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Maruta J. The Scientific Contributions of Bernard Cohen (1929-2019). Front Neurol 2021; 11:624243. [PMID: 33510708 PMCID: PMC7835511 DOI: 10.3389/fneur.2020.624243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/11/2020] [Indexed: 11/13/2022] Open
Abstract
Throughout Bernard Cohen's active career at Mount Sinai that lasted over a half century, he was involved in research on vestibular control of the oculomotor, body postural, and autonomic systems in animals and humans, contributing to our understanding of such maladies as motion sickness, mal de débarquement syndrome, and orthostatic syncope. This review is an attempt to trace and connect Cohen's varied research interests and his approaches to them. His influence was vast. His scientific contributions will continue to drive research directions for many years to come.
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Affiliation(s)
- Jun Maruta
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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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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Cohen B, Lewis R. Editorial: Vestibular Contributions to Health and Disease. Front Neurol 2018; 9:117. [PMID: 29615952 PMCID: PMC5867307 DOI: 10.3389/fneur.2018.00117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 02/19/2018] [Indexed: 01/21/2023] Open
Affiliation(s)
- Bernard Cohen
- Department of Neurology, Mount Sinai School of Medicine, New York, NY, United States
| | - Richard Lewis
- Department of Otolaryngology, Harvard Medical School, Boston, MA, United States.,Department of Neurology, Harvard Medical School, Boston, MA, United States
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Bertolini G, Durmaz MA, Ferrari K, Küffer A, Lambert C, Straumann D. Determinants of Motion Sickness in Tilting Trains: Coriolis/Cross-Coupling Stimuli and Tilt Delay. Front Neurol 2017; 8:195. [PMID: 28555125 PMCID: PMC5430385 DOI: 10.3389/fneur.2017.00195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 04/21/2017] [Indexed: 11/13/2022] Open
Abstract
Faster trains require tilting of the cars to counterbalance the centrifugal forces during curves. Motion sensitive passengers, however, complain of discomfort and overt motion sickness. A recent study comparing different control systems in a tilting train, suggested that the delay of car tilts relative to the curve of the track contributes to motion sickness. Other aspects of the motion stimuli, like the lateral accelerations and the car jitters, differed between the tested conditions and prevented a final conclusion on the role of tilt delay. Nineteen subjects were tested on a motorized 3D turntable that simulated the roll tilts during yaw rotations experienced on a tilting train, isolating them from other motion components. Each session was composed of two consecutive series of 12 ideal curves that were defined on the bases of recordings during an actual train ride. The simulated car tilts started either at the beginning of the curve acceleration phase (no-delay condition) or with 3 s of delay (delay condition). Motion sickness was self-assessed by each subject at the end of each series using an analog motion sickness scale. All subjects were tested in both conditions. Significant increases of motion sickness occurred after the first sequence of 12 curves in the delay condition, but not in the no-delay condition. This increase correlated with the sensitivity of motion sickness, which was self-assessed by each subject before the experiment. The second sequence of curve did not lead to a significant further increase of motion sickness in any condition. Our results demonstrate that, even if the speed and amplitude are as low as those experienced on tilting trains, a series of roll tilts with a delay relative to the horizontal rotations, isolated from other motion stimuli occurring during a travel, generate Coriolis/cross-coupling stimulations sufficient to rapidly induce motion sickness in sensitive individuals. The strength and the rapid onset of the motion sickness reported confirm that, even if the angular velocity involved are low, the Coriolis/cross-coupling resulting from the delay is a major factor in causing sickness that can be resolved by improving the tilt timing relative to the horizontal rotation originating from the curve.
