PMID: 37137531 DOI: 10.1136/pmj-2022-141875] [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: 04/27/2022] [Accepted: 06/18/2022] [Indexed: 11/03/2022]
Abstract
Space medicine is critical in enabling safe human exploration of space. The discipline focuses on supporting human survival, health, and performance in the austere environment of space. It is set to grow ever more important as significant transitions in the standard of space operations in the suborbital, low earth orbit (LEO) and beyond LEO domains will take place in the coming years. NASA along with their international and commercial partners have committed to returning to the Moon through the Artemis missions in this decade with the aim of achieving a permanent sustainable human presence on the lunar surface. Additionally, the development of reusable rockets is set to increase the number and frequency of humans going to space by making space travel more accessible. Commercial spaceflight and missions beyond LEO present many new challenges which space medicine physicians and researchers will need to address. Space medicine operates at the frontier of exploration, engineering, science and medicine. Aviation and Space Medicine (ASM) is the latest specialty to be recognised by the Royal College of Physicians and the General Medical Council in the UK. In this paper, we provide an introduction to space medicine, review the effects of spaceflight on human physiology and health along with countermeasures, medical and surgical issues in space, the varied roles of the ASM physician, challenges to UK space medicine practice and related research, and finally we explore the current representation of space medicine within the undergraduate curriculum.
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Affiliation(s)
- Areeb Mian
- Department of Surgery, University of Cambridge, Cambridge, UK
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Sousa CV, Hwang J, Cabrera-Perez R, Fernandez A, Misawa A, Newhook K, Lu AS. Active video games in fully immersive virtual reality elicit moderate-to-vigorous physical activity and improve cognitive performance in sedentary college students. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:164-171. [PMID: 34004390 PMCID: PMC9068577 DOI: 10.1016/j.jshs.2021.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/09/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Active video games are a new method for increasing physical activity (PA). Fully immersive virtual reality (VR) is a hardware device on which an active video game can run. Active (video games in) VR (AVR), might increase immersion, game engagement, and moderate-to-vigorous PA (MVPA), thereby yielding greater exercise-related benefits, e.g., cognitive performance. METHODS We examined the induction of MVPA via an AVR and a sedentary VR (SVR) as well as the effects of VR play on cognitive performance, which was monitored using 2 different methods. Each of 29 sedentary college students attended three 20-min laboratory sessions (AVR, SVR, or control) in a randomized order; during the control session, they sat quietly doing nothing. A fully immersive headset was used for the 2 video game sessions. We monitored and computed participants' PA using hip-worn accelerometers (wGT3x-bt; ActiGraph, Pensacola, FL, USA) and a heart rate band (Polar H7; Polar, Kempele, Finland). After each session, the participants completed a mnemonic similarity test (MST) to measure recognition memory. They also filled out a motion sickness questionnaire and an abbreviated game experience questionnaire. RESULTS The AVR session induced a significantly greater heart rate and more time spent in MVPA than did either of the other 2 sessions regardless of the PA monitoring method. AVR elicited greater game experience questionnaire-assessed sensory and imaginative immersion, challenge, and positive affect than did SVR. The mnemonic similarity test recognition score was marginally higher post-AVR session than it was post-SVR session. CONCLUSION AVR elicited MVPA without a significant increase in motion sickness and induced a better game experience and better borderline cognitive performance than did SVR.
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Affiliation(s)
- Caio Victor Sousa
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Jungyun Hwang
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL 32603, USA
| | - Romina Cabrera-Perez
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Austin Fernandez
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Aika Misawa
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Kelsey Newhook
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Amy Shirong Lu
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA.
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Ugur E, Konukseven BO. The potential use of virtual reality in vestibular rehabilitation of motion sickness. Auris Nasus Larynx 2022; 49:768-781. [PMID: 35125243 DOI: 10.1016/j.anl.2022.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/16/2022] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Motion sickness (MS) can be triggered by direct or indirect stimuli due to mismatches in the visual-vestibular autonomic pathways. Various studies in the literature have shown that virtual reality technologies can generate provocative stimuli for MS. Therefore, our primary aim is to investigate the usability of virtual reality systems in MS rehabilitation METHODS: 20 normal and 19 MS patients were included. A total of six virtual reality rehabilitation sessions (VRrs) with a game called "Roller Coaster Dreams" playable via PlayStation VR Head Mounted Display were applied thrice a week for 2 weeks, or twice a week for 3 weeks. Participants were evaluated at the pre-rehabilitation phase twice and after third and sixth rehabilitation sessions with the sensory organization test (SOT). The effectiveness of the rehabilitation program was statistically analyzed by comparing the results of SOTs. RESULTS All SOT results of the patient group were compared each other to evaluate the effectiveness of rehabilitation. According to the post-hoc comparisons, a statistically significant difference was found between the 1st, 2nd, 3rd, and 4th SOT- Equilibrium Scores; Condition 2 (p = 0.043), Condition 3 (p = 0.006), Condition 4 (p = 0.031), Condition 5 (p = 0.002) and Condition 6 (p = 0.040). There is no difference obtained in Condition 1 (p > 0.05). The Equilibrium Scores of SOT 3rd and SOT 4th were similar and 4th SOT-Equilibrium Scores were the highest among all SOT measurements. The results show that while the first three sessions were accepted as an orientation and adaptation sessions, 4th, 5thand 6th sessions are habilitation sessions. CONCLUSIONS VR proved to be significantly effective and useful for MS rehabilitation. Additionally, observations indicated that using VR makes rehabilitation fun, increases the efficiency of the process, and reduces the risk of inadaptability to exercise.
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Affiliation(s)
- Emel Ugur
- Acibadem Mehmet Ali Aydinlar University Vocational School of Health Sciences Audiometry, Istanbul, Turkey; Audiology Department, Acibadem Altunizade Hospital, Istanbul, Turkey.
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Bogle JM, Benarroch E, Sandroni P. Vestibular-autonomic interactions: beyond orthostatic dizziness. Curr Opin Neurol 2022; 35:126-134. [PMID: 34839339 DOI: 10.1097/wco.0000000000001013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review aims to summarize the current literature describing vestibular-autonomic interactions and to describe their putative role in various disorders' clinical presentations, including orthostatic dizziness and motion sensitivity. RECENT FINDINGS The vestibular-autonomic reflexes have long been described as they relate to cardiovascular and respiratory function. Although orthostatic dizziness may be in part related to impaired vestibulo-sympathetic reflex (orthostatic hypotension), there are various conditions that may present similarly. A recent clinical classification aims to improve identification of individuals with hemodynamic orthostatic dizziness so that appropriate recommendations and management can be efficiently addressed. Researchers continue to improve understanding of the underlying vestibular-autonomic reflexes with recent studies noting the insular cortex as a cortical site for vestibular sensation and autonomic integration and modulation. Work has further expanded our understanding of the clinical presentation of abnormal vestibular-autonomic interactions that may occur in various conditions, such as aging, peripheral vestibular hypofunction, traumatic brain injury, and motion sensitivity. SUMMARY The vestibular-autonomic reflexes affect various sympathetic and parasympathetic functions. Understanding these relationships will provide improved identification of underlying etiology and drive improved patient management.
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Affiliation(s)
- Jamie M Bogle
- Mayo Clinic Arizona, Department of Otolaryngology - Head and Neck Surgery, Division of Audiology, Scottsdale, AZ, USA
| | | | - Paola Sandroni
- Mayo Clinic Arizona, Department of Neurology, Division of Autonomic Disorders, Scottsdale, AZ, USA
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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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Li N, Liu L, Sun M, Wang R, Jin W, Liu C, Hu Y. Predominant role of gut-vagus-brain neuronal pathway in postoperative nausea and vomiting: evidence from an observational cohort study. BMC Anesthesiol 2021; 21:234. [PMID: 34587905 PMCID: PMC8480048 DOI: 10.1186/s12871-021-01449-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postoperative nausea and vomiting (PONV) as a clinically most common postoperative complication requires multimodal antiemetic medications targeting at a wide range of neurotransmitter pathways. Lacking of neurobiological mechanism makes this 'big little problem' still unresolved. We aim to investigate whether gut-vagus-brain reflex generally considered as one of four typical emetic neuronal pathways might be the primary mediator of PONV. METHODS Three thousand two hundred twenty-three patients who underwent vagus nerve trunk resection (esophagectomy and gastrectomy) and non-vagotomy surgery (hepatectomy, pulmonary lobectomy and colorectomy) from December 2016 to January 2019 were enrolled. Thirty cases of gastrectomy with selective resection on the gastric branch of vagus nerve were also recruited. Nausea and intensity of vomiting was recorded within 24 h after the operation. RESULTS PONV occurred in 11.9% of 1187 patients who underwent vagus nerve trunk resection and 28.7% of 2036 non-vagotomy patients respectively. Propensity score matching showed that vagotomy surgeries accounted for 19.9% of the whole PONV incidence, much less than that observed in the non-PONV group (35.1%, P < 0.01). Multivariate logistic regression result revealed that vagotomy was one of underlying factor that significantly involved in PONV (OR = 0.302, 95% CI, 0.237-0.386). Nausea was reported in 5.9% ~ 8.6% vagotomy and 12 ~ 17% non-vagotomy patients. Most vomiting were mild, being approximately 3% in vagotomy and 8 ~ 13% in non-vagotomy patients, while sever vomiting was much less experienced. Furthermore, lower PONV occurrence (10%) was also observed in gastrectomy undergoing selective vagotomy. CONCLUSION Patients undergoing surgeries with vagotomy developed less PONV, suggesting that vagus nerve dependent gut-brain signaling might mainly contribute to PONV.
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Affiliation(s)
- Nana Li
- Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, P.R. China
| | - Lu Liu
- Department of Anesthesiology, Wuxi Second Hospital Affiliated Nanjing Medical University, Wuxi, 214002, P.R. China
| | - Menghan Sun
- Department of Anesthesiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210029, P.R. China
| | - Ruiliang Wang
- Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, P.R. China
| | - Wenjie Jin
- Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, P.R. China
| | - Cunming Liu
- Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, P.R. China
| | - Youli Hu
- Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, P.R. China.
