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Vlădăreanu L, Iliescu MG, Andronache IT, Danteș E. Incidence and Importance of Peripheral Vestibular Dysfunction in Adolescent Idiopathic Scoliosis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:723. [PMID: 38929302 PMCID: PMC11201755 DOI: 10.3390/children11060723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/05/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
Adolescent idiopathic scoliosis (AIS) is a common form of scoliosis. As the name suggests, etiopathogenesis is not clearly defined, so treatment is still anchored in the musculoskeletal theory and correction/prevention of high Cobb angle values. This study aimed to determine whether there is any connection between developing scoliotic curvature and a positive history of motion sickness as a symptom of a peripheral vestibular dysfunction/deficit, and if vestibular rehabilitation exercises could be integrated into the treatment plan. The study was conducted over 12 months on a selected population of 159 patients to evaluate or treat scoliotic curvatures in a private clinic. The collected data were analyzed using IBM SPSS Statistics 25 and illustrated using Microsoft Office Excel/Word 2021. Patients with peripheral vestibular dysfunction had significantly higher Cobb angle values when compared to patients with a negative result in an instrumental test for peripheral vestibular dysfunction. Motion sickness was considerably more associated with peripheral vestibular dysfunction, and a positive Fukuda stepping test was associated with a positive history of motion sickness. Adolescent idiopathic scoliosis with higher Cobb angles is related to positive motion sickness history as part of peripheral vestibular dysfunction. Conservative treatment for scoliosis could incorporate sensory integration techniques, and a positive history of motion sickness could be an indicator of a higher risk of progression in adolescent idiopathic scoliosis.
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Affiliation(s)
- Liliana Vlădăreanu
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Rehabilitation Department, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania
- Pediatric Neurorehabilitation Department, Techirghiol Balneal and Rehabilitation Sanatorium, 34-41 Climescu Blvd., 906100 Techirghiol, Romania
| | - Mădălina Gabriela Iliescu
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Rehabilitation Department, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania
- Pediatric Neurorehabilitation Department, Techirghiol Balneal and Rehabilitation Sanatorium, 34-41 Climescu Blvd., 906100 Techirghiol, Romania
| | - Iulia Tania Andronache
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Department of Rheumatology, Internal Medicine Clinic, “Alexandru Gafencu” Military Emergency Hospital Constanta, Mamaia Blvd., 900527 Constanța, Romania
| | - Elena Danteș
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Rehabilitation Department, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania
- Clinical Hospital of Pulmonology, 40 Sentinelei Street, 900002 Constanta, Romania
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Hasan R, Alshammari A, Albekairi NA, Bhuia MS, Afroz M, Chowdhury R, Khan MA, Ansari SA, Ansari IA, Mubarak MS, Islam MT. Antiemetic activity of abietic acid possibly through the 5HT 3 and muscarinic receptors interaction pathways. Sci Rep 2024; 14:6642. [PMID: 38503897 PMCID: PMC10951218 DOI: 10.1038/s41598-024-57173-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/14/2024] [Indexed: 03/21/2024] Open
Abstract
The present study was designed to evaluate the antiemetic activity of abietic acid (AA) using in vivo and in silico studies. To assess the effect, doses of 50 mg/kg b.w. copper sulfate (CuSO4⋅5H2O) were given orally to 2-day-old chicks. The test compound (AA) was given orally at two doses of 20 and 40 mg/kg b.w. On the other hand, aprepitant (16 mg/kg), domperidone (6 mg/kg), diphenhydramine (10 mg/kg), hyoscine (21 mg/kg), and ondansetron (5 mg/kg) were administered orally as positive controls (PCs). The vehicle was used as a control group. Combination therapies with the referral drugs were also given to three separate groups of animals to see the synergistic and antagonizing activity of the test compound. Molecular docking and visualization of ligand-receptor interaction were performed using different computational tools against various emesis-inducing receptors (D2, D3, 5HT3, H1, and M1-M5). Furthermore, the pharmacokinetics and toxicity properties of the selected ligands were predicted by using the SwissADME and Protox-II online servers. Findings indicated that AA dose-dependently enhances the latency of emetic retching and reduces the number of retching compared to the vehicle group. Among the different treatments, animals treated with AA (40 mg/kg) exhibited the highest latency (98 ± 2.44 s) and reduced the number of retching (11.66 ± 2.52 times) compared to the control groups. Additionally, the molecular docking study indicated that AA exhibits the highest binding affinity (- 10.2 kcal/mol) toward the M4 receptors and an elevated binding affinity toward the receptors 5HT3 (- 8.1 kcal/mol), M1 (- 7.7 kcal/mol), M2 (- 8.7 kcal/mol), and H1 (- 8.5 kcal/mol) than the referral ligands. Taken together, our study suggests that AA has potent antiemetic effects by interacting with the 5TH3 and muscarinic receptor interaction pathways. However, additional extensive pre-clinical and clinical studies are required to evaluate the efficacy and toxicity of AA.
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Affiliation(s)
- Rubel Hasan
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh
- BioLuster Research Center, Gopalganj, Dhaka, 8100, Bangladesh
| | - Abdulrahman Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Post Box 2455, 11451, Riyadh, Saudi Arabia
| | - Norah A Albekairi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Post Box 2455, 11451, Riyadh, Saudi Arabia
| | - Md Shimul Bhuia
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh
- BioLuster Research Center, Gopalganj, Dhaka, 8100, Bangladesh
| | - Meher Afroz
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh
| | - Raihan Chowdhury
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh
| | - Muhammad Ali Khan
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh
| | - Siddique Akber Ansari
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Irfan Aamer Ansari
- Department of Drug Science and Technology, University of Turin, 10124, Turin, Italy
| | - Mohammad S Mubarak
- Department of Chemistry, The University of Jordan, Amman, 11942, Jordan.
- Department of Chemistry, Indiana University, Bloomington, IN, 47405, USA.
| | - Muhammad Torequl Islam
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
- BioLuster Research Center, Gopalganj, Dhaka, 8100, Bangladesh.
- Pharmacy Discipline, Khulna University, Khulna, 9208, Bangladesh.
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Zhao L, Zhong W, Kong X, Kang Q, Hao L, Zhu J, Lu J. Profiling the chemical properties of Foeniculum vulgare Mill. and its flavonoids through comprehensive LC-MS/MS to evaluate their anti-motion sickness effect. Fitoterapia 2024; 173:105816. [PMID: 38168571 DOI: 10.1016/j.fitote.2023.105816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/06/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024]
Abstract
Foeniculum vulgare Mill. is a medicinal and food homologous plant, and it has various biological activities. Yet, no research has explored its anti-motion sickness effects. Chemical properties of fennel extracts (FvE) and flavonoids (Fvf) were analyzed based on UPLC-QTRAP-MS to elucidate its potential anti-motion sickness components in the present study. The mice models of motion sickness were stimulated by biaxial rotational acceleration. Behavioral experiments such as motion sickness index and open field test and the measurement of neurotransmitters were used to evaluate the efficacy of compounds on motion sickness. Results showed that FvE contains terpenes, alkaloids, flavonoids, etc. Eight flavonoids including quercetin-3β-D-glucoside, rutin, hyperoside, quercetin, miquelianin, trifolin, isorhamnetin and kaempferol were identified in the purified Fvf. FvE and Fvf significantly reduced the motion sickness index of mice by 53.2% and 48.9%, respectively. Fvf also significantly alleviated the anxious behavior of mice after rotational stimulation. Among the eight flavonoids, isorhamnetin had the highest oral bioavailability and moderate drug-likeness index and thus speculated to be the bioactive compound in fennel for its anti-motion sickness effect. It reduced the release of 5-HT and Ach to alleviate the motion sickness response and improve the work completing ability of mice and nervous system dysfunction after rotational stimulation. This study provided in-depth understanding of the anti-motion sickness bioactive chemical properties of fennel and its flavonoids, which will contribute to the new development and utilization of fennel.
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Affiliation(s)
- Li Zhao
- School of Life Sciences, Zhengzhou University, Zhengzhou 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Wanlin Zhong
- School of Life Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Xiaoran Kong
- School of Life Sciences, Zhengzhou University, Zhengzhou 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Qiaozhen Kang
- School of Life Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Limin Hao
- Systems Engineering Institute, Academy of Military Sciences (AMS), Beijing 100010, China
| | - Jiaqing Zhu
- School of Life Sciences, Zhengzhou University, Zhengzhou 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Zhengzhou 450001, Henan, China.
| | - Jike Lu
- School of Life Sciences, Zhengzhou University, Zhengzhou 450001, China; Food Laboratory of Zhongyuan, Zhengzhou University, Zhengzhou 450001, Henan, China.
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Hayashi R, Srisomboon Y, Iijima K, Maniak PJ, Tei R, Kobayashi T, Matsunaga M, Luo H, Masuda MY, O'Grady SM, Kita H. Cholinergic sensing of allergen exposure by airway epithelium promotes type 2 immunity in the lungs. J Allergy Clin Immunol 2024; 153:793-808.e2. [PMID: 38000698 PMCID: PMC10939907 DOI: 10.1016/j.jaci.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Nonneuronal cells, including epithelial cells, can produce acetylcholine (ACh). Muscarinic ACh receptor antagonists are used clinically to treat asthma and other medical conditions; however, knowledge regarding the roles of ACh in type 2 immunity is limited. OBJECTIVE Our aim was to investigate the roles of epithelial ACh in allergic immune responses. METHODS Human bronchial epithelial (HBE) cells were cultured with allergen extracts, and their ACh production and IL-33 secretion were studied in vitro. To investigate immune responses in vivo, naive BALB/c mice were treated intranasally with different muscarinic ACh receptor antagonists and then exposed intranasally to allergens. RESULTS At steady state, HBE cells expressed cellular components necessary for ACh production, including choline acetyltransferase and organic cation transporters. Exposure to allergens caused HBE cells to rapidly release ACh into the extracellular medium. Pharmacologic or small-interfering RNA-based blocking of ACh production or autocrine action through the M3 muscarinic ACh receptors in HBE cells suppressed allergen-induced ATP release, calcium mobilization, and extracellular secretion of IL-33. When naive mice were exposed to allergens, ACh was quickly released into the airway lumen. A series of clinical M3 muscarinic ACh receptor antagonists inhibited allergen-induced IL-33 secretion and innate type 2 immune response in the mouse airways. In a preclinical murine model of asthma, an ACh receptor antagonist suppressed allergen-induced airway inflammation and airway hyperreactivity. CONCLUSIONS ACh is released quickly by airway epithelial cells on allergen exposure, and it plays an important role in type 2 immunity. The epithelial ACh system can be considered a therapeutic target in allergic airway diseases.
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Affiliation(s)
- Ryusuke Hayashi
- Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; Department of Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Yotesawee Srisomboon
- Department of Animal Science, University of Minnesota, St Paul, Minn; Department of Integrative Biology and Physiology, University of Minnesota, St Paul, Minn
| | - Koji Iijima
- Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; Department of Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Peter J Maniak
- Department of Animal Science, University of Minnesota, St Paul, Minn; Department of Integrative Biology and Physiology, University of Minnesota, St Paul, Minn
| | - Rinna Tei
- Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; Department of Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Takao Kobayashi
- Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; Department of Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Mayumi Matsunaga
- Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; Department of Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Huijun Luo
- Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; Department of Medicine, Mayo Clinic, Scottsdale, Ariz
| | - Mia Y Masuda
- Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minn; Mayo Clinic Graduate School of Biomedical Sciences, Scottsdale, Ariz
| | - Scott M O'Grady
- Department of Animal Science, University of Minnesota, St Paul, Minn; Department of Integrative Biology and Physiology, University of Minnesota, St Paul, Minn
| | - Hirohito Kita
- Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; Department of Medicine, Mayo Clinic, Scottsdale, Ariz; Department of Immunology, Mayo Clinic Rochester, Rochester, Minn; Department of Immunology, Mayo Clinic Arizona, Scottsdale, Ariz.
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Ramazan K, Devran AY, Muhammed ON. An old approach to a novel problem: effect of combined balance therapy on virtual reality induced motion sickness: a randomized, placebo controlled, double-blinded study. BMC MEDICAL EDUCATION 2024; 24:156. [PMID: 38374042 PMCID: PMC10875861 DOI: 10.1186/s12909-024-05152-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/08/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND The objective of this study was to investigate the impact of a rehabilitation program aimed at addressing vestibular and proprioceptive deficits, which are believed to underlie the pathophysiology of motion sickness. METHODS A total of 121 medical students with motion sickness participated in this study and were randomly divided into intervention (n = 60) and placebo control (n = 61) groups. The intervention group underwent combined balance, proprioception, and vestibular training three times a week for 4 weeks, while the control group received placebo training. The study assessed various measurements, including the Virtual reality sickness questionnaire (VRSQ), tolerance duration, enjoyment level measured by VAS, stability levels using Biodex, and balance with the Flamingo balance test (FBT). All measurements were conducted both at baseline and 4 weeks later. RESULTS There was no significant difference in pre-test scores between the intervention and control groups, suggesting a similar baseline in both groups (p > 0.05). The results showed a significant improvement in VRSQ, tolerance duration, VAS, Biodex, and FBT scores in the intervention group (p < 0.05). While, the control group showed a significant increase only in VAS scores after 4 weeks of training (p < 0.05). A statistically significant improvement was found between the groups for VRSQ (p < 0.001), tolerance duration (p < 0.001), VAS (p < 0.001), Biodex (p = 0.015), and FBT scores (p < 0.05), in favor of the intervention group. CONCLUSIONS A combined balance training program for motion sickness proves to be effective in reducing motion sickness symptoms, enhancing user enjoyment, and extending the usage duration of virtual reality devices while improving balance and stability. In contrast, placebo training did not alter motion sickness levels. These findings offer valuable insights for expanding the usage of virtual reality, making it accessible to a broader population.
