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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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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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Crichton M, Davidson AR, Innerarity C, Marx W, Lohning A, Isenring E, Marshall S. Orally consumed ginger and human health: an umbrella review. Am J Clin Nutr 2022; 115:1511-1527. [PMID: 35147170 PMCID: PMC9170469 DOI: 10.1093/ajcn/nqac035] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/04/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Emerging evidence supports the health benefits of ginger for a range of conditions and symptoms; however, there is a lack of synthesis of literature to determine which health indications are supported by quality evidence. OBJECTIVES In this umbrella review of systematic reviews we aimed to determine the therapeutic effects and safety of any type of ginger from the Zingiber family administered in oral form compared with any comparator or baseline measures on any health and well-being outcome in humans. METHODS Five databases were searched from inception to April 2021. Review selection and quality were assessed in duplicate using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) checklist and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method, with results presented in narrative form. RESULTS Twenty-four systematic reviews were included with 3% overlap of primary studies. The strongest evidence was found for the antiemetic effects of ginger in pregnant women (effect size: large; GRADE: high), analgesic effects for osteoarthritis (effect size: small; GRADE: high), and glycemic control (effect size: none to very large; GRADE: very low to moderate). Ginger also had a statistically significant positive effect on blood pressure, weight management, dysmenorrhea, postoperative nausea, and chemotherapy-induced vomiting (effect size: moderate to large; GRADE: low to moderate) as well as blood lipid profile (effect size: small; GRADE: very low) and anti-inflammatory and antioxidant biomarkers (effect size: unclear; GRADE: very low to moderate). There was substantial heterogeneity and poor reporting of interventions; however, dosage of 0.5-3 g/d in capsule form administered for up to 3 mo was consistently reported as effective. CONCLUSIONS Dietary consumption of ginger appears safe and may exert beneficial effects on human health and well-being, with greatest confidence in antiemetic effects in pregnant women, analgesic effects in osteoarthritis, and glycemic control. Future randomized controlled and dose-dependent trials with adequate sample sizes and standardized ginger products are warranted to better inform and standardize routine clinical prescription.
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Affiliation(s)
- Megan Crichton
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Alexandra R Davidson
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Celia Innerarity
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Wolfgang Marx
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
- Deakin University, Impact (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, Geelong, Australia
| | - Anna Lohning
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Elizabeth Isenring
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Skye Marshall
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
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Marx W, Ried K, McCarthy AL, Vitetta L, Sali A, McKavanagh D, Isenring L. Ginger-Mechanism of action in chemotherapy-induced nausea and vomiting: A review. Crit Rev Food Sci Nutr 2017; 57:141-146. [PMID: 25848702 DOI: 10.1080/10408398.2013.865590] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Despite advances in antiemetic therapy, chemotherapy-induced nausea and vomiting (CINV) still poses a significant burden to patients undergoing chemotherapy. Nausea, in particular, is still highly prevalent in this population. Ginger has been traditionally used as a folk remedy for gastrointestinal complaints and has been suggested as a viable adjuvant treatment for nausea and vomiting in the cancer context. Substantial research has revealed ginger to possess properties that could exert multiple beneficial effects on chemotherapy patients who experience nausea and vomiting. Bioactive compounds within the rhizome of ginger, particularly the gingerol and shogaol class of compounds, interact with several pathways that are directly implicated in CINV in addition to pathways that could play secondary roles by exacerbating symptoms. These properties include 5-HT3, substance P, and acetylcholine receptor antagonism; antiinflammatory properties; and modulation of cellular redox signaling, vasopressin release, gastrointestinal motility, and gastric emptying rate. This review outlines these proposed mechanisms by discussing the results of clinical, in vitro, and animal studies both within the chemotherapy context and in other relevant fields. The evidence presented in this review indicates that ginger possesses multiple properties that could be beneficial in reducing CINV.