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Gupta AK, Kumar BV, Rajguru R, Parate KD. Assessment of Sea Sickness in Naval Personnel: Incidence and Management. Indian J Occup Environ Med 2021; 25:119-124. [PMID: 34421250 PMCID: PMC8341412 DOI: 10.4103/ijoem.ijoem_94_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/05/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Strategic, operational and tactical superiority of Navy hinges on extremely efficient warships which in turn depend on professionally competent sailors ready to undertake tasks to deliver timely, structured and metered response. Ships and their potentialities are tools to achieve the required strategic advantage which is dependent on the proficiency of sailors. Sailors who are fit ashore may be debilitated on board because of sea sickness. Aims: To study the incidence and severity of sea sickness among 500 naval personnel from various ships. Setting and design: An observational study conducted from May 2019 to March 2020 among 500 naval personnel from various ships of the fleet. Materials and Methods: Motion Sickness Assessment Questionnaire (MSAQ) was used to collect data from personnel of different departments working in different part of ship aged between 20 to 50 years. Results: The majority suffered mild symptoms (78.78%) and did not require any medication. Their symptoms were selflimiting and settled on rest within 24 hours. Moderately severe symptoms were observed among 19.31 % personnel and had to be administered medication and rest for 24 hours. Only 1.91% had severe symptoms and had to be excused from duties along with medication and rest. Conclusion: Sea sickness is unpleasant and has an adverse effect on employability of the sailors. It is mild and self limiting in majority of the personnel not requiring active intervention. Some personnel may require desensitisation along with pharmacotherapy.
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Affiliation(s)
- Arvind K Gupta
- Department of ENT, INHS Asvini, Mumbai, Maharashtra, India
| | | | - Renu Rajguru
- Department of ENT, INHS Asvini, Mumbai, Maharashtra, India
| | - K D Parate
- Fleet Medical Centre, Mumbai, Maharashtra, India
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Evaluation of a Human–Machine Interface for Motion Sickness Mitigation Utilizing Anticipatory Ambient Light Cues in a Realistic Automated Driving Setting. INFORMATION 2021. [DOI: 10.3390/info12040176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Motion sickness (MS) is a syndrome associated with symptoms like nausea, dizziness, and other forms of physical discomfort. Automated vehicles (AVs) are potent at inducing MS because users are not adapted to this novel form of transportation, are provided with less information about the own vehicle’s trajectory, and are likely to engage in non-driving related tasks. Because individuals with an especially high MS susceptibility could be limited in their use of AVs, the demand for MS mitigation strategies is high. Passenger anticipation has been shown to have a modulating effect on symptoms, thus mitigating MS. To find an effective mitigation strategy, the prototype of a human–machine interface (HMI) that presents anticipatory ambient light cues for the AV’s next turn to the passenger was evaluated. In a realistic driving study with participants (N = 16) in an AV on a test track, an MS mitigation effect was evaluated based on the MS increase during the trial. An MS mitigation effect was found within a highly susceptible subsample through the presentation of anticipatory ambient light cues. The HMI prototype was proven to be effective regarding highly susceptible users. Future iterations could alleviate MS in field settings and improve the acceptance of AVs.
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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: 35] [Impact Index Per Article: 11.7] [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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13
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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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14
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Pham Xuan R, Xiong Y, Brietzke A, Marker S. Thermal infrared imaging based facial temperature in comparison to ear temperature during a real-driving scenario. J Therm Biol 2020; 96:102806. [PMID: 33627258 DOI: 10.1016/j.jtherbio.2020.102806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/25/2020] [Accepted: 12/03/2020] [Indexed: 11/16/2022]
Abstract
Motion Sickness is associated with a variety of symptoms, which differ in occurrence rate and intensity between individuals. In order to research the cause of car sickness and develop countermeasures, it is important to determine symptoms and their severity objectively. A tool for this purpose could be the assessment of physiological reactions due to motion sickness. This paper describes and discusses a methodology to identify changes in facial skin temperatures in a real-driving study. Common techniques had to be adjusted in order to meet the requirements given by the challenges of in-car-recording. The examined data was generated in a previous study, which was designed to research motion sickness in a driving environment. A pre-processing technique had to be developed to magnify features on the face and subsequently improve the tracking in thermal imagery. After the pre-processing, regions of interest (ROI) were manually marked and tracked in thermal images. The thereby assessed facial skin temperatures were compared to tympanic temperatures. Derived temperatures from the forehead as well as from the 20 hottest pixels within the face indicated a better tracking, while the nose tip was more affected by detection errors. The correlation of the three features with the tympanic temperature showed remarkable differences between a baseline measurement and the actual driving. Less than 10% of the data derived during the driving and up to 30% of the data during the baseline measurement correlated highly. It is concluded that detecting changes in facial skin temperature using thermal infrared imaging in a moving car is challenging and results are hardly comparable to tympanic temperatures. Future research should aim at the different influencing factors of skin and tympanic temperature, while enhancing tracking or detection of ROI could be achieved by reducing the passengers' movements or choosing the target area more carefully.
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Affiliation(s)
- Rebecca Pham Xuan
- Volkswagen AG Group Innovation, Letterbox 011/17773, 38436, Wolfsburg, Germany; Technical University Berlin, Naturalistic Driving Observation for Energetic Optimization and Accident Avoidance, Institute of Land and Sea Transport Systems, Gustav-Meyer-Allee 25, 13355, Berlin, Germany.
| | - Yuxin Xiong
- Volkswagen AG Group Innovation, Letterbox 011/17773, 38436, Wolfsburg, Germany; Institute of Mechatronic Systems, Gottfried Wilhelm Leibniz University Hannover, 30167, Hannover, Germany
| | - Adrian Brietzke
- Volkswagen AG Group Innovation, Letterbox 011/17773, 38436, Wolfsburg, Germany
| | - Stefanie Marker
- Technical University Berlin, Naturalistic Driving Observation for Energetic Optimization and Accident Avoidance, Institute of Land and Sea Transport Systems, Gustav-Meyer-Allee 25, 13355, Berlin, Germany
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15
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Kitajima N, Sugita-Kitajima A. Ocular counter-rolling in scuba divers with motion sickness. Auris Nasus Larynx 2020; 48:214-220. [PMID: 32828593 DOI: 10.1016/j.anl.2020.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Motion sickness (MS) is a familiar condition to scuba divers. The purpose of this study was to compare otolith organ function of scuba divers who have MS to those without MS. METHOD Video-oculography (VOG) goggles were used to measure video ocular counter-roll (vOCR) in 50 healthy scuba divers with no vestibular pathology. Divers with MS (n = 30) had Graybiel motion sickness (GMS) scores of ≥1 point, and divers without MS (n = 20) had GMS scores of 0. Divers with MS also completed the Motion Sickness Susceptibility Questionnaire short form (MSSQs). For all divers, otolith-ocular function of both ears was tested separately via vOCR testing, which was performed during 30° head tilt. An R-L side asymmetry ratio for vOCR values (%OCRA) was compared to divers' static OCR. RESULTS MSSQs and %OCRA scores differed significantly (p<0.01and p<0.001, respectively) between divers with MS and divers without MS. Their %OCRA scores and severity of MS were significantly correlated. Female divers were more susceptible to MS. ROC analysis for %OCRA revealed that the AUC for divers with MS and divers without MS was 0.8967 (95% CI, 0.8114 to 0.9819), the specificity was 1.000, and the sensitivity was 0.700, with a cutoff value of 45.946. CONCLUSION Physiological differences between R-L otolith organ function could affect the severity and susceptibility to MS. Female hormones may also increase susceptibility to MS. Thus, MS may be a physiological phenomenon induced by functional ear differences in the absence of pathology. As MS is caused by multiple factors, otolaryngologists need to consider various causative factors beyond those related to otolith organ function in scuba divers with MS.
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Affiliation(s)
- Naoharu Kitajima
- Kitajima ENT Clinic, 1-15-15 Tagara Nerima-ku, Tokyo 179-0073, Japan; Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Akemi Sugita-Kitajima
- Kitajima ENT Clinic, 1-15-15 Tagara Nerima-ku, Tokyo 179-0073, Japan; Department of Otolaryngology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan
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16
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Fowler CG, Dallapiazza M, Hadsell KT. Vestibular Function and Motion Sickness Susceptibility: Videonystagmographic Evidence From Oculomotor and Caloric Tests. Am J Audiol 2020; 29:188-198. [PMID: 32320620 DOI: 10.1044/2020_aja-19-00050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose Motion sickness (MS) is a common condition that affects millions of individuals. Although the condition is common and can be debilitating, little research has focused on the vestibular function associated with susceptibility to MS. One causal theory of MS is an asymmetry of vestibular function within or between ears. The purposes of this study, therefore, were (a) to determine if the vestibular system (oculomotor and caloric tests) in videonystagmography (VNG) is associated with susceptibility to MS and (b) to determine if these tests support the theory of an asymmetry between ears associated with MS susceptibility. Method VNG was used to measure oculomotor and caloric responses. Fifty young adults were recruited; 50 completed the oculomotor tests, and 31 completed the four caloric irrigations. MS susceptibility was evaluated with the Motion Sickness Susceptibility Questionnaire-Short Form; in this study, percent susceptibility ranged from 0% to 100% in the participants. Participants were divided into three susceptibility groups (Low, Mid, and High). Repeated-measures analyses of variance and pairwise comparisons determined significance among the groups on the VNG test results. Results Oculomotor test results revealed no significant differences among the MS susceptibility groups. Caloric stimuli elicited responses that were correlated positively with susceptibility to MS. Slow-phase velocity was slowest in the Low MS group compared to the Mid and High groups. There was no significant asymmetry between ears in any of the groups. Conclusions MS susceptibility was significantly and positively correlated with caloric slow-phase velocity. Although asymmetries between ears are purported to be associated with MS, asymmetries were not evident. Susceptibility to MS may contribute to interindividual variability of caloric responses within the normal range.