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Affiliation(s)
- Kurul Ramazan
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey.
| | - Altuntas Yasin Devran
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Ogun Nur Muhammed
- Department of Neurology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Bannigan GM, de Sousa AA, Scheller M, Finnegan DJ, Proulx MJ. Potential factors contributing to observed sex differences in virtual-reality-induced sickness. Exp Brain Res 2024; 242:463-475. [PMID: 38170233 PMCID: PMC10805816 DOI: 10.1007/s00221-023-06760-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024]
Abstract
Virtual reality (VR) technology has been widely adopted for several professional and recreational applications. Despite rapid innovation in hardware and software, one of the long prevailing issues for end users of VR is the experience of VR sickness. Females experience stronger VR sickness compared to males, and previous research has linked susceptibility to VR sickness to the menstrual cycle (Munafo et al., Exp Brain Res 235(3):889-901). Here we investigated the female versus male experience in VR sickness while playing an immersive VR game, comparing days of the menstrual cycle when hormones peak: day 15 (ovulation-peak estrogen) and day 22 (mid-luteal phase-peak progesterone). We found that immersion duration was greater in the second session than the first, and discomfort was lessened, suggesting a powerful adaptation with repeated exposure. Due to the estrogen levels changing along with the exposure, there was no clear independent impact of that; note, though, that there was a significant difference between self-report and physiological measures implying that GSR is potentially an unreliable measure of motion sickness. Although prior work found a delay over 2 days between session would not allow adaptation and habituation to reduce VR sickness susceptibility, we found that a week delay has potential success.
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Affiliation(s)
- Grainne M Bannigan
- Department of Psychology, University of Bath, Bath, UK
- School of Public Health Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Alexandra A de Sousa
- Department of Psychology, University of Bath, Bath, UK
- School of Sciences, Bath Spa University, Bath, UK
- Department of Computer Science, REVEAL Research Centre, University of Bath, Bath, UK
| | | | - Daniel J Finnegan
- School of Computer Science and Informatics, Cardiff University, Cardiff, UK.
| | - Michael J Proulx
- Department of Psychology, University of Bath, Bath, UK.
- Department of Computer Science, REVEAL Research Centre, University of Bath, Bath, UK.
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Lorincz D, Drury HR, Smith DW, Lim R, Brichta AM. Aged mice are less susceptible to motion sickness and show decreased efferent vestibular activity compared to young adults. Brain Behav 2023; 13:e3064. [PMID: 37401009 PMCID: PMC10454360 DOI: 10.1002/brb3.3064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/13/2023] [Accepted: 05/03/2023] [Indexed: 07/05/2023] Open
Abstract
INTRODUCTION The efferent vestibular system (EVS) is a feedback circuit thought to modulate vestibular afferent activity by inhibiting type II hair cells and exciting calyx-bearing afferents in the peripheral vestibular organs. In a previous study, we suggested EVS activity may contribute to the effects of motion sickness. To determine an association between motion sickness and EVS activity, we examined the effects of provocative motion (PM) on c-Fos expression in brainstem efferent vestibular nucleus (EVN) neurons that are the source of efferent innervation in the peripheral vestibular organs. METHODS c-Fos is an immediate early gene product expressed in stimulated neurons and is a well-established marker of neuronal activation. To study the effects of PM, young adult C57/BL6 wild-type (WT), aged WT, and young adult transgenic Chat-gCaMP6f mice were exposed to PM, and tail temperature (Ttail ) was monitored using infrared imaging. After PM, we used immunohistochemistry to label EVN neurons to determine any changes in c-Fos expression. All tissue was imaged using laser scanning confocal microscopy. RESULTS Infrared recording of Ttail during PM indicated that young adult WT and transgenic mice displayed a typical motion sickness response (tail warming), but not in aged WT mice. Similarly, brainstem EVN neurons showed increased expression of c-Fos protein after PM in young adult WT and transgenic mice but not in aged cohorts. CONCLUSION We present evidence that motion sickness symptoms and increased activation of EVN neurons occur in young adult WT and transgenic mice in response to PM. In contrast, aged WT mice showed no signs of motion sickness and no change in c-Fos expression when exposed to the same provocative stimulus.
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Affiliation(s)
- David Lorincz
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
| | - Hannah R. Drury
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
| | - Doug W. Smith
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
| | - Rebecca Lim
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
| | - Alan M. Brichta
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
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Ren B, Guan W, Zhou Q. Study of Motion Sickness Model Based on fNIRS Multiband Features during Car Rides. Diagnostics (Basel) 2023; 13:diagnostics13081462. [PMID: 37189562 DOI: 10.3390/diagnostics13081462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/06/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
Motion sickness is a common physiological discomfort phenomenon during car rides. In this paper, the functional near-infrared spectroscopy (fNIRS) technique was used in real-world vehicle testing. The fNIRS technique was utilized to model the relationship between changes in blood oxygenation levels in the prefrontal cortex of passengers and motion sickness symptoms under different motion conditions. To enhance the accuracy of motion sickness classification, the study utilized principal component analysis (PCA) to extract the most significant features from the test data. Wavelet decomposition was used to extract the power spectrum entropy (PSE) features of five frequency bands highly related to motion sickness. The correlation between motion sickness and cerebral blood oxygen levels was modeled by a 6-point scale calibration for the subjective evaluation of the degree of passenger motion sickness. A support vector machine (SVM) was used to build a motion sickness classification model, achieving an accuracy of 87.3% with the 78 sets of data. However, individual analysis of the 13 subjects showed a varying range of accuracy from 50% to 100%, suggesting the presence of individual differences in the relationship between cerebral blood oxygen levels and motion sickness symptoms. Thus, the results demonstrated that the magnitude of motion sickness during the ride was closely related to the change in the PSE of the five frequency bands of cerebral prefrontal blood oxygen, but further studies are needed to investigate individual variability.
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Affiliation(s)
- Bin Ren
- Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Wanli Guan
- Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Qinyu Zhou
- Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
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Rahimzadeh G, Tay A, Travica N, Lacy K, Mohamed S, Nahavandi D, Pławiak P, Qazani MC, Asadi H. Nutritional and Behavioral Countermeasures as Medication Approaches to Relieve Motion Sickness: A Comprehensive Review. Nutrients 2023; 15:nu15061320. [PMID: 36986050 PMCID: PMC10052985 DOI: 10.3390/nu15061320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/01/2023] [Accepted: 03/04/2023] [Indexed: 03/11/2023] Open
Abstract
The mismatch in signals perceived by the vestibular and visual systems to the brain, also referred to as motion sickness syndrome, has been diagnosed as a challenging condition with no clear mechanism. Motion sickness causes undesirable symptoms during travel and in virtual environments that affect people negatively. Treatments are directed toward reducing conflicting sensory inputs, accelerating the process of adaptation, and controlling nausea and vomiting. The long-term use of current medications is often hindered by their various side effects. Hence, this review aims to identify non-pharmacological strategies that can be employed to reduce or prevent motion sickness in both real and virtual environments. Research suggests that activation of the parasympathetic nervous system using pleasant music and diaphragmatic breathing can help alleviate symptoms of motion sickness. Certain micronutrients such as hesperidin, menthol, vitamin C, and gingerol were shown to have a positive impact on alleviating motion sickness. However, the effects of macronutrients are more complex and can be influenced by factors such as the food matrix and composition. Herbal dietary formulations such as Tianxian and Tamzin were shown to be as effective as medications. Therefore, nutritional interventions along with behavioral countermeasures could be considered as inexpensive and simple approaches to mitigate motion sickness. Finally, we discussed possible mechanisms underlying these interventions, the most significant limitations, research gaps, and future research directions for motion sickness.
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Affiliation(s)
- Ghazal Rahimzadeh
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
| | - Abdullatif Tay
- PepsiCo Inc., Food Safety and Global Process Authority, 433 W Van Buren St., Chicago, IL 60607, USA
- Correspondence: (A.T.); (S.M.); Tel.: +61-3-522-72599 (S.M.)
| | - Nikolaj Travica
- Food & Mood Centre, IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC 3220, Australia
| | - Kathleen Lacy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Shady Mohamed
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
- Correspondence: (A.T.); (S.M.); Tel.: +61-3-522-72599 (S.M.)
| | - Darius Nahavandi
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
| | - Paweł Pławiak
- Department of Computer Science, Faculty of Computer Science and Telecommunications, Cracow University of Technology, Warszawska 24, 31-155 Krakow, Poland
- Institute of Theoretical and Applied Informatics, Polish Academy of Sciences, Bałtycka 5, 44-100 Gliwice, Poland
| | - Mohammadreza Chalak Qazani
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
| | - Houshyar Asadi
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
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Kourtesis P, Amir R, Linnell J, Argelaguet F, MacPherson SE. Cybersickness, Cognition, & Motor Skills: The Effects of Music, Gender, and Gaming Experience. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; PP:2326-2336. [PMID: 37027703 DOI: 10.1109/tvcg.2023.3247062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Recent research has attempted to identify methods to mitigate cybersickness and examine its aftereffects. In this direction, this paper examines the effects of cybersickness on cognitive, motor, and reading performance in VR. Also, this paper evaluates the mitigating effects of music on cybersickness, as well as the role of gender, and the computing, VR, and gaming experience of the user. This paper reports two studies. In the 1st study, 92 participants selected the music tracks considered most calming (low valence) or joyful (high valence) to be used in the 2nd study. In the 2nd study, 39 participants performed an assessment four times, once before the rides (baseline), and then once after each ride (3 rides). In each ride either Calming, or Joyful, or No Music was played. During each ride, linear and angular accelerations took place to induce cybersickness in the participants. In each assessment, while immersed in VR, the participants evaluated their cybersickness symptomatology and performed a verbal working memory task, a visuospatial working memory task, and a psychomotor task. While responding to the cybersickness questionnaire (3D UI), eye-tracking was conducted to measure reading time and pupillometry. The results showed that Joyful and Calming music substantially decreased the intensity of nausea-related symptoms. However, only Joyful music significantly decreased the overall cybersickness intensity. Importantly, cybersickness was found to decrease verbal working memory performance and pupil size. Also, it significantly decelerated psychomotor (reaction time) and reading abilities. Higher gaming experience was associated with lower cybersickness. When controlling for gaming experience, there were no significant differences between female and male participants in terms of cybersickness. The outcomes indicated the efficiency of music in mitigating cybersickness, the important role of gaming experience in cybersickness, and the significant effects of cybersickness on pupil size, cognition, psychomotor skills, and reading ability.
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Keshavarz B, Murovec B, Mohanathas N, Golding JF. The Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ): Estimating Individual Susceptibility to Motion Sickness-Like Symptoms When Using Visual Devices. HUMAN FACTORS 2023; 65:107-124. [PMID: 33874752 PMCID: PMC9846380 DOI: 10.1177/00187208211008687] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVE Two studies were conducted to develop and validate a questionnaire to estimate individual susceptibility to visually induced motion sickness (VIMS). BACKGROUND VIMS is a common side-effect when watching dynamic visual content from various sources, such as virtual reality, movie theaters, or smartphones. A reliable questionnaire predicting individual susceptibility to VIMS is currently missing. The aim was to fill this gap by introducing the Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ). METHODS A survey and an experimental study were conducted. Survey: The VIMSSQ investigated the frequency of nausea, headache, dizziness, fatigue, and eyestrain when using different visual devices. Data were collected from a survey of 322 participants for the VIMSSQ and other related phenomena such as migraine. Experimental study: 23 participants were exposed to a VIMS-inducing visual stimulus. Participants filled out the VIMSSQ together with other questionnaires and rated their level of VIMS using the Simulator Sickness Questionnaire (SSQ). RESULTS Survey: The most prominent symptom when using visual devices was eyestrain, and females reported more VIMS than males. A one-factor solution with good scale reliability was found for the VIMSSQ. Experimental study: Regression analyses suggested that the VIMSSQ can be useful in predicting VIMS (R2 = .34) as measured by the SSQ, particularly when combined with questions pertaining to the tendency to avoid visual displays and experience syncope (R2 = .59). CONCLUSION We generated normative data for the VIMSSQ and demonstrated its validity. APPLICATION The VIMSSQ can become a valuable tool to estimate one's susceptibility to VIMS based on self-reports.