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Affiliation(s)
- Wolfgang Marx
- a Centre of Dietetics Research, University of Queensland , St. Lucia , Queensland , Australia
- b National Institute of Integrative Medicine , Melbourne , Victoria , Australia
| | - Karin Ried
- b National Institute of Integrative Medicine , Melbourne , Victoria , Australia
| | - Alexandra L McCarthy
- c Division of Cancer Services, Princess Alexandra Hospital and Institute of Biomedical Innovation, Queensland University of Technology Brisbane , Queensland , Australia
| | - Luis Vitetta
- d Centre for Integrative Clinical and Molecular Medicine, School of Medicine, Princess Alexandra Hospital , Queensland , Australia
| | - Avni Sali
- b National Institute of Integrative Medicine , Melbourne , Victoria , Australia
| | - Daniel McKavanagh
- e Oncology & Haematology Unit, Princess Alexandra Hospital , Queensland , Australia
| | - Liz Isenring
- a Centre of Dietetics Research, University of Queensland , St. Lucia , Queensland , Australia
- f Department of Nutrition & Dietetics , Princess Alexandra Hospital , Queensland , Australia
- g Health Sciences & Medicine, Bond University , Gold Coast , Queensland , Australia
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Thormann M, Amthauer H, Adolf D, Wollrab A, Ricke J, Speck O. Efficacy of diphenhydramine in the prevention of vertigo and nausea at 7 T MRI. Eur J Radiol 2011; 82:768-72. [PMID: 21945402 DOI: 10.1016/j.ejrad.2011.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 08/03/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE In this study the potential of diphenhydramine in reducing respectively preventing vertigo and nausea induced by the ultra-high static magnetic field at 7 T was evaluated. MATERIALS AND METHODS In a prospective, double blinded, placebo controlled, cross-over randomized study the sensations of 34 volunteers before, during and after exposure to the static magnetic field with and without drug respectively placebo administration were quantified. Fast table motion was applied to increase the incidence of otherwise sparse reports of field related sensations. RESULTS The strength of vertigo can be reduced by the application of diphenhydramine. CONCLUSION Diphenhydramine, even at a low dose, reduces the strength of vertigo at ultra-high static magnetic fields, may be used preventively, and could pave the way to even higher field strength.
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Affiliation(s)
- Markus Thormann
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke Universität, Leipziger Str. 44, 39120 Magdeburg, Germany.
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Affiliation(s)
- Kathy Abascal
- The Botanical Medicine Academy in Vashon, Washington
| | - Eric Yarnell
- The Botanical Medicine Academy, a specialty board for using medicinal herbs, and is a faculty member at Bastyr University in Kenmore, Washington
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Stapleton J, Wo JM. Current treatment of nausea and vomiting associated with gastroparesis: antiemetics, prokinetics, tricyclics. Gastrointest Endosc Clin N Am 2009; 19:57-72, vi. [PMID: 19232281 DOI: 10.1016/j.giec.2008.12.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Gastroparesis is a symptomatic chronic disorder characterized by delayed gastric emptying without a mechanical obstruction. Gastroparesis is most often associated with diabetes, gastric surgery, and systemic disorders affecting the neuromuscular control of the stomach. However, no underlying etiology can be found in up to 40% of patients, a condition referred to as idiopathic gastroparesis. Due to the numerous potential etiologies and the highly variable clinical manifestations, the management of gastroparesis is particularly challenging. The purpose of this review is to provide an update on the use of antiemetics, prokinetics, and tricyclics for the treatment for nausea and vomiting associated with gastroparesis.