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Affiliation(s)
- Cynthia G. Fowler
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
| | - Margaret Dallapiazza
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
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17
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Wooldridge LM, Kangas BD. An assay of drug-induced emesis in the squirrel monkey (Saimiri sciureus). J Med Primatol 2019; 48:236-243. [PMID: 30968960 DOI: 10.1111/jmp.12411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/07/2019] [Accepted: 03/10/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Emesis has significant evolutionary value as a defense mechanism against ingested toxins; however, it is also one of the most common adverse symptoms associated with both disease and medical treatments of disease. The development of improved antiemetic pharmacotherapies has been impeded by a shortage of animal models. METHODS The present studies characterized the responses of the squirrel monkey to pharmacologically diverse emetic drugs. Subjects were administered nicotine (0.032-0.56 mg/kg), lithium chloride (150-250 mg/kg), arecoline (0.01-0.32 mg/kg), or apomorphine (0.032-0.32 mg/kg) and observed for emesis and prodromal hypersalivation. RESULTS Nicotine rapidly produced emesis and hypersalivation. Lithium chloride produced emesis with a longer time course without dose-dependent hypersalivation. Arecoline produced hypersalivation but not emesis. Apomorphine failed to produce emesis or hypersalivation. CONCLUSIONS The squirrel monkey is sensitive to drug-induced emesis by a variety of pharmacological mechanisms and is well-positioned to examine antiemetic efficacy and clinically important side effects of candidate antiemetic pharmacotherapies.
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Affiliation(s)
| | - Brian D Kangas
- Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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18
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Weech S, Kenny S, Barnett-Cowan M. Presence and Cybersickness in Virtual Reality Are Negatively Related: A Review. Front Psychol 2019; 10:158. [PMID: 30778320 PMCID: PMC6369189 DOI: 10.3389/fpsyg.2019.00158] [Citation(s) in RCA: 190] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/16/2019] [Indexed: 12/21/2022] Open
Abstract
In order to take advantage of the potential offered by the medium of virtual reality (VR), it will be essential to develop an understanding of how to maximize the desirable experience of "presence" in a virtual space ("being there"), and how to minimize the undesirable feeling of "cybersickness" (a constellation of discomfort symptoms experienced in VR). Although there have been frequent reports of a possible link between the observer's sense of presence and the experience of bodily discomfort in VR, the amount of literature that discusses the nature of the relationship is limited. Recent research has underlined the possibility that these variables have shared causes, and that both factors may be manipulated with a single approach. This review paper summarizes the concepts of presence and cybersickness and highlights the strengths and gaps in our understanding about their relationship. We review studies that have measured the association between presence and cybersickness, and conclude that the balance of evidence favors a negative relationship between the two factors which is driven principally by sensory integration processes. We also discuss how system immersiveness might play a role in modulating both presence and cybersickness. However, we identify a serious absence of high-powered studies that aim to reveal the nature of this relationship. Based on this evidence we propose recommendations for future studies investigating presence, cybersickness, and other related factors.
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Affiliation(s)
- Séamas Weech
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
- The Games Institute, University of Waterloo, Waterloo, ON, Canada
| | - Sophie Kenny
- The Games Institute, University of Waterloo, Waterloo, ON, Canada
| | - Michael Barnett-Cowan
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
- The Games Institute, University of Waterloo, Waterloo, ON, Canada
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19
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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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20
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Weech S, Varghese JP, Barnett-Cowan M. Estimating the sensorimotor components of cybersickness. J Neurophysiol 2018; 120:2201-2217. [PMID: 30044672 PMCID: PMC6295542 DOI: 10.1152/jn.00477.2018] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 07/17/2018] [Indexed: 11/22/2022] Open
Abstract
The user base of the virtual reality (VR) medium is growing, and many of these users will experience cybersickness. Accounting for the vast interindividual variability in cybersickness forms a pivotal step in solving the issue. Most studies of cybersickness focus on a single factor (e.g., balance, sex, or vection), while other contributors are overlooked. Here, we characterize the complex relationship between cybersickness and several measures of sensorimotor processing. In a single session, we conducted a battery of tests of balance control, vection responses, and vestibular sensitivity to self-motion. Following this, we measured cybersickness after VR exposure. We constructed a principal components regression model using the measures of sensorimotor processing. The model significantly predicted 37% of the variability in cybersickness measures, with 16% of this variance being accounted for by a principal component that represented balance control measures. The strongest predictor was participants' sway path length during vection, which was inversely related to cybersickness [ r(28) = -0.53, P = 0.002] and uniquely accounted for 7.5% of the variance in cybersickness scores across participants. Vection strength reports and measures of vestibular sensitivity were not significant predictors of cybersickness. We discuss the possible role of sensory reweighting in cybersickness that is suggested by these results, and we identify other factors that may account for the remaining variance in cybersickness. The results reiterate that the relationship between balance control and cybersickness is anything but straightforward. NEW & NOTEWORTHY The advent of consumer virtual reality provides a pressing need for interventions that combat sickness in simulated environments (cybersickness). This research builds on multiple theories of cybersickness etiology to develop a predictive model that distinguishes between individuals who are/are not likely to experience cybersickness. In the future this approach can be adapted to provide virtual reality users with curated content recommendations based on more efficient measurements of sensorimotor processing.
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Affiliation(s)
- Séamas Weech
- Department of Kinesiology, University of Waterloo , Waterloo, Ontario , Canada
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21
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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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22
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Li J, Zhang L, Cheng X, Zhang L, Shen B, Qing C, Fan G. Determination of d-amphetamine and diphenhydramine in beagle dog plasma by a 96-well formatted liquid-liquid extraction and capillary zone electrophoresis with field-amplified sample stacking. J Pharm Biomed Anal 2018; 156:263-271. [PMID: 29729640 DOI: 10.1016/j.jpba.2018.04.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 10/17/2022]
Abstract
This paper describes a method for quantification of d-amphetamine and diphenhydramine in beagle dog plasma by organic solvent field-amplified sample stacking (FASS)-capillary zone electrophoresis (CZE), using amlodipine as the internal standard. The separation was carried out at 25 °C in a 40.2 cm × 75 μm fused-silica capillary with an applied voltage of 20 kV using 25 mM phosphate-18.75 mM borate (pH 3.5). The detection wavelength was 200 nm. Clean-up and preconcentration of plasma biosamples were developed by 96-well formatted liquid- liquid extraction (LLE). In this study, the peak areas of d-amphetamine, diphenhydramine and amlodipine in the plasma sample increased by the factor of 48, 67 and 43 compared to the CZE without sample stacking. The method was suitably validated with respect to stability, specificity, linearity, lower limit of quantitation, accuracy, precision and extraction recovery. The calibration graph was linear from 2 to 500 ng/ml for d-amphetamine and 2-5000 ng/ml for diphenhydramine. All the validation data were within the required limits. Compared with the LC/MS/MS method that we previously established, there was no significant difference between the two methods in validation characteristics, except the LLOQs. The developed method was successfully applied to the evaluation of pharmacokinetic study of the Quick-Acting Anti-Motion Capsules (QAAMC) in beagle dogs.
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Affiliation(s)
- Ji Li
- Department of Clinical Pharmacy, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, No. 100 Haining Road, Shanghai 200025, PR China; School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, No. 1168, Chunrong Road, Kunming, Yunnan 650500, PR China
| | - Lingli Zhang
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, No. 325 Guohe Road, Shanghai 200433, PR China; Innovation Medicines and Early Clinical Development Asia, AstraZeneca, No. 199 Liangjing Road, Zhangjiang Hi-Tech Park, Shanghai, 201203, PR China
| | - Xianliang Cheng
- School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, No. 1168, Chunrong Road, Kunming, Yunnan 650500, PR China
| | - Lei Zhang
- School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, No. 1168, Chunrong Road, Kunming, Yunnan 650500, PR China; Department of Gynecologic Oncology, The Third Affiliated Hospital of Kunming Medical University, No. 519, Kunzhou Road, Kunming, Yunnan 650118, PR China
| | - Baochun Shen
- School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, No. 1168, Chunrong Road, Kunming, Yunnan 650500, PR China.
| | - Chen Qing
- School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, No. 1168, Chunrong Road, Kunming, Yunnan 650500, PR China.
| | - Guorong Fan
- Department of Clinical Pharmacy, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, No. 100 Haining Road, Shanghai 200025, PR China; Shanghai Key Laboratory for Pharmaceutical Metabolite Research, No. 325 Guohe Road, Shanghai 200433, PR China; Laboratory of Drug Metabolism & Pharmacokinetics, School of Medicine, Tongji University, No. 1239 Siping Road, Shanghai 200092, PR China.
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23
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Wu WT, Jia ZY, Chen Y, Chen QF, Zu QQ, Yang ZQ, Liu S, Shi HB. The Safety and Efficacy of Oxycodone Versus Fentanyl in Percutaneous Microwave Ablation of a Liver Tumour Abutting the Capsule. Cardiovasc Intervent Radiol 2018; 42:87-94. [PMID: 29740688 DOI: 10.1007/s00270-018-1980-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/30/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE The present study compared the safety and efficacy of oxycodone with those of fentanyl under non-intubated general anaesthesia in percutaneous microwave ablation (MWA) of a liver tumour abutting the capsule. MATERIALS AND METHODS Thirty-eight patients underwent MWA of liver cancers abutting the capsule. Patients received 0.1 mg/kg oxycodone (O group) or 1 μg/kg fentanyl (F group) prior to the start of ablation. Both groups received continuous infusions of propofol for non-intubated general anaesthesia during ablation. The primary outcomes were the pain scores (11-point numeric rating scale, NRS) within 24 h after MWA. Vital signs, body movement during ablation, and opioid side effects after ablation were recorded. The need for additional analgesics was recorded 24 h after MWA. RESULTS The pain NRS scores were lower in the O group than in the F group at 0.5 (P = 0.035), 3 (P = 0.002), and 6 h (P = 0.001) after MWA, and fewer patients required additional analgesics in the O group (6 of 20 vs. 13 of 18, P = 0.022) within 24 h. The average 24-h dose of dezocine was 5.5 ± 4.1 mg in the F group and 2.1 ± 3.3 mg in the O group (P = 0.008). A significant reduction in the respiratory rate (P = 0.020) and more body movements were observed in the F group (P = 0.027) during ablation with non-intubated general anaesthesia. No differences in post-operative nausea and vomiting (PONV) were observed between the two groups, but dizziness occurred significantly more often in the O group (P = 0.033). No significant differences in other vital signs were observed before, during, and after the procedure. CONCLUSIONS Oxycodone provides better analgesia and reduces post-operative opioid consumption without significant respiratory or hemodynamic instability.