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Affiliation(s)
- Behrang Keshavarz
- KITE-Toronto Rehabilitation Institute, University Health
Network, Canada
- Ryerson University, Toronto, Canada
- Behrang Keshavarz, KITE-Toronto
Rehabilitation Institute, University Health Network, 550 University Avenue,
Toronto, ON M5G 2A2, Canada;
| | - Brandy Murovec
- KITE-Toronto Rehabilitation Institute, University Health
Network, Canada
- Ryerson University, Toronto, Canada
| | - Niroshica Mohanathas
- KITE-Toronto Rehabilitation Institute, University Health
Network, Canada
- University of Toronto, Canada
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12
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The global prevalence of vestibular dysfunction in children and adolescents: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:2663-2674. [PMID: 36715738 DOI: 10.1007/s00405-023-07842-z] [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: 11/29/2022] [Accepted: 01/13/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND Vestibular dysfunction has been extensively studied amongst the older population. Recently, conditions and management of vestibular dysfunction among children and adolescent has gained attention. Yet, a lack of awareness and expertise in managing children and adolescents with vestibular dysfunction has led to a delay in diagnosis as well as a trifling prevalence rate. AIM To conduct a systematic review and meta-analyses to estimate the overall pooled prevalence of vestibular dysfunction in children and adolescents. METHODS PubMed, Scopus, and Web of Science databases were searched to identify studies published until 29 April 2022. We used a random-effects model to estimate the pooled prevalence with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic and Cochran's Q test. The robustness of the pooled estimates was checked by different subgroups and sensitivity analyses. RESULTS We identified 1811 studies, of which 39 studies (n = 323,663) were included in the meta-analysis. Overall, the pooled prevalence of children and adolescents with VD was 30.4% [95% CI 28.5-32.3%]. The age of the participants ranged from 1 to 19 years. Participants of the included 39 studies were from 15 countries. Among the studies, 34 were cross-sectional, and five were case-control designed. There were discrepancies found in the studies with objective (higher prevalence) versus subjective (lower prevalence) evaluations. CONCLUSION The prevalence of VD among children and adolescents was found to be 30.4% based on high-quality evidence. Due to the subjective assessment of most studies pooled in the analysis, the results should be interpreted cautiously until future comparative studies with objective assessments are carried out.
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Murphey CP, Shulgach JA, Amin PR, Douglas NK, Bielanin JP, Sampson JT, Horn CC, Yates BJ. Physiological changes associated with copper sulfate-induced nausea and retching in felines. Front Physiol 2023; 14:1077207. [PMID: 36744037 PMCID: PMC9892644 DOI: 10.3389/fphys.2023.1077207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/11/2023] [Indexed: 01/20/2023] Open
Abstract
Nausea is a common disease symptom, yet there is no consensus regarding its physiological markers. In contrast, the process of vomiting is well documented as sequential muscular contractions of the diaphragm and abdominal muscles and esophageal shortening. Nausea, like other self-reported perceptions, is difficult to distinguish in preclinical models, but based on human experience emesis is usually preceded by nausea. Here we focused on measuring gastrointestinal and cardiorespiratory changes prior to emesis to provide additional insights into markers for nausea. Felines were instrumented to chronically record heart rate, respiration, and electromyographic (EMG) activity from the stomach and duodenum before and after intragastric delivery of saline or copper sulfate (CuSO4, from 83 to 322 mg). CuSO4 is a prototypical emetic test agent that triggers vomiting primarily by action on GI vagal afferent fibers when administered intragastrically. CuSO4 infusion elicited a significant increase in heart rate, decrease in respiratory rate, and a disruption of gastric and intestinal EMG activity several minutes prior to emesis. The change in EMG activity was most consistent in the duodenum. Administration of the same volume of saline did not induce these effects. Increasing the dose of CuSO4 did not alter the physiologic changes induced by the treatment. It is postulated that the intestinal EMG activity was related to the retrograde movement of chyme from the intestine to the stomach demonstrated to occur prior to emesis by other investigators. These findings suggest that monitoring of intestinal EMG activity, perhaps in combination with heart rate, may provide the best indicator of the onset of nausea following treatments and in disease conditions, including GI disease, associated with emesis.
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Affiliation(s)
- Charles P. Murphey
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States,Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jonathan A. Shulgach
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States,Mechanical Engineering Department, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Pooja R. Amin
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Nerone K. Douglas
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - John P. Bielanin
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Jacob T. Sampson
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Charles C. Horn
- UPMC Hillman Cancer Center, Pittsburgh, PA, United States,Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States,Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Bill J. Yates
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States,Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States,*Correspondence: Bill J. Yates,
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Zhang T, Guan T, Yao H, Wang LA, Wang Y, Guan Z. Brown Slime Cap Mushroom (Chroogomphus rutilus, Agaricomycetes) Polysaccharide Resists Motion Sickness by Inhibiting the Activity of the Serotonin System in Mice. Int J Med Mushrooms 2023; 25:1-13. [PMID: 37947060 DOI: 10.1615/intjmedmushrooms.2023050471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Motion sickness (MS) is a disorder of the autonomic nervous system caused by abnormal exercise with symptoms such as nausea, vomiting and drowsiness. More than 90% of the human population has experienced different degrees of MS. At present, anticholinergics, antihistamines, and sympathomimetic drugs are used for treating MS, but these drugs generally have some adverse reactions and are not suitable for all people. Therefore, it is necessary to develop anti-MS drugs that have high efficiency and no adverse effects. Previous studies have found that Chroogomphus rutilus polysaccharide (CRP) is effective at preventing and treating MS in rats and mice. However, its mechanism of action is not clear. To clarify whether the CRP has anti-MS effects in mice, and to clarify its mechanism, we performed behavioral, biochemical, and morphological tests in a Kunming mouse model. Our results indicate that CRPs can significantly relieve the symptoms of MS, and their effect is equivalent to that of scopolamine, a commonly used anti-MS medicine. Our results indicate that CRPs may directly act on the gastrointestinal chromaffin cells to inhibit the synthesis and release of serotonin (5-hydroxytryptamine, or 5-HT) and thus reduce the signal from the gastrointestinal tract.
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Affiliation(s)
- Tao Zhang
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
| | - Tianyuan Guan
- Department of Neurology, Hebei General Hospital, Shijiazhuang, 050051, P.R. China
| | - Hui Yao
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
| | - Li-An Wang
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
| | - Yanqin Wang
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
| | - Zhenlong Guan
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
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Abstract
BACKGROUND Motion sickness is a syndrome that occurs as a result of passive body movement in response to actual motion, or the illusion of motion when exposed to virtual and moving visual environments. The most common symptoms are nausea and vomiting. Antihistamines have been used in the management of motion sickness for decades, however studies have shown conflicting results regarding their efficacy. OBJECTIVES To assess the effectiveness of antihistamines in the prevention and treatment of motion sickness in adults and children. SEARCH METHODS The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials; Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 7 December 2021. SELECTION CRITERIA Randomised controlled trials (RCTs) in susceptible adults and children in whom motion sickness was induced under natural conditions such as air, sea and land transportation. We also included studies in which motion sickness was induced under experimental conditions (analysed separately). Antihistamines were included regardless of class, route or dosage and compared to no treatment, placebo or any other pharmacological or non-pharmacological interventions. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were 1) the proportion of susceptible participants who did not experience any motion sickness symptoms; 2) the proportion of susceptible participants who experienced a reduction or resolution of existing symptoms. Secondary outcomes were 1) physiological measures (heart rate, core temperature and gastric tachyarrhythmia (electrogastrography)) and 2) adverse effects (sedation, impaired cognition, blurred vision). We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS We included nine RCTs (658 participants). Studies were conducted across seven countries, with an overall age range of 16 to 55 years. Motion sickness was induced naturally in six studies and experimentally in four studies (rotating chair). All the naturally induced studies only evaluated first-generation antihistamines (cinnarizine and dimenhydrinate). Risk of bias across the studies varied, with mostly low risk for random sequence generation and allocation concealment, and mostly high risk for selective reporting. Only the experimentally induced studies measured physiological parameters and only the naturally induced studies evaluated adverse effects. There were no studies that clearly assessed the paediatric population. Antihistamines versus placebo or no treatment Antihistamines are probably more effective than placebo at preventing motion sickness symptoms under natural conditions (symptoms prevented: 25% placebo; 40% antihistamines) (risk ratio (RR) 1.81, 95% confidence interval (CI) 1.23 to 2.66; 3 studies; 240 participants) (moderate-certainty). The evidence is very uncertain about the effect of antihistamines on preventing motion sickness under experimental conditions (standardised mean difference (SMD) 0.32, 95% CI -0.18 to 0.83; 2 studies; 62 participants) (very low-certainty). No studies reported results on the resolution of existing motion sickness symptoms. Antihistamines may result in little or no difference in gastric tachyarrhythmia under experimental conditions (mean difference (MD) -2.2, 95% CI -11.71 to 7.31; 1 study; 42 participants) (low-certainty). No studies reported results for any other physiological measures. When compared to placebo, antihistamines may be more likely to cause sedation (sedation: 44% placebo; 66% antihistamines) (RR 1.51, 95% CI 1.12 to 2.02; 2 studies; 190 participants) (low-certainty); they may result in little or no difference in blurred vision (blurred vision: 12.5% placebo; 14% antihistamines) (RR 1.14, 95% CI 0.53 to 2.48; 2 studies; 190 participants) (low-certainty); and they may result in little or no difference in terms of impaired cognition (impaired cognition: 33% placebo; 29% antihistamines) (RR 0.89, 95% CI 0.58 to 1.38; 2 studies; 190 participants) (low-certainty). Antihistamines versus scopolamine The evidence is very uncertain about the effect of antihistamines on preventing motion sickness under natural conditions when compared to scopolamine (symptoms prevented: 81% scopolamine; 71% antihistamines) (RR 0.89, 95% CI 0.68 to 1.16; 2 studies; 71 participants) (very low-certainty). No studies were performed under experimental conditions. No studies reported results on the resolution of existing motion sickness symptoms. The evidence is very uncertain about the effect of antihistamines on heart rate under natural conditions (narrative report, 1 study; 20 participants; "No difference in pulse frequency"; very low-certainty). No studies reported results for any other physiological measures. When compared to scopolamine, the evidence is very uncertain about the effect of antihistamines on sedation (sedation: 21% scopolamine; 30% antihistamines) (RR 0.82, 95% CI 0.07 to 9.25; 2 studies; 90 participants) (very low-certainty) and on blurred vision (narrative report: not a significant difference; 1 study; 51 participants; very low-certainty). No studies evaluated impaired cognition. Antihistamines versus antiemetics Antihistamines may result in little or no difference in the prevention of motion sickness under experimental conditions (MD -0.20, 95% CI -10.91 to 10.51; 1 study; 42 participants) (low-certainty). The evidence is of low certainty due to imprecision as the sample size is small and the confidence interval crosses the line of no effect. No studies assessed the effects of antihistamines versus antiemetics under natural conditions. No studies reported results on the resolution of existing motion sickness symptoms. Antihistamines may result in little or no difference in gastric tachyarrhythmia (MD 4.56, 95% CI -3.49 to 12.61; 1 study; 42 participants) (low-certainty). No studies reported results for any other physiological measures. No studies evaluated sedation, impaired cognition or blurred vision. One study reported physiological data for this outcome, evaluating gastric tachyarrhythmia specifically. Antihistamines may result in little or no difference in gastric tachyarrhythmia (MD 4.56, 95% CI -3.49 to 12.61; 1 study; 42 participants; low-certainty evidence). This evidence is of low certainty due to imprecision as the sample size is small and the confidence interval crosses the line of no effect. Antihistamines versus acupuncture The evidence is very uncertain about the effects of antihistamines on the prevention of motion sickness under experimental conditions when compared to acupuncture (RR 1.32, 95% CI 1.12 to 1.57; 1 study; 100 participants) (very low-certainty). This study did not assess the prevention of motion sickness under natural conditions, nor the resolution of existing motion sickness symptoms. There was no study performed under natural conditions. Physiological measures and adverse effects were not reported. AUTHORS' CONCLUSIONS There is probably a reduction in the risk of developing motion sickness symptoms under naturally occurring conditions of motion when using first-generation antihistamines, in motion sickness-susceptible adults, compared to placebo. Antihistamines may be more likely to cause sedation when compared to placebo. No studies evaluated the treatment of existing motion sickness, and there are few data on the effect of antihistamines in children. The evidence for all other outcomes and comparisons (versus scopolamine, antiemetics and acupuncture) was of low or very low certainty and we are therefore uncertain about these effects of antihistamines.
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Affiliation(s)
- Nadine Karrim
- Institute of Research into Space Health and Astronaut Development, International Centre for Astronautical Development, Durban, South Africa
| | - Ryan Byrne
- Institute of Research into Space Health and Astronaut Development, International Centre for Astronautical Development, Dublin, Ireland
| | | | - Yougan Saman
- ENT Department, University Hospitals of Leicester NHS Trust, Leicester, UK
- Department of Neuroscience Psychology and Behaviour, University of Leicester, Leicester, UK
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16
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Emotions are associated with the genesis of visually induced motion sickness in virtual reality. Exp Brain Res 2022; 240:2757-2771. [PMID: 36068308 PMCID: PMC9447355 DOI: 10.1007/s00221-022-06454-z] [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: 07/21/2022] [Accepted: 08/27/2022] [Indexed: 12/03/2022]
Abstract
Visually induced motion sickness (VIMS) is a well-known side effect of virtual reality (VR) immersion, with symptoms including nausea, disorientation, and oculomotor discomfort. Previous studies have shown that pleasant music, odor, and taste can mitigate VIMS symptomatology, but the mechanism by which this occurs remains unclear. We predicted that positive emotions influence the VIMS-reducing effects. To investigate this, we conducted an experimental study with 68 subjects divided into two groups. The groups were exposed to either positive or neutral emotions before and during the VIMS-provoking stimulus. Otherwise, they performed exactly the same task of estimating the time-to-contact while confronted with a VIMS-provoking moving starfield stimulation. Emotions were induced by means of pre-tested videos and with International Affective Picture System (IAPS) images embedded in the starfield simulation. We monitored emotion induction before, during, and after the simulation, using the Self-Assessment Manikin (SAM) valence and arousal scales. VIMS was assessed before and after exposure using the Simulator Sickness Questionnaire (SSQ) and during simulation using the Fast Motion Sickness Scale (FMS) and FMS-D for dizziness symptoms. VIMS symptomatology did not differ between groups, but valence and arousal were correlated with perceived VIMS symptoms. For instance, reported positive valence prior to VR exposure was found to be related to milder VIMS symptoms and, conversely, experienced symptoms during simulation were negatively related to subjects’ valence. This study sheds light on the complex and potentially bidirectional relationship of VIMS and emotions and provides starting points for further research on the use of positive emotions to prevent VIMS.