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Affiliation(s)
- Jeremy Stapleton
- Division of Gastroenterology/Hepatology, Department of Medicine, University of Louisville School of Medicine, 550 S Jackson Street, ACB 3rd floor, Louisville, KY 40202, USA
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Chrubasik S, Pittler MH, Roufogalis BD. Zingiberis rhizoma: a comprehensive review on the ginger effect and efficacy profiles. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2005; 12:684-701. [PMID: 16194058 DOI: 10.1016/j.phymed.2004.07.009] [Citation(s) in RCA: 304] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Zingiberis rhizoma is used as a broadspectrum antiemetic. We, therefore, conducted a comprehensive review of the literature to summarize the pharmacological and clinical effects of this popular plant material. Although clinical and experimental studies suggest that ginger has some antiemetic properties, clinical evidence beyond doubt is only available for pregnancy-related nausea and vomiting. Meta-analyses could not demonstrate the postoperative antiemetic effectiveness, and effect in motion sickness or nausea/vomiting of other ethiology. It also remains to be confirmed that proprietary ginger preparations are clinically useful to alleviate osteoarthritic or other pain, although there is no doubt that ginger constituents interfere with the inflammatory cascade and the vanilloid nociceptor. Ginger exerts in vitro antioxidative, antitumorigenic and immunomodulatory effects and is an effective antimicrobial and antiviral agent. Animal studies demonstrate effects on the gastrointestinal tract, the cardiovascular system, on experimental pain and fever, antioxidative, antilipidemic and antitumor effects, as well as central and other effects. The most relevant human pharmacological studies require a confirmatory study to exclude interaction of ginger preparations with platelet aggregation. Pharmacokinetic data are only available for [6]-gingerol and zingiberene. Preclinical safety data do not rule out potential toxicity, which should be monitored especially following ginger consumption over longer periods.
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Affiliation(s)
- S Chrubasik
- Department of Forensic Medicine, University of Freiburg, Albertstr. 9, 79104 Freiburg, Germany.
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Ficker CE, Arnason JT, Vindas PS, Alvarez LP, Akpagana K, Gbéassor M, De Souza C, Smith ML. Inhibition of human pathogenic fungi by ethnobotanically selected plant extracts. Mycoses 2003; 46:29-37. [PMID: 12588480 DOI: 10.1046/j.1439-0507.2003.00838.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this study, 36 extracts derived from 29 plant species selected using an ethnobotanical approach were tested for antifungal activity against a taxonomically diverse group of 13 human pathogenic fungi. We compared the inhibitory characteristics of these plant extracts with those of the commonly used antifungals, amphotericin B and ketoconazole, and the plant-derived antifungal, berberine. Several plant extracts, notably those from Zingiber officinale (ginger) and Juglans cinerea (butternut), had pronounced antifungal activity against a wide variety of fungi, including strains that were highly resistant to amphotericin B and ketoconazole. Further exploration of Z. officinale as an antifungal is warranted as this species is generally regarded as safe for human consumption.
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Schmid R, Schick T, Steffen R, Tschopp A, Wilk T. Comparison of Seven Commonly Used Agents for Prophylaxis of Seasickness. J Travel Med 1994; 1:203-206. [PMID: 9815340 DOI: 10.1111/j.1708-8305.1994.tb00596.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The objective of the study was to compare the efficacy and tolerability of seven drugs frequently used for the prevention of seasickness: the drugs were namely cinnarizine, cinnarizine with domperidone, cyclizine, dimenhydrinate with caffeine, ginger root, meclozine with caffeine, and scopolamine. The design was a randomized, double-blind study with two arms. On ethical grounds, a placebo group was not included as in a previous study, in the same setting, 80% of the passengers not receiving prophylactic drugs were seasick. The setting was in Andenes (Norway) during a time period from July to September 1992. Subjects were 1741 tourist volunteers who were joining a whale safari. The main outcome measures were vomiting, malaise (modified Graybiel criteria), and subjective reports of adverse events. Follow up was possible in 1489 volunteers (85.5%). In each active treatment group, 4.1-10.2% experienced vomiting and 16.4-23.5% experienced malaise (not significant). Equally, there was no significant difference in the incidence and characteristics of adverse events reported in the various medication groups. Scopolamine Transdermal Therapeutic System (TTS) users exhibited slightly more visual problems and the agent tended to be less effective. Six of the seven medications may be recommended for prevention of seasickness; scopolamine TTS seems the least attractive.
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Affiliation(s)
- R Schmid
- Institute of Social and Preventive Medicine of the University of Zurich, Switzerland
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