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Affiliation(s)
- Wen-Tao Wu
- Department of Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Zhen-Yu Jia
- Department of Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Yu Chen
- Department of Anesthesiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, 300 Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu Province, China.
| | - Qi-Feng Chen
- Department of Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Qing-Quan Zu
- Department of Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Zheng-Qiang Yang
- Department of Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Sheng Liu
- Department of Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Hai-Bin Shi
- Department of Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
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Fowler CG, Sweet A, Steffel E. Effects of motion sickness severity on the vestibular-evoked myogenic potentials. J Am Acad Audiol 2018; 25:814-22. [PMID: 25405837 DOI: 10.3766/jaaa.25.9.4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Motion sickness is a common debilitating condition associated with both actual and perceived motion. Despite the commonality, little is known about the underlying physiological mechanisms. One theory proposes that motion sickness arises from a mismatch between reality and past experience in vertical motions. Physiological tests of the vestibular system, however, have been inconclusive regarding the underlying pathogenesis. Cervical vestibular-evoked myogenic potentials (cVEMPs) arise from the saccule, which responds to vertical motion. If vertical motion elicits motion sickness, the cVEMP should be affected. PURPOSE The purpose of this investigation was to determine if cVEMP characteristics differ among individuals with a range of motion sickness susceptibility from negligible to severe. The hypothesis was that individuals with high susceptibility would have larger cVEMP amplitudes and shorter cVEMP latencies relative to those who are resistant to motion sickness. RESEARCH DESIGN The study had two parts. The first was quasi-experimental in which participants comprised three groups based on susceptibility to motion sickness (low, mild-moderate, high) as identified on the short version of the Motion Sickness Susceptibility Questionnaire (MSSQ-S). The second part of the study was correlational and evaluated the specific relationships between the degree of motion sickness susceptibility and characteristics of the VEMPs. STUDY SAMPLE A total of 24 healthy young adults (ages 20-24 yr) were recruited from the university and the community without regard to motion sickness severity. DATA COLLECTION AND ANALYSIS Participants took the MSSQ-S, which quantifies susceptibility to motion sickness. The participants had a range of motion sickness susceptibility with MSSQ raw scores from 0.0-36.6, which correspond to percent susceptibility from 0.0-99.3%. VEMPs were elicited by 500 Hz tone-bursts monaurally in both ears at 120 dB pSPL. MSSQ-S percent scores were used to divide the participants into low, mild-moderate, and high susceptibility groups. A fixed general linear model with repeated-measures analysis of variance tested cVEMP characteristics for the susceptibility groups (between participants) and ears (within participants). A univariate analysis of variance tested the cVEMP interaural amplitudes across groups. The second analysis was a regression of the severity of motion sickness in percent on cVEMP characteristics. Significance was defined as p < 0.05. RESULTS Participants in the high susceptibility group had significantly higher cVEMP amplitudes than those in the low susceptibility group. cVEMP amplitudes did not differ between ears, and latencies did not differ between the two groups or between ears. Regression analysis on MSSQ-S percent susceptibility by VEMP amplitudes revealed a best-fit cubic function in both ears, with r(2) values of more than 42%. The interaural asymmetry ratio was negatively associated with motion sickness susceptibility (r(2) = 0.389). CONCLUSIONS The current study is the first to report that greater susceptibility to motion sickness is associated with larger cVEMP amplitudes and lower interaural cVEMP asymmetries. Larger interaural asymmetries in cVEMPs did not promote motion sickness susceptibility. The cVEMP findings implicate the saccule and its neural pathways in the production of motion sickness and are consistent with the theory that vertical motions elicit motion sickness. Motion sickness susceptibility may contribute to the variability in normative cVEMP amplitudes.
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Affiliation(s)
- Cynthia G Fowler
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI
| | - Amanda Sweet
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI; Current affiliation: Advanced Audiology, Valencia, CA
| | - Emily Steffel
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI; Currentl affiliation: Audiology Associates, Milan, IL
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Chen MM, Xu LH, Chang L, Yin P, Jiang ZL. Reduction of Motion Sickness Through Targeting Histamine N-Methyltransferase in the Dorsal Vagal Complex of the Brain. J Pharmacol Exp Ther 2018; 364:367-376. [PMID: 29298819 DOI: 10.1124/jpet.117.244475] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/20/2017] [Indexed: 11/22/2022] Open
Abstract
To investigate the role of histamine N-methyltransferase (HNMT) activity in the development of motion sickness (MS) in the dorsal vagal complex (DVC) to inform the development of new drugs for MS, Beagle dogs and Sprague-Dawley rats were rotated to simulate MS. HNMT expression in the brain stem and DVC was measured. The effects of systemic application of tacrine, an HNMT inhibitor, on the development of MS were observed. Moreover, we microinjected a histamine receptor H1 inhibitor, promethazine, into the DVC to verify the involvement of histaminergic neurotransmission in MS. Finally, lentiviral vectors were microinjected into the DVC to determine the effects of altered HNMT expression on MS. We found the following: 1) HNMT expression in the medulla oblongata of dogs and rats insusceptible to MS was higher than in susceptible animals; 2) tacrine dose-dependently promoted MS in both animals and raised histamine level in rat medulla oblongata; 3) blocking histaminergic neurotransmission in the DVC with promethazine inhibited MS; 4) rotatory stimulus induced an elevation in HNMT expression, and vestibular training elevated the basal level of HNMT in the DVC during habituation to MS; 5) in vivo transfection of a lentiviral vector packaged with the HNMT gene increased HNMT expression in the DVC and reduced MS; and 6) microinjection of a lentiviral vector driving the interference of HNMT gene expression in vivo significantly inhibited HNMT expression in the DVC and exacerbated MS. In conclusion, HNMT expression in the brain stem is inversely correlated with MS development. Increasing HNMT expression or stimulating its activity in the DVC could inhibit MS.
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Affiliation(s)
- Miao-Miao Chen
- Department of Neurophysiology and Neuropharmacology, Institute of Nautical Medicine and Co-innovation Center of Neuroregeneration, Nantong University, Chongchuan District, Nantong, Jiangsu, People's Republic of China
| | - Li-Hua Xu
- Department of Neurophysiology and Neuropharmacology, Institute of Nautical Medicine and Co-innovation Center of Neuroregeneration, Nantong University, Chongchuan District, Nantong, Jiangsu, People's Republic of China
| | - Li Chang
- Department of Neurophysiology and Neuropharmacology, Institute of Nautical Medicine and Co-innovation Center of Neuroregeneration, Nantong University, Chongchuan District, Nantong, Jiangsu, People's Republic of China
| | - Peng Yin
- Department of Neurophysiology and Neuropharmacology, Institute of Nautical Medicine and Co-innovation Center of Neuroregeneration, Nantong University, Chongchuan District, Nantong, Jiangsu, People's Republic of China
| | - Zheng-Lin Jiang
- Department of Neurophysiology and Neuropharmacology, Institute of Nautical Medicine and Co-innovation Center of Neuroregeneration, Nantong University, Chongchuan District, Nantong, Jiangsu, People's Republic of China
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Chen LK, Wang MH, Yang HJ, Fan SZ, Chen SS. Prospective observational pharmacogenetic study of side effects induced by intravenous morphine for postoperative analgesia. Medicine (Baltimore) 2017. [PMID: 28640078 PMCID: PMC5484186 DOI: 10.1097/md.0000000000007009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Nausea and vomiting are probably the most unpleasant side effects that occur when morphine used. A number of studies have investigated the effect on pain relief of single nucleotide polymorphisms (SNPs) in genes involved in morphine's metabolism, distribution, binding, and cellular action. The mechanism through which morphine causes nausea and vomiting has not been elucidated clearly. We examined all the reported SNPs which are associated with the complications of morphine, including SNPs in genes for phase I and phase II metabolic enzymes, ABC binding cassette drug transporters, κ and δ opioid receptors, and ion channels implicated in the postreceptor action of morphine.A prospective, observational study in 129 female patients was conducted to investigate the effect of 14 SNPs on nausea or vomiting induced by intravenous patient-controlled analgesia (IVPCA) with morphine after gynecology surgery. Clinical phenotype, subjective complaints, and objective observations were recorded. DNA from blood samples was used to record the SNPs. Eleven SNPs were then analyzed further.No significant association with the presence of phenotype (nausea or vomiting) versus genotype was observed (all P > .05). No significant association with severity of phenotype versus genotype of the 11 SNPs was observed except for unadjusted data for rs2737703.There was no significant difference between severity or incidence of IVPCA morphine-induced nausea and vomiting and genotype (11 SNPs). Further study should perhaps be focused on mRNA and proteinomics rather than SNPs.