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Zhong W, Zhu J, Yi J, Zhao C, Shi Y, Kang Q, Huang J, Hao L, Lu J. Biochemical analysis reveals the systematic response of motion sickness mice to ginger (Zingiber officinale) extract's amelioration effect. JOURNAL OF ETHNOPHARMACOLOGY 2022; 290:115077. [PMID: 35131339 DOI: 10.1016/j.jep.2022.115077] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/01/2022] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE As a common medicinal and edible plant, Zingiber officinale Roscoe (ginger) is often used for the prevention of motion sickness. However, the mechanism of its anti-motion sickness remains to be elucidated. AIM OF THE STUDY To explore novel treatment for motion sickness with less side effects, anti-motion sickness effect of ginger (Zingiber officinale) extract (GE) and the possible molecular mechanisms were investigated. MATERIALS AND METHODS The anti-motion sickness effect of ginger was evaluated through mice animal experimental models. Components of ginger that might contribute to the anti-motion sickness effect were analyzed by LC-MS/MS. Subsequently, biochemical analysis integrated with serum metabolomic profiling were performed to reveal the systematic response of motion sickness mice to ginger extract's amelioration effect. RESULTS Exhaustive swimming time of mice in the GE group reached 8.9 min, which was 52.2% longer than that in the model group. Motion sickness index scores and time taken traversing balance beam of mice in the GE group were decreased by 53.2% and 38.5%, respectively. LC-MS/MS analysis suggested that various active ingredients in GE, such as gingerol, ginger oil and terpenoids, might contribute to its appealing anti-motion sickness activity. Biochemical analysis revealed that GE can relieve motion sickness through reducing histamine and acetylcholine release in vestibular system, regulating fatty acid oxidation, sugar metabolism and bile acid metabolism in mice. CONCLUSION Gavage of mice with GE can effectively relieve the symptoms of autonomic nervous system dysfunction, improve the balance and coordination ability and ameliorate the ability to complete complex work after rotation stimulation. GE has attractive potential for development and utilization as novel anti-motion sickness food or drugs.
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Affiliation(s)
- Wanlin Zhong
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Jiaqing Zhu
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China.
| | - Juanjuan Yi
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Changcheng Zhao
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Yanling Shi
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Qiaozhen Kang
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Jinyong Huang
- School of Agricultural Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Limin Hao
- Institute of Quartermaster Engineering and Technology, Academy of Military Sciences PLA China, Beijing, 100010, China
| | - Jike Lu
- School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China.
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da Silva Marinho A, Terton U, Jones CM. Cybersickness and postural stability of first time VR users playing VR videogames. APPLIED ERGONOMICS 2022; 101:103698. [PMID: 35151982 DOI: 10.1016/j.apergo.2022.103698] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/12/2022] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
This study investigated symptoms of cybersickness and postural instability experienced by new users of head-mounted display virtual reality (HMD-VR), playing VR videogames over long and repeated sessions, and moderation of these symptoms by previous videogame experience and intensity of videogame stimulus. Cybersickness (SSQ) and postural stability (anterior-posterior path-velocity) of new users of VR (n = 80) was collected PRE-VR, POST-VR and 10 min after completing (POST-RECOVERY) a VR gaming experience. Users comprised of videogamers (n = 40) and non-videogamers (n = 40), who were randomly assigned to play either action (high-intensity stimuli) or adventure (low-intensity stimuli) games in VR for 30 min and repeated twice, one week apart. All participants, irrespective of gaming status and genre of game, experienced significant cybersickness after 30 min in VR using current-generation HMD-VR technology, and did not adapt (POST-VR) after two sessions. However videogamers were able to recover (POST-RECOVERY) from cybersickness induced in VR significantly better than non-videogamers. All participants experienced significantly better postural stability after 30 min in VR, irrespective of gaming experience or genre of game. Developers should create VR experiences that minimise negative symptoms of cybersickness and postural instability experience by new users of VR.
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Affiliation(s)
- Adriano da Silva Marinho
- School of Law and Society, University of the Sunshine Coast, Maroochydore DC, Queensland, 4558, Australia
| | - Uwe Terton
- Faculty of Business, Law and Arts, Southern Cross University, Military Road, East Lismore, NSW, 2480, Australia
| | - Christian M Jones
- School of Law and Society, University of the Sunshine Coast, Maroochydore DC, Queensland, 4558, Australia.
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Viola P, Marcianò G, Casarella A, Pisani D, Astorina A, Scarpa A, Siccardi E, Basile E, De Sarro G, Gallelli L, Chiarella G. The Pharmacological Treatment of Pediatric Vertigo. CHILDREN 2022; 9:children9050584. [PMID: 35626761 PMCID: PMC9139449 DOI: 10.3390/children9050584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/09/2022] [Accepted: 04/15/2022] [Indexed: 12/25/2022]
Abstract
Vertigo in children is a challenging topic. The lack of dedicated trials, guidelines and papers causes inhomogeneity in the treatment of vertigo in children. Meniere’s disease, migraine equivalents, vestibular neuritis, paroxysmal positional benign vertigo (BPPV), persistent postural-perceptual dizziness (PPPD) and motion sickness may affect children with various degrees of incidence and clinical severity compared to adults. Several drugs are proposed for the management of these conditions, even if their use is subordinated to the child’s age. In this review, we summarize the existing evidence related to the use of drugs for this clinical condition in children as a start point for new trials, stating the urgent need for international guidelines.
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Affiliation(s)
- Pasquale Viola
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (P.V.); (D.P.); (A.A.)
| | - Gianmarco Marcianò
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Science, School of Medicine, University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy; (G.M.); (A.C.); (E.B.); (G.D.S.); (L.G.)
| | - Alessandro Casarella
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Science, School of Medicine, University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy; (G.M.); (A.C.); (E.B.); (G.D.S.); (L.G.)
| | - Davide Pisani
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (P.V.); (D.P.); (A.A.)
| | - Alessia Astorina
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (P.V.); (D.P.); (A.A.)
| | - Alfonso Scarpa
- Department of Medicine and Surgery, University of Salerno, 84081 Baronissi, Italy;
| | | | - Emanuele Basile
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Science, School of Medicine, University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy; (G.M.); (A.C.); (E.B.); (G.D.S.); (L.G.)
| | - Giovambattista De Sarro
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Science, School of Medicine, University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy; (G.M.); (A.C.); (E.B.); (G.D.S.); (L.G.)
- Research Center FAS@UMG, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy
| | - Luca Gallelli
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Science, School of Medicine, University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy; (G.M.); (A.C.); (E.B.); (G.D.S.); (L.G.)
- Research Center FAS@UMG, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy
- Medifarmagen SRL, Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy
| | - Giuseppe Chiarella
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy; (P.V.); (D.P.); (A.A.)
- Correspondence: ; Tel.: +39-0961364-7124
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Kaufeld M, De Coninck K, Schmidt J, Hecht H. Chewing gum reduces visually induced motion sickness. Exp Brain Res 2022; 240:651-663. [PMID: 34997261 PMCID: PMC8741140 DOI: 10.1007/s00221-021-06303-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/29/2021] [Indexed: 11/05/2022]
Abstract
Visually induced motion sickness (VIMS) is a common side-effect of exposure to virtual reality (VR). Its unpleasant symptoms may limit the acceptance of VR technologies for training or clinical purposes. Mechanical stimulation of the mastoid and diverting attention to pleasant stimuli-like odors or music have been found to ameliorate VIMS. Chewing gum combines both in an easy-to-administer fashion and should thus be an effective countermeasure against VIMS. Our study investigated whether gustatory-motor stimulation by chewing gum leads to a reduction of VIMS symptoms. 77 subjects were assigned to three experimental groups (control, peppermint gum, and ginger gum) and completed a 15-min virtual helicopter flight, using a VR head-mounted display. Before and after VR exposure, we assessed VIMS with the Simulator Sickness Questionnaire (SSQ), and during the virtual flight once every minute with the Fast Motion Sickness Scale (FMS). Chewing gum (peppermint gum: M = 2.44, SD = 2.67; ginger gum: M = 2.57, SD = 3.30) reduced the peak FMS scores by 2.05 (SE = 0.76) points as compared with the control group (M = 4.56, SD = 3.52), p < 0.01, d = 0.65. Additionally, taste ratings correlated slightly negatively with both the SSQ and the peak FMS scores, suggesting that pleasant taste of the chewing gum is associated with less VIMS. Thus, chewing gum may be useful as an affordable, accepted, and easy-to-access way to mitigate VIMS in numerous applications like education or training. Possible mechanisms behind the effect are discussed.
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Affiliation(s)
- Mara Kaufeld
- Human Systems Engineering (MMS), Fraunhofer Institute for Communication, Information Processing and Ergonomics (FKIE), Zanderstr. 5, 53111, Bonn, Germany.
| | - Katharina De Coninck
- Human Systems Engineering (MMS), Fraunhofer Institute for Communication, Information Processing and Ergonomics (FKIE), Zanderstr. 5, 53111, Bonn, Germany.,Hochschule Döpfer University of Applied Sciences, Cologne, Germany
| | - Jennifer Schmidt
- Hochschule Döpfer University of Applied Sciences, Cologne, Germany.,Muenster School of Health, FH Muenster University of Applied Sciences, Münster, Germany
| | - Heiko Hecht
- Psychologisches Institut, Johannes Gutenberg-University Mainz, Mainz, Germany
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21
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Zhao Q, Ning BF, Zhou JY, Wang J, Yao YJ, Peng ZY, Yuan ZL, Chen JD, Xie WF. Transcutaneous Electrical Acustimulation Ameliorates Motion Sickness Induced by Rotary Chair in Healthy Subjects: A Prospective Randomized Crossover Study. Neuromodulation 2022; 25:1421-1430. [DOI: 10.1016/j.neurom.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/25/2021] [Accepted: 08/16/2021] [Indexed: 11/28/2022]
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22
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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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23
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Zhang W, Cao Y, Chen S, Li F, Chen X, Liu Y. Integrated metabolomics and network pharmacology approach to exploring the potential mechanism of tianxiang capsule for treating motion sickness. JOURNAL OF ETHNOPHARMACOLOGY 2021; 275:114107. [PMID: 33845144 DOI: 10.1016/j.jep.2021.114107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Motion sickness is a multi-system syndrome caused by abnormal spatial environmental sensory conflicts. Tianxiang Capsule (TXC) is a traditional Chinese medicine (TCM) formula for the prevention and treatment of motion sickness for years. However, the main active components of TXC and mechanism of its therapeutic effects on motion sickness are still unclear. AIM OF THE STUDY The purpose of this work is to investigate the mechanism of TXC in preventing motion sickness based on serum metabolomics and network pharmacology. On the basis of the clear validation of the anti-motion sickness effect of TXC, we used the strategy of combined GC-MS metabolomics and network pharmacology to screen 60 differential metabolites regulated by TXC. MATERIALS AND METHODS The rat models of motion sickness were stimulated by biaxial rotational acceleration, spontaneous activity was used to evaluate the efficacy of TXC on motion sickness. Serum metabolomics-based analysis was conducted to screen the differential metabolites related to motion sickness. Then, network pharmacology analysis was used to integrate the information of differential metabolites with target proteins and chemical components, and the "components-target protein-metabolite related protein-metabolite" network was constructed to explore the mechanism of the protective effect of TXC against motion sickness. RESULTS The results of network integration analysis showed that the 50 TXC potential active ingredients mediated the differential expression of 49 metabolic biomarkers by targeting 25 target protein and regulated arachidonic acid metabolism, calcium signaling pathways, etc. In addition, we found that TXC can promote the secretion of insulin mediated by arachidonic acid pathway metabolites, regulate the levels of adrenaline and leptin, maintain blood glucose balance, and achieve the therapeutic effect of motion sickness. CONCLUSIONS Our results indicated that the arachidonic acid metabolic pathway and related targets are the key ways for TXC to exert its efficacy, and its target protein and anti-motion sickness mechanism deserve further study. Our work proved that the integrated strategy of metabolomics and network pharmacology can well explain the "multi-component - multi-target" mechanism of complex TCM in vivo, which is a practical approach for the study of TCM formula.
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Affiliation(s)
- Weiyue Zhang
- School of Nursing, Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Yan Cao
- School of Pharmacy, Second Military Medical University, Shanghai, 200433, China.
| | - Si Chen
- School of Medicine, Shanghai University, Shanghai, 200444, China.
| | - Feng Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Xiaofei Chen
- School of Pharmacy, Second Military Medical University, Shanghai, 200433, China.
| | - Yue Liu
- School of Pharmacy, Second Military Medical University, Shanghai, 200433, China.
