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Space motion sickness: incidence, etiology, and countermeasures.

Space motion sickness is experienced by 60% to 80% of space travelers during their first 2 to 3 days in microgravity and by a similar proportion during their first few days after return to Earth. Space motion sickness symptoms are similar to those in other forms of motion sickness; they include: pallor, increased body warmth, cold sweating, malaise, loss of appetite, nausea, fatigue, vomiting, and anorexia. These are important because they may affect the operational performance of astronauts. Two hypotheses have been proposed to explain space motion sickness: the fluid shift hypothesis and the sensory conflict hypothesis. The fluid shift hypothesis suggests that space motion sickness results from the cranial shifting of body fluids resulting from the loss of hydrostatic pressure gradients in the lower body when entering microgravity. The cranial fluid shifts lead to visible puffiness in the face, and are thought to increase the intracranial pressure, the cerebrospinal-fluid pressure or the inner ear fluid pressures, altering the response properties of the vestibular receptors and inducing space motion sickness. The sensory conflict hypothesis suggests that loss of tilt-related otolith signals upon entry into microgravity causes a conflict between actual and anticipated signals from sense organs subserving spatial orientation. Such sensory conflicts are thought to induce motion sickness in other environments. Space motion sickness is usually treated using pharmaceuticals, most of which have undesirable side effects. Further studies elucidating the underlying mechanism for space motion sickness may be required for developing new treatments.

Antiemetics↗

Childhood migraine and motion sickness.

The incidence of motion sickness among 222 children in four diagnostic categories--migraine, nonmigraine headaches, seizure disorders, and learning disabilities--was compared. Motion sickness was found to be an associated feature in 45% of the cases of childhood migraine, in contrast to a 5% to 7% incidence in the other groups. Therefore, it is suggested that motion sickness be regarded as an additional reliable minor criterion in the diagnosis of childhood migraine. Hypotheses of common central and peripheral mechanisms underlying both conditions are offered.

Adolescent↗

A heuristic mathematical model for the dynamics of sensory conflict and motion sickness.

The etiology of motion sickness is now usually explained in terms of a qualitatively formulated "sensory conflict" hypothesis. By consideration of the information processing task faced by the central nervous system in estimating body spatial orientation and in controlling active body movement using an "internal model" referenced control strategy, a mathematical model for sensory conflict generation is developed. The model incorporates and extends models proposed by von Holst, Held, and Reason, and is congruent with multisensory models for spatial orientation developed by Young and coworkers. The model postulates a major dynamic functional role for sensory conflict signals in movement control, as well as in sensory-motor adaptation. It accounts for the role of active movement in creating motion sickness symptoms in some experimental circumstances, and in alleviating them in others. The relationship between motion sickness produced by "sensory rearrangement" and that resulting from external motion disturbances is explicitly defined. A nonlinear conflict averaging model is proposed which describes dynamic aspects of experimentally observed subjective discomfort sensation, and suggests resulting behaviours. The model admits several possibilities for adaptive mechanisms which do not involve internal model updating. Further systematic efforts to experimentally refine and validate the model are indicated.

Conflict, Psychological↗

The correlation between aerobic fitness and motion sickness susceptibility.

Susceptibility to motion sickness has been linked to aerobic fitness in several studies, however, these studies have not elucidated the underlying physiological mechanism by which increased aerobic fitness is related to a decreased ability to tolerate motion sickness stimuli. This pilot study provides further evidence of a relationship between aerobic fitness and motion sickness susceptibility. It also suggests that aerobic capacity is more specifically linked to signs and symptoms of vasomotor origin including stomach discomfort, nausea and/or vomiting, headache, and diaphoresis. By independently correlating vasomotor susceptibility and neurogenic susceptibility to maximum oxygen uptake, we find that vasomotor symptoms in particular are significantly increased in aerobically fit individuals. Larger studies should be conducted to confirm this relationship.

Adult↗

Factors influencing the susceptibility of anurans to motion sickness.

We examined the propensity for motion sickness in five anuran species, concentrating our efforts on the treefrog Rhacophorus schlegelii, because it had shown the greatest susceptibility to motion sickness in a previous study. We used parabolic flight as our provocative stimulus and fed all specimens a known volume of food 1.5-3 h before flight. The presence of vomitus in a frog's cage was our indicator of motion sickness. Significantly more emesis was observed in flight-exposed than in control R. schlegelii (P < 0.05). There was no sex difference in susceptibility to motion sickness (P > 0.5). Individuals that vomited were significantly larger (P < 0.02) than those that did not. Among microgravity-treated frogs, those that vomited spent on average 85% more time airborne and tumbling in microgravity than those that did not vomit (P=0.031). Our data support the view that postural instability and sensory conflict are elements of motion sickness in anurans. Specifically, conflicts between tactile, vestibular and visual input seem essential for producing motion-induced emesis in anurans. Since the factors that induce motion sickness in R. schlegelii are the same ones that produce motion sickness in humans, arboreal frogs may be useful alternative models to mammals in motion sickness research.