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Affiliation(s)
- Li-Kuei Chen
- Department of Anesthesiology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City Department of Anesthesiology, National Taiwan University Hospital, Taipei Department of Anesthesiology, Chung Shan Medical University, Taichung City Department of Anesthesiology, En-Chu-Kon Hospital, Taipei Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei Department of Urology, School of Medicine, National Yang-Ming University, Taipei Division of Urology, Taipei City Hospital Heping Fuyou Branch, Taipei National United University Commission for General Education, Miaoli, Taiwan
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Sun W, Yang Y, Yu H, Wang L, Pan S. The Synergistic Effect of Microwave Radiation and Hypergravity on Rats and the Intervention Effect of Rana Sylvatica Le Conte Oil. Dose Response 2017; 15:1559325817711511. [PMID: 28717348 PMCID: PMC5502943 DOI: 10.1177/1559325817711511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
AIM The phenomena of hypergravity and microwave radiation are widespread, which cause more and more concern for the hazards to human health. The aim of this study was to investigate the synergistic effect of microwave radiation and hypergravity on rats and observe the protective effect of Rana sylvatica Le conte oil. METHODS Rats were exposed to microwave radiation and hypergravity, and the rat weight, the climbing pole height, serum enzyme activities, blood urea nitrogen concentration, and total antioxidant capacity were detected. RESULTS The climbing pole height, the activities of choline acetyl transferase and cholinesterase, and the total antioxidant capacity decreased, whereas the activities of alanine aminotransferase, aspartate aminotransferase, areatine kinase, isocitric dehydrogenase, hydroxybutyrate dehydrogenase, and the blood urea nitrogen concentration increased in the hypergravity irradiation group as compared with the others. CONCLUSION These results imply that the motion and nervous system of rats might be affected critically by the synergistic effect of microwave radiation and hypergravity, and it causes damage to most rat organs, such as the bone, skeletal muscle, liver, heart, and kidney, and the antioxidant effect is also damaged, while the injury resulted from it could be protected by Rana sylvatica Le conte oil.
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Affiliation(s)
- Wei Sun
- Department of Molecular Biology, College of Basic Medical Sciences, Jilin University, Changchun Jilin, China
| | - Yudan Yang
- China-Japan Union Hospital of Jilin University, Changchun, People's Republic of China
| | - Hongmei Yu
- China-Japan Union Hospital of Jilin University, Changchun, People's Republic of China
| | - Luowei Wang
- Department of Molecular Biology, College of Basic Medical Sciences, Jilin University, Changchun Jilin, China
| | - Su Pan
- Department of Orthopedics, the Second Hospital of Jilin University, Changchun, People's Republic of China
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Muscarinic Acetylcholine Receptors and M-Currents Underlie Efferent-Mediated Slow Excitation in Calyx-Bearing Vestibular Afferents. J Neurosci 2017; 37:1873-1887. [PMID: 28093476 DOI: 10.1523/jneurosci.2322-16.2017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/21/2022] Open
Abstract
Stimulation of vestibular efferent neurons excites calyx and dimorphic (CD) afferents. This excitation consists of fast and slow components that differ >100-fold in activation kinetics and response duration. In the turtle, efferent-mediated fast excitation arises in CD afferents when the predominant efferent neurotransmitter acetylcholine (ACh) activates calyceal nicotinic ACh receptors (nAChRs); however, it is unclear whether the accompanying efferent-mediated slow excitation is also attributed to cholinergic mechanisms. To identify synaptic processes underlying efferent-mediated slow excitation, we recorded from CD afferents innervating the turtle posterior crista during electrical stimulation of efferent neurons, in combination with pharmacological probes and mechanical stimulation. Efferent-mediated slow excitation was unaffected by nAChR compounds that block efferent-mediated fast excitation, but were mimicked by muscarine and antagonized by atropine, indicating that it requires ACh and muscarinic ACh receptor (mAChR) activation. Efferent-mediated slow excitation or muscarine application enhanced the sensitivity of CD afferents to mechanical stimulation, suggesting that mAChR activation increases afferent input impedance by closing calyceal potassium channels. These observations were consistent with suppression of a muscarinic-sensitive K+-current, or M-current. Immunohistochemistry for putative M-current candidates suggested that turtle CD afferents express KCNQ3, KCNQ4, and ERG1-3 potassium channel subunits. KCNQ channels were favored as application of the selective antagonist XE991 mimicked and occluded efferent-mediated slow excitation in CD afferents. These data highlight an efferent-mediated mechanism for enhancing afferent sensitivity. They further suggest that the clinical effectiveness of mAChR antagonists in treating balance disorders may also target synaptic mechanisms in the vestibular periphery, and that KCNQ channel modulators might offer similar therapeutic value.SIGNIFICANCE STATEMENT Targeting the efferent vestibular system (EVS) pharmacologically might prove useful in ameliorating some forms of vestibular dysfunction by modifying ongoing primary vestibular input. EVS activation engages several kinetically distinct synaptic processes that profoundly alter the discharge rate and sensitivity of first-order vestibular neurons. Efferent-mediated slow excitation of vestibular afferents is of considerable interest given its ability to elevate afferent activity over an extended time course. We demonstrate for the first time that efferent-mediated slow excitation of vestibular afferents is mediated by muscarinic acetylcholine receptor (mAChR) activation and the subsequent closure of KCNQ potassium channels. The clinical effectiveness of some anti-mAChR drugs in treating motion sickness suggest that we may, in fact, already be targeting the peripheral EVS.
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Hasegawa T, Oe H, Taki M, Sakaguchi H, Hirano S, Wada Y. End-tidal CO 2 relates to seasickness susceptibility: A study in Antarctic voyages. Auris Nasus Larynx 2016; 44:534-539. [PMID: 27986366 DOI: 10.1016/j.anl.2016.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/13/2016] [Accepted: 11/16/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the relationship between end-tidal CO2 (EtCO2) and seasickness (motion sickness at sea) during an Antarctic voyage. METHODS In this study, we measured EtCO2 and severity of seasickness using the subjective symptoms of motion sickness (SSMS). We sampled EtCO2 and SSMS every 3-4h for 3 days from the date of sail in 16 healthy subjects. This experiment was performed on an icebreaker (standard displacement: 12,650t). RESULTS Since 2 subjects dropped out because of severe motion sickness, available data were collected from 14 subjects. On analysis of all data of all subjects grouped together, there seemed to be a significant negative correlation between EtCO2 and SSMS (R=-0.27, P=0.0005). However, in individual subjects, this correlation was not obvious. During the voyage, EtCO2 level in the seasickness susceptible group was lower than that in the non-susceptible group (P=0.018). Both EtCO2 increasing in the non-susceptible group and decreasing in the susceptible group contribute to the difference in EtCO2 levels. We suggest that the cause of this increase in EtCO2 level in the non-susceptible group was unwitting slow and deep breathing to resist seasickness. CONCLUSION We revealed that for seasickness during an Antarctic voyage, EtCO2 level relates to susceptibility, but not occurrence or severity. Measurement of EtCO2 levels may be useful to identify seasickness-susceptible persons and to efficiently prevent seasickness.
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Affiliation(s)
- Tatsuhisa Hasegawa
- National Institute of Polar Research, 10-3 Midori-cho, Tachikawa, Tokyo, Japan; Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan; Department of Otolaryngology, Ayabe City Hospital, 20-1 Ootsuka, Aono-cho, Ayabe, Kyoto, Japan.
| | - Hirofumi Oe
- National Institute of Polar Research, 10-3 Midori-cho, Tachikawa, Tokyo, Japan
| | - Masakatsu Taki
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - Hirofumi Sakaguchi
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - Shigeru Hirano
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan
| | - Yoshiro Wada
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan; Wada Ear, Nose and Throat Clinic, 4-7-15 Komagawa, Higashisumiyosi-ku, Osaka, Japan
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Abstract
OPINION STATEMENT The use of opioids for the treatment of chronic non-cancer pain is growing at an alarming rate. Opioid-induced bowel dysfunction (OBD) is a common adverse effect of long-term opioid treatment manifesting as constipation, nausea, and vomiting. These effects are primarily mediated by peripheral μ-opioid receptors with resultant altered GI motility and function. As a result, patients may present with opioid-induced constipation (OIC), opioid-induced nausea and vomiting (OINV), and/or narcotic bowel syndrome (NBS). This often leads to decreased quality of life and in many cases, discontinuation of opioid therapy. There is limited evidence to support the use of traditional anti-emetics and laxatives in the treatment of OBD. Tapering the dose of opioids, switching to transdermal application, opioid rotation, or dual-action opioids, such as tapentadol, may be helpful in the treatment of OBD. Novel agents, such as peripherally acting μ-opioid receptor antagonists which target the cause of OIC, show promise in the treatment of OBD and should be considered when conventional laxatives fail. This chapter will review the pathophysiology of OBD, including OINV and OIC, and treatment options available.
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Wang J, Lewis RF. Contribution of intravestibular sensory conflict to motion sickness and dizziness in migraine disorders. J Neurophysiol 2016; 116:1586-1591. [PMID: 27385797 PMCID: PMC5144688 DOI: 10.1152/jn.00345.2016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/05/2016] [Indexed: 11/22/2022] Open
Abstract
Migraine is associated with enhanced motion sickness susceptibility and can cause episodic vertigo [vestibular migraine (VM)], but the mechanisms relating migraine to these vestibular symptoms remain uncertain. We tested the hypothesis that the central integration of rotational cues (from the semicircular canals) and gravitational cues (from the otolith organs) is abnormal in migraine patients. A postrotational tilt paradigm generated a conflict between canal cues (which indicate the head is rotating) and otolith cues (which indicate the head is tilted and stationary), and eye movements were measured to quantify two behaviors that are thought to minimize this conflict: suppression and reorientation of the central angular velocity signal, evidenced by attenuation ("dumping") of the vestibuloocular reflex and shifting of the rotational axis of the vestibuloocular reflex toward the earth vertical. We found that normal and migraine subjects, but not VM patients, displayed an inverse correlation between the extent of dumping and the size of the axis shift such that the net "conflict resolution" mediated through these two mechanisms approached an optimal value and that the residual sensory conflict in VM patients (but not migraine or normal subjects) correlated with motion sickness susceptibility. Our findings suggest that the brain normally controls the dynamic and spatial characteristics of central vestibular signals to minimize intravestibular sensory conflict and that this process is disrupted in VM, which may be responsible for the enhance motion intolerance and episodic vertigo that characterize this disorder.