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Obereisenbuchner F, Dowsett J, Taylor PCJ. Self-initiation Inhibits the Postural and Electrophysiological Responses to Optic Flow and Button Pressing. Neuroscience 2021; 470:37-51. [PMID: 34273415 DOI: 10.1016/j.neuroscience.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
As we move through our environment, our visual system is presented with optic flow, a potentially important cue for perception, navigation and postural control. How does the brain anticipate the optic flow that arises as a consequence of our own movement? Converging evidence suggests that stimuli are processed differently by the brain if occurring as a consequence of self-initiated actions, compared to when externally generated. However, this has mainly been demonstrated with auditory stimuli. It is not clear how this occurs with optic flow. We measured behavioural, neurophysiological and head motion responses of 29 healthy participants to radially expanding, vection-inducing optic flow stimuli, simulating forward transitional motion, which were either initiated by the participant's own button-press ("self-initiated flow") or by the computer ("passive flow"). Self-initiation led to a prominent and left-lateralized inhibition of the flow-evoked posterior event-related alpha desynchronization (ERD), and a stabilisation of postural responses. Neither effect was present in control button-press-only trials, without optic flow. Additionally, self-initiation also produced a large event-related potential (ERP) negativity between 130-170 ms after optic flow onset. Furthermore, participants' visual induced motion sickness (VIMS) and vection intensity ratings correlated positively across the group - although many participants felt vection in the absence of any VIMS, none reported the opposite combination. Finally, we found that the simple act of making a button press leads to a detectable head movement even when using a chin rest. Taken together, our results indicate that the visual system is capable of predicting optic flow when self-initiated, to affect behaviour.
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Affiliation(s)
- Florian Obereisenbuchner
- MMRS - Munich Medical Research School, University Hospital, LMU Munich, Germany; Faculty of Medicine, LMU Munich, Germany.
| | - James Dowsett
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders, University Hospital, LMU Munich, Germany; Department of Psychology, LMU Munich, Germany.
| | - Paul C J Taylor
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders, University Hospital, LMU Munich, Germany; Department of Psychology, LMU Munich, Germany; Faculty of Philosophy and Philosophy of Science, LMU Munich, Germany; Munich Center for Neurosciences - Brain and Mind, LMU Munich, Germany.
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Abstract
PURPOSE OF REVIEW Determining the etiology of disorders that manifest with chronic dizziness can seem a daunting task, but extracting some basic elements of the patient's history can reduce the differential diagnosis significantly. This includes determining initial triggers, timing of symptoms, associated features, and exacerbating factors. This article covers distinct causes of chronic dizziness including persistent postural perceptual dizziness, mal de débarquement syndrome, motion sickness and visually induced motion sickness, bilateral vestibulopathy, and persistent dizziness after mild concussion. RECENT FINDINGS To date, none of the disorders above has a cure but are considered chronic syndromes with fluctuations that are both innate and driven by environmental stressors. As such, the mainstay of therapy for chronic disorders of dizziness involves managing factors that exacerbate symptoms and adding vestibular rehabilitation or cognitive-behavioral therapy alone or in combination, as appropriate. These therapies are supplemented by serotonergic antidepressants that modulate sensory gating and reduce anxiety. Besides expectation management, ruling out concurrent disorders and recognizing behavioral and lifestyle factors that affect symptom severity are critical issues in reducing morbidity for each disorder. SUMMARY Many syndromes of chronic dizziness can be diagnosed by recognition of key features, although many symptoms overlap between these groups. Symptoms may be manageable and improve with time, but they are often incompletely relieved.
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Zhu HS, Li D, Li C, Huang JX, Chen SS, Li LB, Shi Q, Ju XL. Prior transfusion of umbilical cord mesenchymal stem cells can effectively alleviate symptoms of motion sickness in mice through interleukin 10 secretion. World J Stem Cells 2021; 13:177-192. [PMID: 33708346 PMCID: PMC7933988 DOI: 10.4252/wjsc.v13.i2.177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/31/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Motion sickness (MS) is a disease that occurs during unbalanced movement, characterized by gastrointestinal symptoms and autonomic nervous system activation. Current clinical treatments for MS are limited. Recent evidence indicates that the levels of pro-inflammatory cytokines increase during MS and are associated with an inner ear immune imbalance. In the present study, mesenchymal stem cells (MSCs) have been shown to exert strong immuno-suppressive effects.
AIM To explore whether umbilical cord-derived mesenchymal stem cells (UC-MSCs) can prevent the occurrence of MS, and the underlying mechanism regulated by MSCs in a mouse model of MS.
METHODS A total of 144 (equal numbers of males and females) 5wkold BALB/c mice were randomly divided into five groups: Normal group (n = 16), MS group (n = 32), MSCs group (n = 32), MS + MSCs group (n = 32), and MS + AS101/MSCs group (n = 32). The MSCs group (n = 32), MS + MSCs group (n = 32), and MS + AS101/MSCs group (n = 32) were preventively transplanted with UC-MSCs or AS101-treated UC-MSCs (1 × 106 cells/mouse). Mice in the MS (n = 32), MS + MSCs, and MS + AS101/MSCs groups were subjected to rotation on a centrifuge for 10 min at 8 × g/min for MS model establishment on days 3, 5, 8, and 10 after UC-MSCs injection. The Morris water maze (MWM) test was used to observe the symptom of dizziness. Enzyme-linked immunosorbent assay (ELISA) and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) were used to detect the levels of inflammatory cytokines in mice peripheral blood and the petrous part of the temporal bone samples. Western blot analysis was performed to analyze the JAK2/STAT3 signaling pathway in the cochlear tissues. Histological examination was performed by hematoxylin and eosin (HE) staining for conventional morphological evaluation in the petrous part of temporal bone samples.
RESULTS The MWM test demonstrated that UC-MSCs improved the symptoms of MS. The MS + MSCs group was faster than the MS group on days 3 and 5 (P = 0.036 and P = 0.002, respectively). ELISA and RT-qPCR showed that the serum and mRNA levels of interleukin-10 (IL-10) in the cochlear tissues were increased after transplantation with UC-MSCs (MS + MSCs group vs MS group at 3 and 5 d, P = 0.002 and cP < 0.001, respectively). RT-qPCR results confirmed a significant increase in IL-10 levels at four time points (MS + MSCs group vs MS group, P = 0.009, P = 0.009, P = 0.048, and P = 0.049, respectively). This suggested that UC-MSCs reduced the sensitivity of the vestibular microenvironment by secreting IL-10. Moreover, Western blot analysis showed that the MSCs activated the JAK2/STAT3 signaling pathway in the cochlear tissues. The levels of IL-10, IL-10RA, JAK2, STAT3, and phosphorylated JAK2 and STAT3 in the MS + MSCs group were increased compared to those of the MS group (P < 0.05). The morphological changes in the four groups showed no significant differences. The role of IL-10 secretion on the ability of UC-MSCs to successfully improve the symptoms of MS was confirmed by the diminished therapeutic effects associated with treatment with the IL-10 inhibitor ammonium trichloro (dioxoethylene-o,o′) tellurate (AS101).
CONCLUSION Prophylactic transplantation of UC-MSCs can alleviate the clinical symptoms of MS in mice, particularly at 3-5 d after preventive transplantation. The mechanism for UC-MSCs to reduce the sensitivity of vestibular cortex imbalance may be the secretion of IL-10. The next step is to demonstrate the possibility of curing MS in the vestibular environment by intermittent transplantation of MSCs. Above all, MSCs are expected to become a new method for the clinical prevention and treatment of MS.
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Affiliation(s)
- Hua-Su Zhu
- Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| | - Dong Li
- Stem Cell and Regenerative Medicine Research Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| | - Cong Li
- Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| | - Jin-Xian Huang
- Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| | - Shan-Shan Chen
- Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| | - Lan-Bo Li
- Department of Animal Laboratory, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| | - Qing Shi
- Stem Cell and Regenerative Medicine Research Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| | - Xiu-Li Ju
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
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Cha YH, Golding J, Keshavarz B, Furman J, Kim JS, Lopez-Escamez JA, Magnusson M, Yates BJ, Lawson BD, Staab J, Bisdorff A. Motion sickness diagnostic criteria: Consensus document of the classification committee of the Bárány society. J Vestib Res 2021; 31:327-344. [PMID: 33646187 PMCID: PMC9249300 DOI: 10.3233/ves-200005] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present diagnostic criteria for motion sickness, visually induced motion sickness (VIMS), motion sickness disorder (MSD), and VIMS disorder (VIMSD) to be included in the International Classification of Vestibular Disorders. Motion sickness and VIMS are normal physiological responses that can be elicited in almost all people, but susceptibility and severity can be high enough for the response to be considered a disorder in some cases. This report provides guidelines for evaluating signs and symptoms caused by physical motion or visual motion and for diagnosing an individual as having a response that is severe enough to constitute a disorder. The diagnostic criteria for motion sickness and VIMS include adverse reactions elicited during exposure to physical motion or visual motion leading to observable signs or symptoms of greater than minimal severity in the following domains: nausea and/or gastrointestinal disturbance, thermoregulatory disruption, alterations in arousal, dizziness and/or vertigo, headache and/or ocular strain. These signs and/or symptoms occur during the motion exposure, build as the exposure is prolonged, and eventually stop after the motion ends. Motion sickness disorder and VIMSD are diagnosed when recurrent episodes of motion sickness or VIMS are reliably triggered by the same or similar stimuli, severity does not significantly decrease after repeated exposure, and signs/symptoms lead to activity modification, avoidance behavior, or aversive emotional responses. Motion sickness/MSD and VIMS/VIMSD can occur separately or together. Severity of symptoms in reaction to physical motion or visual motion stimuli varies widely and can change within an individual due to aging, adaptation, and comorbid disorders. We discuss the main methods for measuring motion sickness symptoms, the situations conducive to motion sickness and VIMS, and the individual traits associated with increased susceptibility. These additional considerations will improve diagnosis by fostering accurate measurement and understanding of the situational and personal factors associated with MSD and VIMSD.
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Affiliation(s)
- Yoon-Hee Cha
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - John Golding
- Psychology, School for Social Sciences, University of Westminster, London UK
| | - Behrang Keshavarz
- Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada; Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Joseph Furman
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ji-Soo Kim
- Department of Neurology Seoul National University, Seoul, Republic of Korea
| | - Jose A Lopez-Escamez
- Department of Surgery, Division of Otolaryngology, Universidad de Granada, Granada, Spain.,Otology and Neurotology Group CTS495, Department of Genomic Medicine, Centre for Genomics and Oncology Research - Pfizer/Univ. de Granada/Junta de Andalucía (GENyO), PTS, Granada, Spain.,Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs. GRANADA Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Måns Magnusson
- Department of Otorhinolaryngology, Lund University, Lund, Sweden
| | - Bill J Yates
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ben D Lawson
- Naval Submarine Medical Research Laboratory, Naval Submarine Base New London, Groton CT, USA
| | - Jeffrey Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Alexandre Bisdorff
- Department of Neurology, Centre Hospitalier Emile Mayrisch, L-4005 Esch-sur-Alzette, Luxembourg
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Immersive Virtual Tasks With Motor and Cognitive Components: A Feasibility Study With Young and Older Adults. J Aging Phys Act 2020; 29:400-411. [PMID: 33091873 DOI: 10.1123/japa.2019-0491] [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: 01/03/2020] [Revised: 07/16/2020] [Accepted: 08/04/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To analyze the feasibility, safety, and acceptability of immersive virtual tasks. METHODS The authors recruited 11 young adults and 10 older adults. The participants performed three virtual reaching tasks while walking on a virtual path. The descriptive analysis and comparison between participants were performed using the Mann-Whitney U test and chi-square test for nonparametric and nominal variables, respectively. The authors also used analysis of variance for a between-groups comparison for normal variables. RESULTS Twenty percent of older adults and 81.8% of young adults completed all three tasks (chi-square test; p = .005). Both groups reported minor symptoms, with no significant differences. The older adults were more motivated to practice the tasks (Mann-Whitney U test; p = .015) and would be more likely to suggest them to others (chi-square test; p = .034). CONCLUSION All three tasks were feasible for young adults. All participants, except for one, had cybersickness. The symptoms were mostly mild and subsided once the interaction was complete.
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29
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Peck K, Russo F, Campos JL, Keshavarz B. Examining potential effects of arousal, valence, and likability of music on visually induced motion sickness. Exp Brain Res 2020; 238:2347-2358. [PMID: 32757060 DOI: 10.1007/s00221-020-05871-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
The present study investigated how valence, arousal, and subjective liking of music affect visually induced motion sickness (VIMS). VIMS is a common side effect when interacting with virtual environments, resulting in discomfort, dizziness, and/or nausea. Music has previously been shown to reduce VIMS, but the precise nature of this effect remains unknown. Eighty participants watched a video of a bicycle ride filmed from a first-person perspective. First, participants (n = 40) were randomly assigned to one of four groups that listened to pre-selected, classical music excerpts varying in valence and arousal (happy, peaceful, agitated, sad) while watching the video. Second, the level of subjective liking of music was maximized by asking participants to select their favourite music (n = 20), which was then played during the video. A control group (n = 20) watched the video without music. VIMS was measured using the Fast Motion Sickness Scale (FMS) and the Simulator Sickness Questionnaire (SSQ). No effects of valence or arousal on VIMS symptoms were found. Instead, we found that VIMS was significantly reduced when music liking was maximized: Participants who listened to their favourite music reported less VIMS compared to those who did not listen to music at all or to pre-selected music that they liked less. Music that is highly liked can, under certain circumstances, successfully reduce VIMS. These effects appear to be independent of the valence and arousal characteristics of the music.