Animals↗

Relation between motion sickness susceptibility and vasovagal syncope susceptibility.

Motion sickness is common in the population, especially in children, but its physiopathology is only partially understood and the true nature of the particular susceptibility of certain subjects remains completely unknown. Some symptoms of motion sickness, like pallor and cold sweating, are of an autonomic nature and the role of the autonomic nervous system in vasovagal syncope is well known. Our aim was therefore to study the relationship between motion sickness susceptibility and vasovagal syncope susceptibility. Questionnaires about susceptibility to motion sickness and to vasovagal syncope or presyncope in adulthood and childhood, filled in by 899 students (20.4 +/- 2.1 years, 405 men), were analysed. Motion sickness susceptibility in childhood was 31.1% and in adulthood 7.9% (p < 0.001). Vasovagal syncope susceptibility in childhood was 36.4% and in adulthood 33.9% (NS). A relationship between motion sickness susceptibility in adulthood and vasovagal syncope susceptibility in childhood and adulthood (p = 0.004 and 0.005, respectively) was found. Despite the limitations of a retrospective study this relationship between motion sickness susceptibility and vasovagal syncope susceptibility may indicate that a common mechanism exists, explaining the particular susceptibility of some subjects to both disorders. This paradigm may prove useful in better understanding the true nature of motion sickness and vasovagal syncope.

Aging↗

Comparison of treatment strategies for Space Motion Sickness.

Treatment strategies for Space Motion Sickness were compared using the results of postflight oral debriefings. Standardized questionnaires were administered to all crewmembers immediately following Space Shuttle flights by NASA flight surgeons. Cases of Space Motion Sickness were graded as mild, moderate or severe based on published criteria, and medication effectiveness was judged based on subjective reports of symptom relief. Since October 1989, medication effectiveness is reported inflight through Private Medical Conferences with the crew. A symptom matrix was analyzed for 19 crewmembers treated with an oral combination of scopolamine and dextroamphetamine (scopdex) and 15 crewmembers treated with promethazine delivered by intramuscular (IM) or suppository routes. Scopdex has been given preflight as prophaxis for Space Motion Sickness but analysis showed delayed symptom presentation in 9 crewmembers or failed to prevent symptoms in 7. Only three crewmembers who took scopdex had no symptoms inflight. Fourteen out of 15 crewmembers treated with IM promethazine and 6 of 8 treated with promethazine suppositories after symptom development had immediate (within 12 h) symptom relief and required no additional medication. There were no cases of delayed symptom presentation in the crewmembers treated with promethazine. This response is in contrast to untreated crewmembers who typically have slow symptom resolution over 72-96 h. We conclude that promethazine is an effective treatment of Space Motion Sickness symptoms inflight. NASA policy currently recommends treating crewmembers with Space Motion Sickness after symptom development, and no longer recommends prophylaxis with scopdex due to delayed symptom development and apparent variable absorption of oral medications during early flight days.

Aerospace Medicine↗

A stimulator for laboratory studies of motion sickness in cats.

A motion sickness device is described which produces motion sickness in about 40% of an unselected population of unrestrained female cats during a 30-min exposure at 0.28 Hz. The apparatus provides a gentle wave stimulus, similar to that provided by an amusement park Ferris Wheel. Two cats may be tested at the same time. This device is useful for studies of putative antimotion sickness drugs or the biochemical basis of the emetic response to motion.

Animals↗

Pharmacological interventions for motion sickness: cardiovascular effects.

Motion sickness (MS) was provoked in healthy volunteers subjected to simultaneous rotation through the vertical axis with head movements (HM). Arterial blood pressure (BP), heart rate (HR) and forearm blood flows (BF) were intermittently monitored. Forearm BF was measured by venous occluding plethysmography. Rotation at 20 rpm and cyclic HM were continued for 10 min or until the subject requested cessation of HM because of imminent emesis. There were no consistent changes in BP or HR, but marked increases in BF were observed with MS. There was an inverse correlation between duration of HM tolerance and increments in BF. Antimotion sickness medications scopolamine:d-amphetamine (0.4:5.0 mg) or promethazine:ephedrine (25:60 mg) failed to significantly increase the duration of HM; the latter mixture, however, did significantly reduce the HM-induced-hyperemic responses. Administration of naproxyn (275 or 550 mg) did not significantly alter HM duration or BF responses. These studies suggest that BF changes may be an objective index of MS susceptibility.

Adult↗

A clinically useful polling technique for assessing susceptibility to motion sickness.

Susceptibility to motion sickness is a powerful index of individual differences and can be assessed in large populations without a test of performance. Although all questionnaire techniques introduce some error, we have demonstrated that a simple set of questions can lead to a five-point rating system with adequate validity and reliability. Our observations may be useful to any investigator interested in individual differences and have been extremely effective in sorting out behavioral trends in large samples of patients.

Female↗

[A study on central and peripheral nerve transmitter mechanism of motion sickness].