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Affiliation(s)
- Joanne Wang
- Case Western University Medical School, Cleveland, Ohio
| | - Richard F Lewis
- Jenks Vestibular Physiology Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts; and Department of Neurology, Harvard Medical School, Boston, Massachusetts
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Lucot JB. Effects of naloxone on motion sickness in cats alone and with broad spectrum antiemetics. Auton Neurosci 2016; 202:97-101. [PMID: 27615675 DOI: 10.1016/j.autneu.2016.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/25/2016] [Accepted: 08/29/2016] [Indexed: 11/18/2022]
Abstract
Doses of naloxone far below those which elicit emesis increase the sensitivity to motion sickness. In order to evaluate the possible interaction with broad spectrum antiemetics, low doses of naloxone were tested alone and in combination with 8-hydroxy-2-(di-n-propylamine)tetralin (DPAT), fentanyl and the NK1 antagonist CP-99994. A modified autonomic symptom rating scale was unaffected by any drug and thus considered of little value. Fentanyl and NK1 antagonists decreased the duration of the retch/vomit sequence. Naloxone alone and in combination with each of the drugs increased the duration of retching/vomiting. Naloxone also increased the number of vomiting sequences. The results are interpreted in terms of possible site(s) of action of the antiemetic drugs.
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Affiliation(s)
- James B Lucot
- Department of Pharmacology and Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH, United States.
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Balaban CD, Yates BJ. What is nausea? A historical analysis of changing views. Auton Neurosci 2016; 202:5-17. [PMID: 27450627 DOI: 10.1016/j.autneu.2016.07.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 12/27/2022]
Abstract
The connotation of "nausea" has changed across several millennia. The medical term 'nausea' is derived from the classical Greek terms ναυτια and ναυσια, which designated the signs and symptoms of seasickness. In classical texts, nausea referred to a wide range of perceptions and actions, including lethargy and disengagement, headache (migraine), and anorexia, with an awareness that vomiting was imminent only when the condition was severe. However, some recent articles have limited the definition to the sensations that immediately precede emesis. Defining nausea is complicated by the fact that it has many triggers, and can build-up slowly or rapidly, such that the prodromal signs and symptoms can vary. In particular, disengagement responses referred to as the "sopite syndrome" are typically present only when emetic stimuli are moderately provocative, and do not quickly culminate in vomiting or withdrawing from the triggering event. This review considers how the definition of "nausea" has evolved over time, and summarizes the physiological changes that occur prior to vomiting that may be indicative of nausea. Also described are differences in the perception of nausea, as well as the accompanying physiological responses, that occur with varying stimuli. This information is synthesized to provide an operational definition of nausea.
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Affiliation(s)
- Carey D Balaban
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Bill J Yates
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA 15213, USA; Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Gupta RG, Schafer C, Ramaroson Y, Sciullo MG, Horn CC. Role of the abdominal vagus and hindbrain in inhalational anesthesia-induced vomiting. Auton Neurosci 2016; 202:114-121. [PMID: 27396693 DOI: 10.1016/j.autneu.2016.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/28/2022]
Abstract
The incidence of postoperative nausea and vomiting (PONV) can be as high as 80% in patients with risk factors (e.g., females, history of motion sickness). PONV delays postoperative recovery and costs several hundred million dollars annually. Cell-based assays show that halogenated ethers (e.g., isoflurane) activate 5-HT3 receptors, which are found on gastrointestinal vagal afferents and in the hindbrain - key pathways for producing nausea and vomiting. This project evaluated the role of the vagus and activation of the hindbrain in isoflurane-induced emesis in musk shrews, a small animal model with a vomiting reflex, which is lacking in rats and mice. Sham-operated and abdominal vagotomized shrews were exposed to 1 to 3% isoflurane to determine effects on emesis; vagotomy was confirmed by lack of vagal transport of the neuronal tracer Fluoro-Gold. In an additional study, shrews were exposed to isoflurane and hindbrain c-Fos was measured at 90min after exposure using immunohistochemistry. There were no statistically significant effects of vagotomy on isoflurane-induced emesis compared to sham-operated controls. Isoflurane exposure produced a significant increase in c-Fos-positive cells in the nucleus of the solitary tract and vestibular nuclei but not in the area postrema or dorsal motor nucleus. These results indicate that the abdominal vagus plays no role in isoflurane-induced emesis and suggest that isoflurane activates emesis by action on the hindbrain, as shown by c-Fos labeling. Ultimately, knowledge of the mechanisms of inhalational anesthesia-induced PONV could lead to more targeted therapies to control PONV.
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Affiliation(s)
- Ragini G Gupta
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Claire Schafer
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Michael G Sciullo
- Biobehavioral Oncology Program, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Charles C Horn
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Biobehavioral Oncology Program, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA; Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States.
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Granston A, Drummond PD. Painful Stimulation of the Temple During Optokinetic Stimulation Triggers Migraine-Like Attacks in Migraine Sufferers. Cephalalgia 2016; 25:219-24. [PMID: 15689198 DOI: 10.1111/j.1468-2982.2004.00844.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To determine whether motion sickness induced by optokinetic stimulation would trigger migraine-like attacks, 27 migraine sufferers and 23 controls attended the laboratory up to three times at intervals of at least 3 weeks. On one occasion subjects experienced up to 15 min of optokinetic stimulation, followed by three 30-s applications of ice to the temple at 4-min intervals. On another occasion, the ice applications preceded and accompanied optokinetic stimulation. On a third occasion, one hand was immersed in ice water for 30 s, three times at 4-min intervals before and during optokinetic stimulation. Subjects recorded headache activity in a diary over the course of the study. None of the controls experienced a migraine-like attack at any stage of the experiment. In migraine sufferers, the incidence of migraine-like attacks was greater than the expected daily incidence of 8% after sessions that involved painful stimulation of the temple during or after optokinetic stimulation (44% and 28% of the group, respectively) ( P < 0.001). In contrast, migraine-like attacks developed in only 13% of migraine sufferers after the session that involved immersing the hand in ice water during optokinetic stimulation (not significant). The development of nausea and headache during optokinetic stimulation increased the likelihood of migraine-like attacks afterwards. These findings indicate that motion sickness and head pain increase susceptibility to migrainous attacks in migraine sufferers, and suggest that the symptoms of migraine build upon each other in a vicious circle. Thus, targeting multiple symptoms should be more effective than targeting individual symptoms, both for preventing and treating attacks of migraine.
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Affiliation(s)
- A Granston
- School of Psychology, Murdoch University, Western Australia
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Zhang LL, Liu HQ, Yu XH, Zhang Y, Tian JS, Song XR, Han B, Liu AJ. The Combination of Scopolamine and Psychostimulants for the Prevention of Severe Motion Sickness. CNS Neurosci Ther 2016; 22:715-22. [PMID: 27160425 DOI: 10.1111/cns.12566] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 04/16/2016] [Accepted: 04/18/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS Severe motion sickness is a huge obstacle for people conducting precise aviation, marine or emergency service tasks. The combination of scopolamine and d-amphetamine is most effective in preventing severe motion sickness. However, this combination is not included in any present pharmacopoeia due to the abuse liability of d-amphetamine. We wanted to find a combination to replace it for the treatment of severe motion sickness. METHODS AND RESULTS We compared the efficacy of scopolamine, diphenhydramine, and granisetron (representing three classes of drugs) with different doses, and found that scopolamine was the most effective one. We also found scopolamine inhibited central nervous system at therapeutic doses and caused anxiety. Then, we combined it with different doses of psychostimulants (d-amphetamine, modafinil, caffeine) to find the best combination for motion sickness. The efficacy of scopolamine with modafinil (1 + 10 mg/kg) was equivalent to that of scopolamine with d-amphetamine (1 + 1 mg/kg); This combination also excited central nervous system and abolished the anxiety caused by scopolamine. CONCLUSIONS The optimal dose ratio of scopolamine and modafinil is 1:10. This combination is beneficial for motion sickness and can abolish the side effects of scopolamine. So, it might be a good replacement of scopolamine and d-amphetamine for severe motion sickness.
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Affiliation(s)
- Li-Li Zhang
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Hong-Qi Liu
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Xu-Hong Yu
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Ying Zhang
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Jia-Sheng Tian
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Xu-Rui Song
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Bing Han
- Department of Pharmacy, Minhang Hospital, Fudan University, Shanghai, China
| | - Ai-Jun Liu
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China
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Abstract
During gestation, cells of the brain and gut develop almost simultaneously into the central nervous system (CNS) and enteric nervous system (ENS), respectively. They remain connected via the vagal nerve lifelong. While it is well known that the brain sends signal to the gut, communication is in fact bidirectional. Just as the brain can modulate gut functioning, the gut, and likely what we ingest, can in fact influence our brain functioning. We will first review both gastrointestinal (GI) function and migraine pathophysiology and then discuss evidence linking the migraine brain to various GI disorders. Lastly, we discuss the effects of gut microbiota on brain functioning and speculate how the gut and particularly diet may affect migraine.
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Abstract
Over 2000 years ago the Greek physician Hippocrates wrote, "sailing on the sea proves that motion disorders the body." Indeed, the word "nausea" derives from the Greek root word naus, hence "nautical," meaning a ship. The primary signs and symptoms of motion sickness are nausea and vomiting. Motion sickness can be provoked by a wide variety of transport environments, including land, sea, air, and space. The recent introduction of new visual technologies may expose more of the population to visually induced motion sickness. This chapter describes the signs and symptoms of motion sickness and different types of provocative stimuli. The "how" of motion sickness (i.e., the mechanism) is generally accepted to involve sensory conflict, for which the evidence is reviewed. New observations concern the identification of putative "sensory conflict" neurons and the underlying brain mechanisms. But what reason or purpose does motion sickness serve, if any? This is the "why" of motion sickness, which is analyzed from both evolutionary and nonfunctional maladaptive theoretic perspectives. Individual differences in susceptibility are great in the normal population and predictors are reviewed. Motion sickness susceptibility also varies dramatically between special groups of patients, including those with different types of vestibular disease and in migraineurs. Finally, the efficacy and relative advantages and disadvantages of various behavioral and pharmacologic countermeasures are evaluated.