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Affiliation(s)
- Katlyn Peck
- Department of Psychology, Ryerson University, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada
| | - Frank Russo
- Department of Psychology, Ryerson University, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada
| | - Jennifer L Campos
- KITE-Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Behrang Keshavarz
- Department of Psychology, Ryerson University, Toronto, ON, Canada.
- KITE-Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.
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Lipson S, Wang A, Corcoran M, Zhou G, Brodsky JR. Severe motion sickness in infants and children. Eur J Paediatr Neurol 2020; 28:176-179. [PMID: 32682672 DOI: 10.1016/j.ejpn.2020.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/21/2020] [Accepted: 06/21/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Susceptibility to severe motion sickness has not been well described in the pediatric population, particularly in very young children. This study aimed to describe and evaluate risk factors and treatment responses in a group of children with severe motion sickness, including infants and toddlers. METHODS We conducted a retrospective review of patients less than 18 years of age seen in our pediatric vestibular program for evaluation of motion sickness over a 6-year period. RESULTS A total of 23 patients with motion sickness were identified. Age of onset ranged from 0 to 15 years old, with a mean age of 6.6 ± 4.2 years. Eleven patients (47.8%) were diagnosed with a migraine variant. Vestibular deficits were identified in four out of 17 patients (23.5%) who underwent formal vestibular testing. Other frequent comorbid conditions included recurrent/chronic otitis media (n = 9; 39.1%) and a history of motor delay (n = 7; 30.4%). A high proportion of patients reported symptom improvement when treated with meclizine, ondansetron, cyproheptadine, or vestibular rehabilitation. DISCUSSION Motion sickness can impact children even in infancy. Common comorbid conditions that may contribute to pediatric motion sickness include migraine disorders, vestibular impairment, otitis media, and motor delay. Treatments such as cyproheptadine and vestibular rehabilitation may be helpful but require further study.
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Affiliation(s)
- Sophie Lipson
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Alicia Wang
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Meghan Corcoran
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Guangwei Zhou
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA; Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
| | - Jacob R Brodsky
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA; Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.
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Nie GY, Duh HBL, Liu Y, Wang Y. Analysis on Mitigation of Visually Induced Motion Sickness by Applying Dynamical Blurring on a User's Retina. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2020; 26:2535-2545. [PMID: 30668475 DOI: 10.1109/tvcg.2019.2893668] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Visually induced motion sickness (MS) experienced in a 3D immersive virtual environment (VE) limits the widespread use of virtual reality (VR). This paper studies the effects of a saliency detection-based approach on the reduction of MS when the display on a user's retina is dynamic blurred. In the experiment, forty participants were exposed to a VR experience under a control condition without applying dynamic blurring, and an experimental condition applying dynamic blurring. The experimental results show that the participants under the experimental condition report a statistically significant reduction in the severity of MS symptoms on average during the VR experience compared to those under the control condition, which demonstrates that the proposed approach may alleviate visually induced MS in VR and enable users to remain in a VE for a longer period of time.
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Laitinen L, Nurmi M, Ellilä P, Rautava P, Koivisto M, Polo-Kantola P. Nausea and vomiting of pregnancy: associations with personal history of nausea and affected relatives. Arch Gynecol Obstet 2020; 302:947-955. [PMID: 32653947 PMCID: PMC7471164 DOI: 10.1007/s00404-020-05683-3] [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: 01/24/2020] [Accepted: 07/04/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE To examine whether personal history of nausea or history of nausea and vomiting of pregnancy (NVP) in relatives are risk factors for a woman to suffer from NVP. Further, to evaluate if these factors are associated with the severity of NVP. METHODS Cohort study of 2411 pregnant women recruited from maternity health care clinics. The severity of NVP was categorized according to Pregnancy-Unique Quantification of Emesis (PUQE) questionnaire into no/mild/moderate/severe NVP. History of nausea was assessed in connection with motion sickness, seasickness, migraine or other kinds of headache, after anesthesia, related to the use of contraceptives, and other kinds of nausea. History of NVP in relatives was categorized into first-degree (mother/sister) and second-degree relatives (more distant). RESULTS In multivariable analysis including previous personal history of nausea, motion sickness (OR 3.17, 95% CI 1.81-5.56, p < 0.0001) and nausea in migraine (OR 3.18, 95% CI 1.86-5.45, p < 0.0001) were associated with severe NVP. History of nausea in other kinds of headache was associated with moderate NVP (OR 1.91, 95% CI 1.34-2.72, p = 0.001). Women with affected first-degree relatives had higher odds for moderate (OR 3.84, 95% CI 2.72-5.40) and severe (OR 3.19, 95% CI 1.92-5.28) NVP (p < 0.0001). All these results remained significant after adjusting for parity, body mass index, smoking, employment and age. CONCLUSION Women with personal history of nausea or family history of NVP have an increased susceptibility of NVP. This information is useful in pre-pregnancy counselling.
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Affiliation(s)
- Linda Laitinen
- Department of Obstetrics and Gynecology, Central Finland Central Hospital, Keskussairaalantie 19, 40620, Jyväskylä, Finland. .,University of Turku, Turku, Finland.
| | - Miina Nurmi
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Pauliina Ellilä
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, Turku, Finland.,Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
| | - Mari Koivisto
- Turku Clinical Research Centre, Turku University Hospital, Turku, Finland.,Department of Biostatistics, University of Turku, Turku, Finland
| | - Päivi Polo-Kantola
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
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Leung AK, Hon KL. Motion sickness: an overview. Drugs Context 2019; 8:dic-2019-9-4. [PMID: 32158479 PMCID: PMC7048153 DOI: 10.7573/dic.2019-9-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/18/2022] Open
Abstract
Background Motion sickness is a common phenomenon that affects almost everybody at some point in their lifetime. Clinicians should be familiar with the proper management of this condition. Objective To provide an update on the current understanding of the pathophysiology and management of motion sickness. Methods A PubMed search was performed with Clinical Queries using the key term ‘motion sickness.’ The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. The information retrieved from the earlier search was used in the compilation of the present article. Results Motion sickness is typically triggered by low-frequency vertical, lateral, angular, rotary motion, or virtual stimulator motion, to which an individual has not adapted. Sine qua non for developing motion sickness is when the brain receives conflicting information from different sensors about real body movements or virtual environment. The principal sensors are the eyes, the vestibular apparatus, and proprioceptive receptors. The conflicting information is judged in relation to a pattern of expected associations formed under normal or experienced conditions stored in the brain. Motion sickness typically presents with malaise, anorexia, nausea, yawning, sighing, increased salivation, burping, headache, blurred vision, non-vertiginous dizziness, drowsiness, spatial disorientation, difficulty concentrating, and sometimes vomiting. Simple behavioral and environmental modifications can be effective in the prevention of motion sickness. Medications that are effective in the prophylaxis and/or treatment of motion sickness include anticholinergics, antihistamines, and sympathomimetics. Conclusion In most cases, motion sickness can be prevented by behavioral and environmental modifications (avoidance, habituation, and minimization of motion stimuli). Pharmacotherapy should be considered in the prevention and/or treatment of more severe motion sickness and for patients who do not respond to conservative measures. Medications are most effective when combined with behavioral and environmental modifications. Drugs that are effective in the prophylaxis and/or treatment of motion sickness include anticholinergic agents and antihistamines.
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Affiliation(s)
- Alexander Kc Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong
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Tu L, Lu Z, Ngan MP, Lam FFY, Giuliano C, Lovati E, Pietra C, Rudd JA. The brain-penetrating, orally bioavailable, ghrelin receptor agonist HM01 ameliorates motion-induced emesis in Suncus murinus (house musk shrew). Br J Pharmacol 2019; 177:1635-1650. [PMID: 31722444 DOI: 10.1111/bph.14924] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 09/13/2019] [Accepted: 10/31/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND PURPOSE HM01, a novel, orally bioavailable, brain-penetrating agonist of ghrelin receptors, ameliorates emesis in Suncus murinus. This study compared HM01's activity against motion sickness with that of the less brain-penetrating ghrelin receptor agonist, HM02. EXPERIMENTAL APPROACH The potential of HM01 and HM02 to relax isolated mesenteric arteries and to increase feeding was investigated. Radio telemetry was used to record gastric slow waves and body temperature. Plethysmography was used to measure respiratory function. HM01 and HM02 were administered p.o. 1 hr prior to provocative motion, and c-Fos expression in brain sections was assessed. KEY RESULTS HM01 and HM02 both relaxed precontracted arteries, yielding EC50 values of 2.5 ± 0.5 and 3.5 ± 0.4 nM respectively. HM01 increased feeding, but HM02 did not. Both compounds caused hypothermia and bradygastria. Motion induced 123 ± 24 emetic events. HM01, but not HM02, reduced motion-induced emesis by 67.6%. Motion increased c-Fos expression in the nucleus tractus solitarius (NTS), dorsal motor nucleus of the vagus (DMNV), medial vestibular nucleus (MVe), central nucleus of the amygdala, and paraventricular hypothalamic nucleus (PVH). HM01 alone increased c-Fos expression in the area postrema, NTS, DMNV, PVH, and arcuate hypothalamic nucleus; HM02 had a similar pattern except it did not increase c-Fos in the PVH. Both compounds antagonized the motion-induced increases in c-Fos expression in the MVe. CONCLUSIONS AND IMPLICATIONS HM01 is more effective than HM02 in preventing motion-induced emesis. The difference in potency may relate to activation of ghrelin receptors in the PVH.
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Affiliation(s)
- Longlong Tu
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Zengbing Lu
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Man P Ngan
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Francis F Y Lam
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Claudio Giuliano
- Research and Preclinical Development Department, Helsinn Healthcare SA, Lugano, Switzerland
| | - Emanuela Lovati
- Research and Preclinical Development Department, Helsinn Healthcare SA, Lugano, Switzerland
| | - Claudio Pietra
- Research and Preclinical Development Department, Helsinn Healthcare SA, Lugano, Switzerland
| | - John A Rudd
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong.,The Laboratory Animal Services Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
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Javaid A, Chouhna H, Varghese B, Hammam E, Macefield VG. Changes in skin blood flow, respiration and blood pressure in participants reporting motion sickness during sinusoidal galvanic vestibular stimulation. Exp Physiol 2019; 104:1622-1629. [PMID: 31468621 DOI: 10.1113/ep087385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 08/27/2019] [Indexed: 12/12/2022]
Abstract
NEW FINDINGS What is the central question of the study? We have previously shown that sinusoidal galvanic vestibular stimulation induces greater modulation of skin sympathetic nerve activity, but not muscle sympathetic nerve activity, in participants who report nausea during simulated motion, but the effects on skin blood flow and blood pressure are unknown. What is the main finding and its importance? During vestibular stimulation, nausea was associated with a greater increase in skin blood flow and a progressive reduction in skin sympathetic nerve activity, but no changes in muscle sympathetic nerve activity. This emphasizes the differential changes in sympathetic outflow to different tissues during nausea. ABSTRACT We tested the hypothesis that galvanic vestibular stimulation, which produces illusions of side-to-side swaying, causes a greater reduction in skin blood flow in participants who report stimulation-induced nausea. A retrospective analysis was performed on data obtained in 30 participants. Bipolar sinusoidal galvanic vestibular stimulation (sGVS) was applied across the mastoid processes (±2 mA, 0.08 Hz) for 21 min. ECG, continuous blood pressure, respiration and skin blood flow were recorded. Muscle sympathetic nerve activity was recorded in 17 participants and skin sympathetic nerve activity in 12. Ten participants reported motion sickness, whereas 20 did not. Both groups showed an initial reduction in skin (finger) blood flow during sGVS, followed by a sustained increase and a subsequent return towards baseline levels throughout the stimulation; the increase was greater in those who experienced nausea. The increase fits with the progressive reduction in skin sympathetic nerve activity observed in the nauseous group. Mean blood pressure was significantly lower in those who experienced nausea and showed a much larger increase at the onset of sGVS, compared with those who did not. Moreover, the respiratory rate was higher at the outset for the subjects who experienced nausea, decreasing progressively during sGVS, whereas respiratory rate remained constant in those who did not experience nausea. Heart rate was more labile in the subjects who experienced nausea, showing a sustained increase towards the end of stimulation. We have shown that several autonomic parameters change during the nausea induced by vestibular stimulation, but a sustained decrease in skin blood flow is not a hallmark of incipient motion sickness.