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Affiliation(s)
- Giovanni Bertolini
- Department of Neurology, Zurich University Hospital, Zurich, Switzerland
| | - Meek Angela Durmaz
- Department of Neurology, Zurich University Hospital, Zurich, Switzerland
| | - Kim Ferrari
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland.,Neuroscience Center, University and ETH Zurich, Zurich, Switzerland
| | - Alexander Küffer
- Department of Neurosurgery, Zurich University Hospital, Zurich, Switzerland
| | - Charlotte Lambert
- Department of Neurology, Zurich University Hospital, Zurich, Switzerland
| | - Dominik Straumann
- Department of Neurology, Zurich University Hospital, Zurich, Switzerland
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Cohen B, Martinelli GP, Xiang Y, Raphan T, Yakushin SB. Vestibular Activation Habituates the Vasovagal Response in the Rat. Front Neurol 2017; 8:83. [PMID: 28360882 PMCID: PMC5350135 DOI: 10.3389/fneur.2017.00083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/24/2017] [Indexed: 12/16/2022] Open
Abstract
Vasovagal syncope is a significant medical problem without effective therapy, postulated to be related to a collapse of baroreflex function. While some studies have shown that repeated static tilts can block vasovagal syncope, this was not found in other studies. Using anesthetized, male Long–Evans rats that were highly susceptible to generation of vasovagal responses, we found that repeated activation of the vestibulosympathetic reflex (VSR) with ±2 and ±3 mA, 0.025 Hz sinusoidal galvanic vestibular stimulation (sGVS) caused incremental changes in blood pressure (BP) and heart rate (HR) that blocked further generation of vasovagal responses. Initially, BP and HR fell ≈20–50 mmHg and ≈20–50 beats/min (bpm) into a vasovagal response when stimulated with Sgv\S in susceptible rats. As the rats were continually stimulated, HR initially rose to counteract the fall in BP; then the increase in HR became more substantial and long lasting, effectively opposing the fall in BP. Finally, the vestibular stimuli simply caused an increase in BP, the normal sequence following activation of the VSR. Concurrently, habituation caused disappearance of the low-frequency (0.025 and 0.05 Hz) oscillations in BP and HR that must be present when vasovagal responses are induced. Habituation also produced significant increases in baroreflex sensitivity (p < 0.001). Thus, repeated low-frequency activation of the VSR resulted in a reduction and loss of susceptibility to development of vasovagal responses in rats that were previously highly susceptible. We posit that reactivation of the baroreflex, which is depressed by anesthesia and the disappearance of low-frequency oscillations in BP and HR are likely to be critically involved in producing resistance to the development of vasovagal responses. SGVS has been widely used to activate muscle sympathetic nerve activity in humans and is safe and well tolerated. Potentially, it could be used to produce similar habituation of vasovagal syncope in humans.
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Affiliation(s)
- Bernard Cohen
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Giorgio P Martinelli
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Yongqing Xiang
- Department of Computer and Information Science, Brooklyn College, City University of New York , New York, NY , USA
| | - Theodore Raphan
- Department of Computer and Information Science, Brooklyn College, City University of New York , New York, NY , USA
| | - Sergei B Yakushin
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, NY , USA
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Bertolini G, Straumann D. Moving in a Moving World: A Review on Vestibular Motion Sickness. Front Neurol 2016; 7:14. [PMID: 26913019 PMCID: PMC4753518 DOI: 10.3389/fneur.2016.00014] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 02/01/2016] [Indexed: 11/13/2022] Open
Abstract
Motion sickness is a common disturbance occurring in healthy people as a physiological response to exposure to motion stimuli that are unexpected on the basis of previous experience. The motion can be either real, and therefore perceived by the vestibular system, or illusory, as in the case of visual illusion. A multitude of studies has been performed in the last decades, substantiating different nauseogenic stimuli, studying their specific characteristics, proposing unifying theories, and testing possible countermeasures. Several reviews focused on one of these aspects; however, the link between specific nauseogenic stimuli and the unifying theories and models is often not clearly detailed. Readers unfamiliar with the topic, but studying a condition that may involve motion sickness, can therefore have difficulties to understand why a specific stimulus will induce motion sickness. So far, this general audience struggles to take advantage of the solid basis provided by existing theories and models. This review focuses on vestibular-only motion sickness, listing the relevant motion stimuli, clarifying the sensory signals involved, and framing them in the context of the current theories.
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Affiliation(s)
- Giovanni Bertolini
- Department of Neurology, University Hospital Zurich , Zurich , Switzerland
| | - Dominik Straumann
- Department of Neurology, University Hospital Zurich , Zurich , Switzerland
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Lamb S, Kwok KCS. MSSQ-Short Norms May Underestimate Highly Susceptible Individuals: Updating the MSSQ-Short Norms. HUMAN FACTORS 2015; 57:622-633. [PMID: 25977322 DOI: 10.1177/0018720814555862] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/24/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of this study was to provide more reliable and robust norms for the Motion Sickness Susceptibility Questionnaire (MSSQ-Short). BACKGROUND The previous norms for the MSSQ-Short involved a small sample overrepresenting younger female participants, which may provide misleading estimates of susceptibility in the general population. METHOD We measured MSSQ-Short scores in a sample of 1,711 members of the general public in New Zealand and Australia. The sample is 6.6 times larger than the original norm sample, and age and gender closely match the general population. RESULTS Compared with the current study, the original norms underrepresent those of high susceptibility by a factor of 3.6, or 0.52 standard deviations. The analysis detected higher levels of susceptibility in females and significantly lower susceptibility in those ages 65 years and older. CONCLUSION This study provides the largest sample of MSSQ-Short scores with more representative demographic characteristics of age and gender. Despite the potential for a self-selection bias toward high levels of susceptibility, we argue that the current norms provide more reliable and robust norms than the original sample. APPLICATION These updated norms provide the tools for researchers and designers to evaluate the likely effect of various motion environments on the general population. Robust norm data can inform research, including general motion sickness research and environmental design.
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Affiliation(s)
- Steve Lamb
- University of Western Sydney, Penrith, Australia
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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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