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Affiliation(s)
- J F Golding
- Department of Psychology, Faculty of Science and Technology, University of Westminster, London, UK.
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Meredith FL, Kirk ME, Rennie KJ. Kv1 channels and neural processing in vestibular calyx afferents. Front Syst Neurosci 2015; 9:85. [PMID: 26082693 PMCID: PMC4451359 DOI: 10.3389/fnsys.2015.00085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 05/18/2015] [Indexed: 11/13/2022] Open
Abstract
Potassium-selective ion channels are important for accurate transmission of signals from auditory and vestibular sensory end organs to their targets in the central nervous system. During different gravity conditions, astronauts experience altered input signals from the peripheral vestibular system resulting in sensorimotor dysfunction. Adaptation to altered sensory input occurs, but it is not explicitly known whether this involves synaptic modifications within the vestibular epithelia. Future investigations of such potential plasticity require a better understanding of the electrophysiological mechanisms underlying the known heterogeneity of afferent discharge under normal conditions. This study advances this understanding by examining the role of the Kv1 potassium channel family in mediating action potentials in specialized vestibular afferent calyx endings in the gerbil crista and utricle. Pharmacological agents selective for different sub-types of Kv1 channels were tested on membrane responses in whole cell recordings in the crista. Kv1 channels sensitive to α-dendrotoxin and dendrotoxin-K were found to prevail in the central regions, whereas K(+) channels sensitive to margatoxin, which blocks Kv1.3 and 1.6 channels, were more prominent in peripheral regions. Margatoxin-sensitive currents showed voltage-dependent inactivation. Dendrotoxin-sensitive currents showed no inactivation and dampened excitability in calyces in central neuroepithelial regions. The differential distribution of Kv1 potassium channels in vestibular afferents supports their importance in accurately relaying gravitational and head movement signals through specialized lines to the central nervous system. Pharmacological modulation of specific groups of K(+) channels could help alleviate vestibular dysfunction on earth and in space.
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Affiliation(s)
- Frances L Meredith
- Department of Otolaryngology, University of Colorado School of Medicine Aurora, Colorado, USA
| | - Matthew E Kirk
- Department of Otolaryngology, University of Colorado School of Medicine Aurora, Colorado, USA
| | - Katherine J Rennie
- Department of Otolaryngology, University of Colorado School of Medicine Aurora, Colorado, USA ; Department of Physiology and Biophysics, University of Colorado School of Medicine Aurora, Colorado, USA
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Rudd JA, Nalivaiko E, Matsuki N, Wan C, Andrews PL. The involvement of TRPV1 in emesis and anti-emesis. Temperature (Austin) 2015; 2:258-76. [PMID: 27227028 PMCID: PMC4843889 DOI: 10.1080/23328940.2015.1043042] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/13/2015] [Accepted: 04/16/2015] [Indexed: 12/29/2022] Open
Abstract
Diverse transmitter systems (e.g. acetylcholine, dopamine, endocannabinoids, endorphins, glutamate, histamine, 5-hydroxytryptamine, substance P) have been implicated in the pathways by which nausea and vomiting are induced and are targets for anti-emetic drugs (e.g. 5-hydroxytryptamine3 and tachykinin NK1 antagonists). The involvement of TRPV1 in emesis was discovered in the early 1990s and may have been overlooked previously as TRPV1 pharmacology was studied in rodents (mice, rats) lacking an emetic reflex. Acute subcutaneous administration of resiniferatoxin in the ferret, dog and Suncus murinus revealed that it had “broad–spectrum” anti-emetic effects against stimuli acting via both central (vestibular system, area postrema) and peripheral (abdominal vagal afferents) inputs. One of several hypotheses discussed here is that the anti-emetic effect is due to acute depletion of substance P (or another peptide) at a critical site (e.g. nucleus tractus solitarius) in the central emetic pathway. Studies in Suncus murinus revealed a potential for a long lasting (one month) effect against the chemotherapeutic agent cisplatin. Subsequent studies using telemetry in the conscious ferret compared the anti-emetic, hypothermic and hypertensive effects of resiniferatoxin (pungent) and olvanil (non-pungent) and showed that the anti-emetic effect was present (but reduced) with olvanil which although inducing hypothermia it did not have the marked hypertensive effects of resiniferatoxin. The review concludes by discussing general insights into emetic pathways and their pharmacology revealed by these relatively overlooked studies with TRPV1 activators (pungent an non-pungent; high and low lipophilicity) and antagonists and the potential clinical utility of agents targeted at the TRPV1 system.
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Key Words
- 12-HPETE, 12-hydroperoxy-eicosatetraenoic acid
- 5-HT, 5-hydroxytryptamine
- 5-HT3, 5-hdroxytryptamine3
- 8-OH-DPAT, (±)-8-Hydroxy-2-dipropylaminotetralin
- AM404
- AM404, N-arachidonoylaminophenol
- AMT, anandamide membrane transporter
- AP, area postrema
- BBB, blood brain barrier
- CB1, cannabinoid1
- CGRP, calcitonin gene-related peptide
- CINV, chemotherapy-induced nausea and vomiting
- CP 99,994
- CTA, conditioned taste aversion
- CVO's, circumventricular organs
- D2, dopamine2
- DRG, dorsal root ganglia
- FAAH, fatty acid amide hydrolase
- H1, histamine1
- LTB4, leukotriene B4
- NADA, N-arachidonoyl-dopamine
- NK1, neurokinin1
- POAH, preoptic anterior hypothalamus
- RTX
- Suncus murinus
- TRPV1
- TRPV1, transient receptor potential vanilloid receptor1
- anti-emetic
- capsaicin
- ferret
- i.v., intravenous
- nausea
- olvanil
- thermoregulation
- vanilloid
- vomiting
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Affiliation(s)
- John A Rudd
- Brain and Mind Institute; Chinese University of Hong Kong; Shatin; New Territories, Hong Kong SAR; School of Biomedical Sciences; Faculty of Medicine; Chinese University of Hong Kong; Shatin; New Territories, Hong Kong SAR
| | - Eugene Nalivaiko
- School of Biomedical Sciences and Pharmacy; University of Newcastle ; Callaghan, NSW, Australia
| | - Norio Matsuki
- Laboratory of Chemical Pharmacology; Graduate School of Pharmaceutical Sciences; The University of Tokyo ; Tokyo, Japan
| | - Christina Wan
- School of Biomedical Sciences; Faculty of Medicine; Chinese University of Hong Kong ; Shatin; New Territories, Hong Kong SAR
| | - Paul Lr Andrews
- Division of Biomedical Sciences; St George's University of London ; London, UK
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Imaizumi S, Honma M, Hibino H, Koyama S. Illusory visual motion stimulus elicits postural sway in migraine patients. Front Psychol 2015; 6:542. [PMID: 25972832 PMCID: PMC4411888 DOI: 10.3389/fpsyg.2015.00542] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/15/2015] [Indexed: 11/13/2022] Open
Abstract
Although the perception of visual motion modulates postural control, it is unknown whether illusory visual motion elicits postural sway. The present study examined the effect of illusory motion on postural sway in patients with migraine, who tend to be sensitive to it. We measured postural sway for both migraine patients and controls while they viewed static visual stimuli with and without illusory motion. The participants' postural sway was measured when they closed their eyes either immediately after (Experiment 1), or 30 s after (Experiment 2), viewing the stimuli. The patients swayed more than the controls when they closed their eyes immediately after viewing the illusory motion (Experiment 1), and they swayed less than the controls when they closed their eyes 30 s after viewing it (Experiment 2). These results suggest that static visual stimuli with illusory motion can induce postural sway that may last for at least 30 s in patients with migraine.
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Affiliation(s)
- Shu Imaizumi
- Graduate School of Engineering, Chiba University Chiba, Japan ; Japan Society for the Promotion of Science Tokyo, Japan
| | | | - Haruo Hibino
- Graduate School of Engineering, Chiba University Chiba, Japan
| | - Shinichi Koyama
- Graduate School of Engineering, Chiba University Chiba, Japan ; School of Medicine, Showa University Tokyo, Japan ; School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore Singapore
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Park JH, Lee C, Shin Y, An JH, Ban JS, Lee JH. Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery. Korean J Anesthesiol 2015; 68:153-8. [PMID: 25844134 PMCID: PMC4384403 DOI: 10.4097/kjae.2015.68.2.153] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 10/17/2014] [Accepted: 10/21/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Opioids are widely used in boluses and patient-controlled analgesia (PCA) for postoperative pain control. In this study, we compared the effects of oxycodone and fentanyl on postoperative pain in patients with intravenous patient-controlled analgesia (IV-PCA) after laparoscopic gynecological surgery. METHODS Seventy-four patients undergoing elective total laparoscopic hysterectomy or laparoscopic myomectomy were randomly assigned to the administration of either fentanyl or oxycodone using IV-PCA (potency ratio 1 : 60). The cumulative dose administered in the patient-controlled mode during the initial 48 hours after the operation was measured. Patients were also assessed for postoperative pain severity, adverse effects, and patient satisfaction. RESULTS No significant differences were observed in patient satisfaction with the analgesia during the postoperative period. Patients in the oxycodone group experienced significantly more dizziness compared to the fentanyl group. Patients in the oxycodone group showed significantly lower consumption of opioid in the patient-controlled mode (10.1 ± 8.5 ml vs. 16.6 ± 12.0 ml, P = 0.013). CONCLUSIONS Our data suggest that oxycodone and fentanyl demonstrated similar effects, and therefore oxycodone may be a good alternative to fentanyl in postoperative pain management. Further studies in various clinical settings will be needed to determine the adequate potency ratio.