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Affiliation(s)
- Anadil Javaid
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Houda Chouhna
- College of Medicine, Mohammed Bin Rashid University of Medicine & Health Sciences, Dubai, United Arab Emirates
| | - Ben Varghese
- College of Medicine, Mohammed Bin Rashid University of Medicine & Health Sciences, Dubai, United Arab Emirates
| | - Elie Hammam
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Vaughan G Macefield
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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Effect of Gaze Stability Exercises on Chronic Motion Sensitivity: A Randomized Controlled Trial. J Neurol Phys Ther 2019; 42:72-79. [PMID: 29547480 DOI: 10.1097/npt.0000000000000216] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Motion sensitivity is a common condition among the general population and may be accompanied by postural instability and anxiety. Preliminary studies suggest that minimal dosage of gaze stability exercises improves postural stability in young adults with chronic motion sensitivity. The aim of this study was to investigate the effect of progressive gaze stability exercises on postural stability, motion sensitivity, and anxiety in healthy young adults with chronic motion sensitivity. METHODS We conducted a single-blind randomized controlled trial to assess the effect of gaze stability exercises on chronic motion sensitivity. Forty-one participants of both genders ages 20 to 40 years with chronic motion sensitivity were randomly assigned to 2 groups. The intervention group performed gaze stability exercises while the sham group performed saccadic eye movement exercises for 6 weeks. Computerized Dynamic Posturography with Immersion Virtual Reality (CDP-IVR)-condition 1 (C1) and condition 2 (C2)-Motion Sensitivity Quotient (MSQ), Motion Sickness Sensitivity Susceptibility Questionnaire Short Form (MSSQ-Short: MSA, MSB), and State-Trait Anxiety Inventory for Adults (STAI Form Y-2) were the outcome measures used. RESULTS There was no significant group × time interaction for MSA, MSB, MSSQ percentile, STAI, MSQ, C1 mean, or C2 mean. However, posttreatment a significant difference in the mean CDP-IVR score of C2 was identified between the 2 groups. For C2, the intervention group demonstrated a 117% increase in the mean CDP-IVR score compared with a 35.2% increase in the sham group. MSQ reduced significantly from baseline to 6 weeks postintervention in the intervention group (4.0 ± 1.2 vs 1.9 ± 0.9). Anxiety was significantly reduced in the sham group only (38.2 ± 1.9 vs 35.8 ± 2.2). DISCUSSION AND CONCLUSIONS Based on the results of this study, progressive gaze stability exercises appear to have value for managing chronic motion sensitivity in healthy young adults. Further research with larger sample size and broader age range is needed to generalize these findings.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A203).
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Elbin RJ, Kontos AP, Sufrinko A, McElroy M, Stephenson-Brown K, Mohler S, D'Amico NR, Collins MW. Motion Sickness Susceptibility and Baseline Vestibular and Ocular-Motor Performance in Adolescent Athletes. J Athl Train 2019; 54:939-944. [PMID: 31454287 DOI: 10.4085/1062-6050-347-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT High school athletes with a history of motion sickness susceptibility exhibit higher baseline vestibular and ocular-motor scores than those without a history of motion sickness susceptibility. OBJECTIVE To examine the effects of motion sickness susceptibility on baseline vestibular and ocular-motor functioning, neurocognitive performance, and symptom scores. DESIGN Cross-sectional study. SETTING Preseason concussion testing. PATIENTS OR OTHER PARTICIPANTS A convenience sample of high school athletes (N = 308, age = 15.13 ± 1.21 years) involved in a variety of sports. MAIN OUTCOME MEASURE(S) Vestibular/Ocular Motor Screening, computerized neurocognitive assessment, symptom scale, and Motion Sickness Susceptibility Questionnaire-Short Form (MSSQ-S). RESULTS Participants were categorized into 3 groups based on a median split of the scores (eg, NONE, LOW, and HIGH). The LOW (n = 95) and HIGH (n = 92) groups (ie, MSSQ-S score > 0) were 2.64 times more likely (χ21,257 = 7.94, P = .01, 95% confidence interval = 1.32, 5.26) to have baseline Vestibular/Ocular Motor Screening scores larger than the clinical cutoffs for the NONE group (n = 70). No between-groups main effects were present for the NONE (n = 52), LOW (n = 89), and HIGH (n = 90) MSSQ-S groups for verbal (F2,230 = .09, P = .91, η2 = .001) and visual (F2,230 = .15, P = .86, η2 = .001) memory, processing speed (F2,230 = .78, P = .46, η2 = .007), or reaction time (F2,230 = 2.21, P = .11, η2 = .002). The HIGH group exhibited higher total baseline symptom scores than the LOW (U = 3325.50, z = -1.99, P = .05, r = .15) and NONE (U = 1647.50, z = -2.83, P = .005, r = .24) groups. CONCLUSIONS Motion sickness should be considered a preexisting risk factor that might influence specific domains of the baseline concussion assessment and postinjury management.
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Affiliation(s)
- R J Elbin
- Office for Sport Concussion Research, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville
| | - Anthony P Kontos
- UPMC Sports Medicine Concussion Program-Department of Orthopaedic Surgery, University of Pittsburgh, PA
| | - Alicia Sufrinko
- UPMC Sports Medicine Concussion Program-Department of Orthopaedic Surgery, University of Pittsburgh, PA
| | - Mallory McElroy
- Office for Sport Concussion Research, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville
| | - Katie Stephenson-Brown
- Office for Sport Concussion Research, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville
| | - Samantha Mohler
- Office for Sport Concussion Research, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville
| | - Nathan R D'Amico
- Office for Sport Concussion Research, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville
| | - Michael W Collins
- UPMC Sports Medicine Concussion Program-Department of Orthopaedic Surgery, University of Pittsburgh, PA
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History of High Motion Sickness Susceptibility Predicts Vestibular Dysfunction Following Sport/Recreation-Related Concussion. Clin J Sport Med 2019; 29:318-323. [PMID: 31241535 DOI: 10.1097/jsm.0000000000000528] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare vestibular dysfunction at 1 to 10 and 11 to 20 days following sport/recreation-related concussion (SRC) in athletes with and without history of motion sickness susceptibility. Secondary aims of this study were to investigate differences in neurocognitive performance and affective symptoms in these groups. DESIGN Cross-sectional. SETTING Concussion Specialty Clinic. PARTICIPANTS One hundred twenty-four adolescents and adults (82 males, 42 females) aged 14 to 26 (16.36 ± 2.10) years, diagnosed with SRC in the past 10 (4.56 ± 2.54) days; 47 participants composed the sample for quartile analyses. INDEPENDENT VARIABLE Motion sickness susceptibility questionnaire short form score. MAIN OUTCOME MEASURES Computerized neurocognitive test scores, vestibular/oculomotor screening scores (VOMS), and symptom factor scores from a standardized concussion symptom inventory. RESULTS There was no association between history of motion sickness susceptibility and VOMS scores (above or below clinical cutoff) at 1 to 10 days after injury, although at 11 to 20 days after injury there was an association between high motion sickness susceptibility and symptoms above clinical cutoff on 5 of the 6 VOMS items (P values 0.01-0.04). The high motion sickness group had more affective symptoms on the symptom inventory than the no motion sickness group (P = 0.002) at 1 to 10 days after injury. Groups did not differ on computerized neurocognitive testing (P = 0.11). CONCLUSION Athletes with a preexisting history of motion sensitivity may exhibit more prolonged vestibular dysfunction following SRC, and may experience more affective symptoms early in recovery.
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Ono HK, Hirose S, Narita K, Sugiyama M, Asano K, Hu DL, Nakane A. Histamine release from intestinal mast cells induced by staphylococcal enterotoxin A (SEA) evokes vomiting reflex in common marmoset. PLoS Pathog 2019; 15:e1007803. [PMID: 31112582 PMCID: PMC6546250 DOI: 10.1371/journal.ppat.1007803] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/03/2019] [Accepted: 04/30/2019] [Indexed: 01/31/2023] Open
Abstract
Staphylococcal enterotoxins (SEs) produced by Staphylococcus aureus are known as causative agents of emetic food poisoning. We previously demonstrated that SEA binds with submucosal mast cells and evokes mast cell degranulation in a small emetic house musk shrew model. Notably, primates have been recognized as the standard model for emetic assays and analysis of SE emetic activity. However, the mechanism involved in SEA-induced vomiting in primates has not yet been elucidated. In the present study, we established common marmosets as an emetic animal model. Common marmosets were administered classical SEs, including SEA, SEB and SEC, and exhibited multiple vomiting responses. However, a non-emetic staphylococcal superantigen, toxic shock syndrome toxin-1, did not induce emesis in these monkeys. These results indicated that the common marmoset is a useful animal model for assessing the emesis-inducing activity of SEs. Furthermore, histological analysis uncovered that SEA bound with submucosal mast cells and induced mast cell degranulation. Additionally, ex vivo and in vivo pharmacological results showed that SEA-induced histamine release plays a critical role in the vomiting response in common marmosets. The present results suggested that 5-hydroxytryptamine also plays an important role in the transmission of emetic stimulation on the afferent vagus nerve or central nervous system. We conclude that SEA induces histamine release from submucosal mast cells in the gastrointestinal tract and that histamine contributes to the SEA-induced vomiting reflex via the serotonergic nerve and/or other vagus nerve. Staphylococcal enterotoxin A (SEA) is a bacterial toxin that has been recognized as a leading causative agent of staphylococcal food poisoning since 1930. The primary symptoms of staphylococcal food poisoning are nausea and emesis, which develop up to 1–6 h after ingestion of the causative foods contaminated by the bacteria. In the present study, we established the common marmoset as an emetic animal model and investigated the mechanisms of SEA-induced emesis in the primate model. Common marmosets that received SEA showed multiple emetic responses. We observed that SEA bound with submucosal mast cells in the intestinal tract and induced mast cell degranulation. Furthermore, SEA promoted histamine release from mast cells. We also demonstrated that histamine plays an important role in the SEA-induced emetic response in common marmosets. We conclude that SEA induces histamine release from submucosal mast cells in the intestinal tract and that the stimulation is transmitted from intestine to the brain via nerves, causing emesis. Our study provides a novel insight into functions of submucosal mast cells in the digestive tract.
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Affiliation(s)
- Hisaya K. Ono
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Zoonoses, Kitasato University School of Veterinary Medicine, Towada, Aomori, Japan
| | - Shouhei Hirose
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Biopolymer and Health Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kouji Narita
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Institute for Animal Experimentation, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Makoto Sugiyama
- Department of Veterinary Anatomy, Kitasato University School of Veterinary Medicine, Towada, Japan
| | - Krisana Asano
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Biopolymer and Health Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Dong-Liang Hu
- Department of Zoonoses, Kitasato University School of Veterinary Medicine, Towada, Aomori, Japan
| | - Akio Nakane
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Biopolymer and Health Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- * E-mail:
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Survey of motion sickness susceptibility in children and adolescents aged 3 months to 18 years. J Neurol 2019; 266:65-73. [DOI: 10.1007/s00415-019-09333-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 10/26/2022]
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Phencynonate S-isomer as a eutomer is a novel central anticholinergic drug for anti-motion sickness. Sci Rep 2019; 9:2000. [PMID: 30760797 PMCID: PMC6374516 DOI: 10.1038/s41598-018-38305-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 12/21/2018] [Indexed: 12/04/2022] Open
Abstract
To compare and evaluate the differences of stereoselective activity, the binding affinity, metabolism, transport and molecular docking of phencynonate isomers to muscarinic acetylcholine receptor (mAChR) were investigated in this study. The rotation stimulation and locomotor experiments were used to evaluate anti-motion sickness effects. The competitive affinity with [3H]-QNB and molecular docking were used for studying the interactions between the two isomers and mAChR. The stereoselective mechanism of isomers was investigated by incubation with rat liver microsomes, a protein binding assay and membrane permeability assay across a Caco-2 cell monolayer using a chiral column HPLC method. The results indicated that S-isomer was more effective against motion sickness and had not anxiogenic action at therapeutic doses. S-isomer has the higher affinity and activity for mAChR in cerebral cortex and acted as a competitive mAChR antagonist. The stereoselective elimination of S-isomer was primarily affected by CYP1B1 and 17A1 enzymes, resulting in a higher metabolic stability and slower elimination. Phencynonate S isomer, as a eutomer and central anticholinergic chiral drug, is a novel anti-motion sickness drug with higher efficacy and lower central side effect. Our data assisted the development of a novel drug and eventual use of S-isomer in clinical practice.
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Acute behavioral effects of deliriant hallucinogens atropine and scopolamine in adult zebrafish. Behav Brain Res 2019; 359:274-280. [DOI: 10.1016/j.bbr.2018.10.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/19/2018] [Accepted: 10/23/2018] [Indexed: 01/06/2023]
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Volgin AD, Yakovlev OA, Demin KA, Alekseeva PA, Kyzar EJ, Collins C, Nichols DE, Kalueff AV. Understanding Central Nervous System Effects of Deliriant Hallucinogenic Drugs through Experimental Animal Models. ACS Chem Neurosci 2019; 10:143-154. [PMID: 30252437 DOI: 10.1021/acschemneuro.8b00433] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Hallucinogenic drugs potently alter human behavior and have a millennia-long history of use for medicinal and religious purposes. Interest is rapidly growing in their potential as CNS modulators and therapeutic agents for brain conditions. Antimuscarinic cholinergic drugs, such as atropine and scopolamine, induce characteristic hyperactivity and dream-like hallucinations and form a separate group of hallucinogens known as "deliriants". Although atropine and scopolamine are relatively well-studied drugs in cholinergic physiology, deliriants represent the least-studied class of hallucinogens in terms of their behavioral and neurological phenotypes. As such, novel approaches and new model organisms are needed to investigate the CNS effects of these compounds. Here, we comprehensively evaluate the preclinical effects of deliriant hallucinogens in various animal models, their mechanisms of action, and potential interplay with other signaling pathways. We also parallel experimental and clinical findings on deliriant agents and outline future directions of translational research in this field.
