Effect of body position on incidence of motion sickness

Brainstem processing of vestibular sensory exafference: implications for motion sickness etiology

The origin of the internal "sensory conflict" stimulus causing motion sickness has been debated for more than four decades. Recent studies show a subclass of neurons in the vestibular nuclei and deep cerebellar nuclei that respond preferentially to passive head movements. During active movement, the semicircular canal and otolith input ("reafference") to these neurons are canceled by a mechanism comparing the expected consequences of self-generated movement (estimated with an internal model-presumably located in the cerebellum) with the actual sensory feedback. The un-canceled component ("exafference") resulting from passive movement normally helps compensate for unexpected postural disturbances. Notably, the existence of such vestibular "sensory conflict" neurons had been postulated as early as 1982, but their existence and putative role in posture control and motion sickness have been long debated. Here, we review the development of "sensory conflict" theories in relation to recent evidence for brainstem and cerebellar reafference cancelation, and identify some open research questions. We propose that conditions producing persistent activity of these neurons, or their targets, stimulate nearby brainstem emetic centers-via an as yet unidentified mechanism. We discuss how such a mechanism is consistent with the notable difference in motion sickness susceptibility of drivers as opposed to passengers, human immunity to normal self-generated movement and why head restraint or lying horizontal confers relative immunity. Finally, we propose that fuller characterization of these mechanisms and their potential role in motion sickness could lead to more effective, scientifically based prevention and treatment for motion sickness.

Motion sickness, console video games, and head-mounted displays

OBJECTIVE

We evaluated the nauseogenic properties of commercial console video games (i.e., games that are sold to the public) when presented through a head-mounted display.

BACKGROUND

Anecdotal reports suggest that motion sickness may occur among players of contemporary commercial console video games.

METHODS

Participants played standard console video games using an Xbox game system. We varied the participants' posture (standing vs. sitting) and the game (two Xbox games). Participants played for up to 50 min and were asked to discontinue if they experienced any symptoms of motion sickness.

RESULTS

Sickness occurred in all conditions, but it was more common during standing. During seated play there were significant differences in head motion between sick and well participants before the onset of motion sickness.

CONCLUSION

The results indicate that commercial console video game systems can induce motion sickness when presented via a head-mounted display and support the hypothesis that motion sickness is preceded by instability in the control of seated posture.

APPLICATION

Potential applications of this research include changes in the design of console video games and recommendations for how such systems should be used.

Cabin location and the likelihood of motion sickness in cruise ship passengers

BACKGROUND

The prevalence of motion sickness approaches 100% on rough seas. Some previous studies have reported a strong association between location on a ship and the risk of motion sickness, whereas other studies found no association. This study was undertaken to determine if there is a statistical association between the location of the passenger cabin on a ship and the risk of motion sickness in unadapted passengers.

METHODS

Data were collected on 260 passengers on an expedition ship traversing the Drake Passage between South America and Antarctica, during rough sea conditions. A standard scale was employed to record motion sickness severity.

RESULTS

The risk of motion sickness was found to be statistically associated with age and sex. However, no association was found with the location of the passenger cabin.

CONCLUSIONS

Previous research reporting a strong association of motion sickness and passenger location on a ship, studied passengers in the seated position. Passengers who are able to lie in a supine position are at considerably reduced risk of motion sickness. Expedition or cruise ships that provide ready access to berths, allow passengers to avoid the most nauseogenic positions. The location of the passenger cabin does not appear to be related to the likelihood of seasickness.

Motion sickness in public road transport: passenger behavior and susceptibility

The aim of this research was to identify personal and environmental factors influencing individual susceptibility to motion sickness during road transport. A questionnaire survey of 3256 coach travellers was conducted. Information on passenger characteristics, travel regularity, activity during travel, use of anti-motion sickness drugs and self-reported motion sickness susceptibility were collected over 56 private hire coach journeys. Details of the travel environment (visibility, temperature and seating) were also recorded. The relationship of these variables with passenger illness and more specific symptoms of motion sickness are examined. Overall, 28.4% of passengers reported feeling ill, 12.8% reported nausea and 1.7% reported vomiting during coach travel. Travel sickness decreased with increasing passenger age and greater travel experience. Females were more likely to report feeling ill during coach travel than males by a ratio of four to three. Poor forward visibility was found to increase sickness. Passenger illness occurrence was approximately three times higher for passengers with no view of the road ahead (mean, 34.6%) compared to passengers who could see the road ahead extremely well (mean, 12.7%). No relationships were found between the occurrence of travel sickness and temperature or time of travel. Differences in the pattern of sickness responses exhibited by coach travellers suggest: (1) habituation through greater travel regularity may occur independently of reductions in travel sickness that occur with age; (2) females are more affected by poor forward visibility than males; and (3) the incidence of travel sickness could be significantly reduced by improving the external visibility afforded to passengers.

[Visual prevention from motion sickness in cars]

The differential effects of vision on motion sickness in cars were tested under real road conditions using linear accelerations, in order to confirm earlier laboratory results on visual modulation of vestibular nausea induced by angular accelerations of the body. The 18 voluntary subjects were exposed to repetitive braking maneuvers (linear accelerations: 0.1-1.2 g) on a highway. The simultaneous visual stimulus conditions for the 3 separate days were: I) eyes open, visual control of car motion; II) eyes closed; III) eyes open, artificial stationary visual field (reading). The severity of motion sickness (magnitude estimation 1-10) was a function of the visual stimulus condition with significant differences among these conditions: I) moderate nausea (less than 1) with adequate visual motion perception; II) medium nausea (approximately equal to 2) with eyes closed and somatosensory-vestibular excitation only; III) strong nausea (greater than 5) with conflicting sensory input, when vestibular acceleration is in disagreement with the visual information of no movement. Providing ample peripheral vision of the relatively moving surround is the best strategy to alleviate car sickness.

Vision and motion sickness

The development of motion sickness appears intimately related to the visual system. The Sensory Rearrangement Theory states that situations which promote motion sickness are characterized by a condition in which the motion signals transmitted by the eyes, vestibular system, and the nonvestibular proprioceptors are at variance as to what was expected previously. The evolutionary significance of motion sickness rests in its linkage to an early warning system to avoid poisoning. Vision is capable of aiding in the development of suppression of motion sickness. Therapy of motion sickness includes posture, restriction of head movement, visual manipulations, concurrent activity, drugs, and adaptation.