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Affiliation(s)
- Joong-Ho Park
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Chiu Lee
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Youngmin Shin
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Ji-Hyun An
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jong-Seouk Ban
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Ji-Hyang Lee
- Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea
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Santurtun E, Phillips CJC. The impact of vehicle motion during transport on animal welfare. Res Vet Sci 2015; 100:303-8. [PMID: 25847285 DOI: 10.1016/j.rvsc.2015.03.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 02/23/2015] [Accepted: 03/14/2015] [Indexed: 10/23/2022]
Abstract
Motion sickness is a common response in humans and some species of farm livestock during transport, but research on the impact of motion has been primarily focused on the use of animal models for humans. During livestock transportation, animals seek to minimise uncontrolled movements to reduce energy consumption and maintain posture. Road and sea transport of livestock can produce motion sickness and stress responses. Clinical signs are the result of autonomous nervous system activation. Studies conducted on road transportation effects in domestic animals showed several motion sickness behaviours including vomiting and, in ruminants, a reduction in rumination. However, there is a lack of knowledge on the impact of sea transport motion. Despite the paucity of data on livestock, there is sufficient evidence to believe that motion might affect animal welfare when animals are transported by road or sea.
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Affiliation(s)
- Eduardo Santurtun
- Centre for Animal Welfare and Ethics, School of Veterinary Science, University of Queensland, Gatton 4343, Queensland, Australia.
| | - Clive J C Phillips
- Centre for Animal Welfare and Ethics, School of Veterinary Science, University of Queensland, Gatton 4343, Queensland, Australia
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Esposito M, Precenzano F, Sorrentino M, Avolio D, Carotenuto M. A Medical Food Formulation of Griffonia simplicifolia/Magnesium for Childhood Periodic Syndrome Therapy: An Open-Label Study on Motion Sickness. J Med Food 2015; 18:916-20. [PMID: 25590358 DOI: 10.1089/jmf.2014.0113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Motion sickness (MS) is a disabling condition dominated by disagreement between visually perceived movement and the vestibular system's sense of movement, with symptoms like dizziness, fatigue, and nausea, and other autonomic disabling symptoms. Preparations of Griffonia simplicifolia, containing high concentrations of 5-HTP, might be effective for serotonin-related disorders, including MS. Therefore, the aim of the present study is to assess the efficacy and safety of the G. simplicifolia/magnesium complex in a pediatric population with MS. The Griffonia/magnesium complex (50 and 200 mg, respectively) was orally administered as a prophylactic therapy for MS twice a day for 3 months to group A, and no therapy for MS was administered to group B. The MS clinical signs were recorded by parents or, where possible, directly from children by a specific module, which included validated questions for the diagnoses that were administered to all subjects and parents of both groups. Two study groups were matched for age (P=.224), sex (P=.801), and z-score body-mass index (P=.173). At T0, all recruited subjects in both groups complained about MS. After 3 months (T1), group A showed an MS prevalence of 36%, significantly lower than MS prevalence in group B (73%) (P<.001). The findings of the present study suggest the role of the Griffonia/magnesium complex as a potential treatment with middle-term efficacy even for MS.
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Affiliation(s)
- Maria Esposito
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Center for Childhood Headache, Second University of Naples , Naples, Italy
| | - Francesco Precenzano
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Center for Childhood Headache, Second University of Naples , Naples, Italy
| | - Michele Sorrentino
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Center for Childhood Headache, Second University of Naples , Naples, Italy
| | - Deborah Avolio
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Center for Childhood Headache, Second University of Naples , Naples, Italy
| | - Marco Carotenuto
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Center for Childhood Headache, Second University of Naples , Naples, Italy
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46
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Singh NK, Pandey P, Mahesh S. Assessment of otolith function using cervical and ocular vestibular evoked myogenic potentials in individuals with motion sickness. ERGONOMICS 2014; 57:1907-1918. [PMID: 25220694 DOI: 10.1080/00140139.2014.952683] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The involvement of otolith organs in motion sickness has long been debated; however, equivocal findings exist in literature. The present study thus aimed at evaluating the otolith functioning in individuals with motion sickness. Cervical and ocular vestibular evoked myogenic potentials were recorded from 30 individuals with motion sickness, 30 professional drivers and 30 healthy individuals. The results revealed no significant difference in latencies and amplitudes between the groups (p>0.05). Nonetheless, thresholds were significantly elevated and inter-aural asymmetry ratio significantly higher in motion sickness susceptible group (p < 0.001) for both the potentials. All the individuals in the motion sickness group had high asymmetry ratio at least on one of the two potentials. Thus, reduced response and/or asymmetric otolithic function seem the likely reasons behind motion sickness susceptibility.
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Affiliation(s)
- Niraj Kumar Singh
- a Department of Audiology , All India Institute of Speech and Hearing , Karnataka , India
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47
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Abstract
Motion sickness is a complex syndrome that includes many features besides nausea and vomiting. This review describes some of these factors and points out that under normal circumstances, many cases of motion sickness go unrecognized. Motion sickness can occur during exposure to physical motion, visual motion, and virtual motion, and only those without a functioning vestibular system are fully immune. The range of vulnerability in the normal population varies about 10,000 to 1. Sleep deprivation can also enhance susceptibility. Systematic studies conducted in parabolic flight have identified velocity storage of semicircular canal signals-velocity integration-as being a key factor in both space motion sickness and terrestrial motion sickness. Adaptation procedures that have been developed to increase resistance to motion sickness reduce this time constant. A fully adequate theory of motion sickness is not presently available. Limitations of two popular theories, the evolutionary and the ecological, are described. A sensory conflict theory can explain many but not all aspects of motion sickness elicitation. However, extending the theory to include conflicts related to visceral afferent feedback elicited by voluntary and passive body motion greatly expands its explanatory range. Future goals should include determining why some conflicts are provocative and others are not but instead lead to perceptual reinterpretations of ongoing body motion. The contribution of visceral afferents in relation to vestibular and cerebellar signals in evoking sickness also deserves further exploration. Substantial progress is being made in identifying the physiological mechanisms underlying the evocation of nausea, vomiting, and anxiety, and a comprehensive understanding of motion sickness may soon be attainable. Adequate anti-motion sickness drugs without adverse side effects are not yet available.
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Affiliation(s)
- James R Lackner
- Volen Center for Complex Systems, Brandeis University, Waltham, MA, 02454, USA,
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48
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Stockhorst U, Hall G, Enck P, Klosterhalfen S. Effects of overshadowing on conditioned and unconditioned nausea in a rotation paradigm with humans. Exp Brain Res 2014; 232:2651-64. [DOI: 10.1007/s00221-014-3998-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 05/16/2014] [Indexed: 12/13/2022]
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49
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Oman CM, Cullen KE. Brainstem processing of vestibular sensory exafference: implications for motion sickness etiology. Exp Brain Res 2014; 232:2483-92. [PMID: 24838552 DOI: 10.1007/s00221-014-3973-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/20/2014] [Indexed: 11/29/2022]
Abstract
The origin of the internal "sensory conflict" stimulus causing motion sickness has been debated for more than four decades. Recent studies show a subclass of neurons in the vestibular nuclei and deep cerebellar nuclei that respond preferentially to passive head movements. During active movement, the semicircular canal and otolith input ("reafference") to these neurons are canceled by a mechanism comparing the expected consequences of self-generated movement (estimated with an internal model-presumably located in the cerebellum) with the actual sensory feedback. The un-canceled component ("exafference") resulting from passive movement normally helps compensate for unexpected postural disturbances. Notably, the existence of such vestibular "sensory conflict" neurons had been postulated as early as 1982, but their existence and putative role in posture control and motion sickness have been long debated. Here, we review the development of "sensory conflict" theories in relation to recent evidence for brainstem and cerebellar reafference cancelation, and identify some open research questions. We propose that conditions producing persistent activity of these neurons, or their targets, stimulate nearby brainstem emetic centers-via an as yet unidentified mechanism. We discuss how such a mechanism is consistent with the notable difference in motion sickness susceptibility of drivers as opposed to passengers, human immunity to normal self-generated movement and why head restraint or lying horizontal confers relative immunity. Finally, we propose that fuller characterization of these mechanisms and their potential role in motion sickness could lead to more effective, scientifically based prevention and treatment for motion sickness.
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Affiliation(s)
- Charles M Oman
- Man Vehicle Laboratory, Massachusetts Institute of Technology, Room 37-219, MIT 77 Massachusetts Avenue, Cambridge, MA, 02139, USA,
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50
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Yates BJ, Catanzaro MF, Miller DJ, McCall AA. Integration of vestibular and emetic gastrointestinal signals that produce nausea and vomiting: potential contributions to motion sickness. Exp Brain Res 2014; 232:2455-69. [PMID: 24736862 DOI: 10.1007/s00221-014-3937-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/25/2014] [Indexed: 12/23/2022]
Abstract
Vomiting and nausea can be elicited by a variety of stimuli, although there is considerable evidence that the same brainstem areas mediate these responses despite the triggering mechanism. A variety of experimental approaches showed that nucleus tractus solitarius, the dorsolateral reticular formation of the caudal medulla (lateral tegmental field), and the parabrachial nucleus play key roles in integrating signals that trigger nausea and vomiting. These brainstem areas presumably coordinate the contractions of the diaphragm and abdominal muscles that result in vomiting. However, it is unclear whether these regions also mediate the autonomic responses that precede and accompany vomiting, including alterations in gastrointestinal activity, sweating, and changes in blood flow to the skin. Recent studies showed that delivery of an emetic compound to the gastrointestinal system affects the processing of vestibular inputs in the lateral tegmental field and parabrachial nucleus, potentially altering susceptibility for vestibular-elicited vomiting. Findings from these studies suggested that multiple emetic inputs converge on the same brainstem neurons, such that delivery of one emetic stimulus affects the processing of another emetic signal. Despite the advances in understanding the neurobiology of nausea and vomiting, much is left to be learned. Additional neurophysiologic studies, particularly those conducted in conscious animals, will be crucial to discern the integrative processes in the brain stem that result in emesis.
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Affiliation(s)
- Bill J Yates
- Department of Otolaryngology, Eye and Ear Institute, University of Pittsburgh, Room 519, Pittsburgh, PA, 15213, USA,
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