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Affiliation(s)
- Andrey D. Volgin
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
- Military Medical Academy, St. Petersburg 194044, Russia
| | - Oleg A. Yakovlev
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
- Military Medical Academy, St. Petersburg 194044, Russia
| | | | | | - Evan J. Kyzar
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois 60612, United States
- The International Zebrafish Neuroscience Research Consortium (ZNRC), New Orleans, Louisiana 70458, United States
| | - Christopher Collins
- The International Zebrafish Neuroscience Research Consortium (ZNRC), New Orleans, Louisiana 70458, United States
| | - David E. Nichols
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina 27599, United States
| | - Allan V. Kalueff
- School of Pharmacy, Southwest University, Chongqing 400716, China
- Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk 630117, Russiai
- Ural Federal University, Ekaterinburg 620075, Russia
- ZENEREI Research Center, Slidell, Louisiana 70458, United States
- Laboratory of Biological Psychiatry, Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
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45
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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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46
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Sanger GJ, Andrews PLR. A History of Drug Discovery for Treatment of Nausea and Vomiting and the Implications for Future Research. Front Pharmacol 2018; 9:913. [PMID: 30233361 PMCID: PMC6131675 DOI: 10.3389/fphar.2018.00913] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/25/2018] [Indexed: 12/24/2022] Open
Abstract
The origins of the major classes of current anti-emetics are examined. Serendipity is a recurrent theme in discovery of their anti-emetic properties and repurposing from one indication to another is a continuing trend. Notably, the discoveries have occurred against a background of company mergers and changing anti-emetic requirements. Major drug classes include: (i) Muscarinic receptor antagonists-originated from historical accounts of plant extracts containing atropine and hyoscine with development stimulated by the need to prevent sea-sickness among soldiers during beach landings; (ii) Histamine receptor antagonists-searching for replacements for the anti-malaria drug quinine, in short supply because of wartime shipping blockade, facilitated the discovery of histamine (H1) antagonists (e.g., dimenhydrinate), followed by serendipitous discovery of anti-emetic activity against motion sickness in a patient undergoing treatment for urticaria; (iii) Phenothiazines and dopamine receptor antagonists-investigations of their pharmacology as "sedatives" (e.g., chlorpromazine) implicated dopamine receptors in emesis, leading to development of selective dopamine (D2) receptor antagonists (e.g., domperidone with poor ability to penetrate the blood-brain barrier) as anti-emetics in chemotherapy and surgery; (iv) Metoclopramide and selective 5-hydroxytryptamine3(5-HT3) receptor antagonists-metoclopramide was initially assumed to act only via D2 receptor antagonism but subsequently its gastric motility stimulant effect (proposed to contribute to the anti-emetic action) was shown to be due to 5-hydroxytryptamine4 receptor agonism. Pre-clinical studies showed that anti-emetic efficacy against the newly-introduced, highly emetic, chemotherapeutic agent cisplatin was due to antagonism at 5-HT3 receptors. The latter led to identification of selective 5-HT3 receptor antagonists (e.g., granisetron), a major breakthrough in treatment of chemotherapy-induced emesis; (v) Neurokinin1receptor antagonists-antagonists of the actions of substance P were developed as analgesics but pre-clinical studies identified broad-spectrum anti-emetic effects; clinical studies showed particular efficacy in the delayed phase of chemotherapy-induced emesis. Finally, the repurposing of different drugs for treatment of nausea and vomiting is examined, particularly during palliative care, and also the challenges in identifying novel anti-emetic drugs, particularly for treatment of nausea as compared to vomiting. We consider the lessons from the past for the future and ask why there has not been a major breakthrough in the last 20 years.
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Affiliation(s)
- Gareth J. Sanger
- Blizard Institute and the National Centre for Bowel Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Paul L. R. Andrews
- Division of Biomedical Sciences, St George's University of London, London, United Kingdom
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47
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Rudd JA, Chan SW, Ngan MP, Tu L, Lu Z, Giuliano C, Lovati E, Pietra C. Anti-emetic Action of the Brain-Penetrating New Ghrelin Agonist, HM01, Alone and in Combination With the 5-HT 3 Antagonist, Palonosetron and With the NK 1 Antagonist, Netupitant, Against Cisplatin- and Motion-Induced Emesis in Suncus murinus (House Musk Shrew). Front Pharmacol 2018; 9:869. [PMID: 30127745 PMCID: PMC6087754 DOI: 10.3389/fphar.2018.00869] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/18/2018] [Indexed: 11/22/2022] Open
Abstract
Ghrelin has well-known activity to stimulate appetite and weight gain. Evidence suggests that ghrelin may also have effects in reducing chemotherapy-induced emesis via growth hormone secretagogue receptors (GHS-R1A) in the brain. However, it is not known whether the stimulation of GHS-R1A has broad inhibitory anti-emetic effects. In the present studies, we used Suncus murinus to investigate the potential of the new and novel orally bioavailable brain-penetrating GHS-R1A mimetic, HM01 (1-[(1S)-1-(2,3-dichloro-4-methoxyphenyl)ethyl]-3-methyl-3-[(4R)-1-Methyl-3,3-dimethyl-4-piperidyl]urea), to reduce emesis induced by a variety of emetic challenges. HM01 (1 to 30 mg/kg, p.o.) antagonized emesis induced by cisplatin (30 mg/kg, i.p.) and by motion (4 cm horizontal displacement, 1 Hz) but was ineffective against emesis induced by nicotine (5 mg/kg, s.c.) and copper sulfate (120 mg/kg by intragastric gavage). In other experiments, HM01 (3 mg/kg, p.o.) enhanced the anti-emetic control of a regimen of palonosetron (0.01 mg/kg, p.o.) alone and palonosetron (0.01 mg/kg p.o.) plus netupitant (1 mg/kg, p.o.). HM01 (10 mg/kg, p.o.) also had positive effects in increasing feeding and drinking in nicotine-treated animals, and it shortened the latency to drink in animals treated with cisplatin. These data indicate that brain-penetrating GHS-R1A agonists may have use alone and/or in combination with standard anti-emetic regimens for the treatment of chemotherapy-induced nausea and vomiting and motion sickness.
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Affiliation(s)
- John A Rudd
- Emesis Research Group, School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.,Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Sze W Chan
- School of Health Sciences, Caritas Institute of Higher Education, Tseung Kwan O New Town, Hong Kong
| | - Man P Ngan
- Emesis Research Group, School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Longlong Tu
- Emesis Research Group, School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Zengbing Lu
- Emesis Research Group, School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Claudio Giuliano
- Helsinn Healthcare SA, Research and Development, Lugano, Switzerland
| | - Emanuela Lovati
- Helsinn Healthcare SA, Research and Development, Lugano, Switzerland
| | - Claudio Pietra
- Helsinn Healthcare SA, Research and Development, Lugano, Switzerland
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48
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Inprasit C, Lin YW, Huang CP, Wu SY, Hsieh CL. Targeting TRPV1 to relieve motion sickness symptoms in mice by electroacupuncture and gene deletion. Sci Rep 2018; 8:10365. [PMID: 29985388 PMCID: PMC6037734 DOI: 10.1038/s41598-018-23793-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 03/06/2018] [Indexed: 11/09/2022] Open
Abstract
Motion sickness (MS) is an acute disorder that occurs in healthy individuals worldwide regardless of gender, age, or ethnicity. Our study used a mouse model to rule out the effects of any psychological factors related to MS and EA. Subjects were randomly separated into four groups, namely the control group (Con), motion sickness inducing group (MS), mentioning sickness inducing with electroacupuncture treatment group (EA) and motion sickness inducing only in TRPV1 knockout mice group (TRPV1-/-). The consumption of kaolin, a non-nutrient substance, was measured as a behavior observed response of an emetic reflex in a murine model. This behavior is referred to as pica behavior. Our results showed that pica behavior was observed in the MS group. Moreover, kaolin consumption in the EA group decreased to the average baseline of the control group. A similar result was observed in TRPV1 null mice. We also observed an increase of TRPV1 and related molecules in the thalamus, hypothalamic and brain stem after MS stimulation and a significant decrease in the EA and TRPV1 null groups. This is the first study to demonstrate that TRPV1 pathways are possibly associated with mechanisms of MS, and can be attended through EA or TRPV1 genetic manipulation.
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Affiliation(s)
- Chanya Inprasit
- College of Chinese Medicine, Graduate Institute of Acupuncture Science International Master Program, China Medical University, Taichung, 404, Taiwan
| | - Yi-Wen Lin
- Chinese Medicine Research Center, China Medical University, Taichung, 404, Taiwan
- College of Chinese Medicine, Graduate Institute of Acupuncture Science, China Medical University, Taichung, 404, Taiwan
| | - Chun-Ping Huang
- Chinese Medicine Research Center, China Medical University, Taichung, 404, Taiwan
| | - Shu-Yih Wu
- Department of Rehabilitation Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ching-Liang Hsieh
- Chinese Medicine Research Center, China Medical University, Taichung, 404, Taiwan.
- College of Chinese Medicine, Graduate Institute of Acupuncture Science, China Medical University, Taichung, 404, Taiwan.
- College of Chinese Medicine, Graduate Institute of Integrated Medicine, China Medical University, Taichung, 404, Taiwan.
- Department of Chinese Medicine, China Medical University Hospital, Taichung, 404, Taiwan.
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49
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de Abreu MS, Friend AJ, Amstislavskaya TG, Kalueff AV. Commentary: Establishing zebrafish as a model to study the anxiolytic effects of scopolamine. Front Pharmacol 2018; 9:293. [PMID: 29667652 PMCID: PMC5891632 DOI: 10.3389/fphar.2018.00293] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 03/14/2018] [Indexed: 12/26/2022] Open
Affiliation(s)
- Murilo S de Abreu
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil.,Postgraduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, Brazil.,Neuroscience Program, School of Science and Engineering, Tulane University, New Orleans, LA, United States
| | - Ashton J Friend
- Neuroscience Program, School of Science and Engineering, Tulane University, New Orleans, LA, United States.,The International Zebrafish Neuroscience Research Consortium, Slidell, LA, United States
| | | | - Allan V Kalueff
- School of Pharmacy, Southwest University, Chongqing, China.,Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia.,Institute of Experimental Medicine, Almazov National Medical Research Center, St. Petersburg, Russia.,Ural Federal University, Ekaterinburg, Russia.,Russian National Granov's Research Center for Radiology and Surgical Technologies, Pesochny, Russia.,Laboratory of Translational Biopsychiatry, Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia.,ZENEREI Research Center, Slidell, LA, United States
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50
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Tian D, Mo F, Cai X, Miao Z, Xiao F, Chang Y, Wu L, Tang Y, Wang X, Ye C, Qian X, Gu W, Li M. Acupuncture relieves motion sickness via the IRβ-ERK1/2-dependent insulin receptor signalling pathway. Acupunct Med 2018; 36:153-161. [PMID: 29436382 DOI: 10.1136/acupmed-2016-011202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Acupuncture has been widely used for the treatment of motion sickness (MS), but the underlying mechanisms are unclear. The aim of this research was to study the mechanism of acupuncture in the treatment of MS. METHODS To observe the effects of acupuncture in the treatment of MS, 80 rats were randomised into five groups that were subjected to acceleration and either remained untreated (CTRL), or received restraint (REST), scopolamine (SCOP) or acupuncture at SP4 (sham) or PC6+ST36 (verum) acupuncture points. To study the mechanism underlying the effects of acupuncture in the treatment of MS, 48 rats were randomised into three groups: acupuncture+extracellular regulated protein kinases (ERK) 1/2 inhibitor (ERKinh), acupuncture+insulin receptor (IR) antagonist (IRant), and acupuncture+vehicle (VEH). After acceleration, the MS index (MSI) and spontaneous activity (SA) of the rats were recorded. Serum stress hormones, Fos-positive cells, c-fos mRNA in the vestibular nucleus, and IRβ-, p-IRβ-, ERK1/2- and p-ERK1/2-positive cells in the dorsal motor nucleus of the vagus nerve (DMV) were detected. RESULTS After acceleration, MS symptoms in the PC6+ST36 and SCOP groups were reduced compared with the CTRL, REST, and SP4 groups. The number of p-IRβ- and p-ERK1/2-positive cells and insulin levels were higher in the PC6+ST36 group than in the CTRL, REST, and SP4 groups. After ERK1/2 inhibitor and IR antagonist treatment, MS symptoms in the VEH group were lower than in the ERKinh and IRant groups. CONCLUSIONS Our study demonstrates that acupuncture significantly alleviates MS through the IRβ-ERK1/2-dependent insulin receptor signalling pathway in the DMV.
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Affiliation(s)
- Dawei Tian
- Department of Aerospace Medicine Aerospace Biodynamics, Fourth Military Medical University, Xi'an, China
| | - Fengfeng Mo
- Department of Ship Hygiene, Faculty of Navy Medicine, Second Military Medical University, Shanghai, China
| | - Xingjian Cai
- Department of Ship Hygiene, Faculty of Navy Medicine, Second Military Medical University, Shanghai, China
| | - Zhiyuan Miao
- Faculty of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
| | - Feng Xiao
- Department of Ship Hygiene, Faculty of Navy Medicine, Second Military Medical University, Shanghai, China
| | - Yifang Chang
- Department of Urology, Changhai Hospital, Shanghai, China
| | - Lusha Wu
- Department of Ship Hygiene, Faculty of Navy Medicine, Second Military Medical University, Shanghai, China
| | - Yuxiao Tang
- Department of Ship Hygiene, Faculty of Navy Medicine, Second Military Medical University, Shanghai, China
| | - Xin Wang
- Department of Ship Hygiene, Faculty of Navy Medicine, Second Military Medical University, Shanghai, China
| | - Chen Ye
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaolu Qian
- Faculty of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
| | - Wei Gu
- Faculty of Traditional Chinese Medicine, Second Military Medical University, Shanghai, China
| | - Min Li
- Department of Ship Hygiene, Faculty of Navy Medicine, Second Military Medical University, Shanghai, China
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