Model of motion sickness (MS) was induced in rats by accelerating and decelerating vertical rotation for 60 min. The contents of Ach, NA, A and 5-HT and the activity of AchE in brain and blood of rats were examined after 60 min of rotation. The results showed: NA contents and AchE activity decreased significantly while A and 5-HT increased in rat's brain. Levels of Ach, NA and A in blood were increased. The results suggested that MS may be related to the imbalance of transmitters in the central nervous system resulting in the reduction of central arousal, and the imbalance between sympathetic and parasympathetic nerves.

Acetylcholine↗

Self-induced motion sickness in unperturbed stance.

Motion sickness typically occurs when the body is subjected to externally imposed motions, but there are situations in which sickness occurs in the absence of imposed motion. We report a new and unanticipated instance of the latter. Subjects in a study of spontaneous standing postural sway sometimes reported dizziness and motion sickness. Reports of sickness were correlated with changes in postural sway. We consider possible implications of these findings for two current theories of motion sickness etiology: the sensory conflict theory and the postural instability theory.

Adaptation, Physiological↗

The incidence and effects of motion sickness among medical attendants during transport.

Motion sickness is a common and often debilitating problem. The purpose of this study was to determine the incidence and effects of the motion sickness syndromes, the Nausea and Sopite Syndromes, among medical transport personnel. Members of the Transport Teams of the University of North Carolina Hospitals completed a questionnaire to identify a history of susceptibility to motion sickness. An additional questionnaire evaluated each individual for symptoms of motion sickness during transport. The Digit Span Test portion of the Mini-Mental Status Examination (DST-MMSE) was used to evaluate cognitive function after transport. Control data on each subject were obtained by testing during nontransport shifts. The Nausea Syndrome was observed during transport in 46% of subjects; 65% experienced symptoms consistent with the Sopite Syndrome. Pretransport surveys were predictive of the Nausea Syndrome, but not of the Sopite Syndrome. The Nausea Syndrome was related to subjective assessments of the severity of motion experienced; the Sopite Syndrome did not correlate with the severity of motion. The DST-MMSE scores after transport were significantly lower than scores during nontransport periods in 85% of personnel. We conclude that transport personnel are susceptible to motion sickness manifested by both the Nausea Syndrome and the Sopite Syndrome. The presence of motion sickness is associated with a significant decline in performance on tests of attention and concentration.

Air Ambulances↗

Effect of roll oscillation frequency on motion sickness.

BACKGROUND: In many environments associated with motion sickness there are low frequency motions in several axes, including roll. Roll motion has often been assumed to be a cause of motion sickness, either alone or in combination with motions in other axes. However, there have been no systematic studies of the effects of roll frequency on sickness. HYPOTHESIS: It was hypothesized that sickness caused by roll oscillation would depend on the frequency of roll. METHOD: There were 100 male subjects (aged 18 to 26 yr) who participated in a laboratory study. Prior to experiencing motion, all subjects completed a motion sickness history questionnaire giving information on travel and motion sickness experience. The seated subjects were exposed within a closed cabin to 30 min of sinusoidal roll motion at one of five frequencies: 0.025 Hz, 0.05 Hz, 0.10 Hz, 0.20 Hz, or 0.40 Hz. At each frequency, the cabin oscillated through +/-8 degrees about a center of rotation located on the seat surface. Ratings of motion sickness were obtained at 1-min intervals. RESULTS: Subject illness ratings were positively correlated with their previous motion sickness, although at each frequency the amount of sickness was small. Overall, there was no significant difference in the sickness ratings produced by the five motions. CONCLUSIONS: The frequency dependence of motion sickness produced by roll oscillation differs from that associated with vertical and horizontal oscillation. Motion sickness associated with pure roll oscillation of a seat will usually be less than the sickness associated with pure translational oscillation of the seat or the sickness associated with combined translation and rotation.

Adolescent↗

Responses in skin microcirculation to vestibular stimulation before and during motion sickness.

BACKGROUND: Observation of physiological changes during motion sickness is required to quantify the degree of sickness. The review of the literature does not show unifying results. An objective symptom of motion sickness is facial pallor. It reflects changes in skin microcirculation which have not been measured so far. METHODS: Eleven healthy volunteers susceptible to motion sickness were subjected to eccentric vertical axis rotation. The dynamics and the correspondence of the changes in skin blood flow in two segments, forehead and finger, were measured by laser Doppler flowmeter. RESULTS AND CONCLUSIONS: The difference in the microcirculatory skin blood flow across the phases of motion sickness is significant for the forehead but not for the fingertip: the established dynamics of the forehead blood flow during motion sickness will be of benefit in quantifying the degree of sickness; there is no correlation between the blood flow changes in both measured areas; the rhythmic blood flow fluctuation increases during motion sickness; there is a difference between the blood flow responses to vestibular stimulation before the appearance of motion sickness and in the course of the sickness. Laser Doppler flowmetry is a reliable method in quantifying the degree of motion sickness.

Adult↗

Reduction of motion sickness in prehospital trauma care.

Motion sickness adds to the discomfort of many patients being transported by ambulance. Recent research has demonstrated the effectiveness of oxygen therapy in reducing motion sickness during transport to hospital. However, patients reported negative reactions to wearing a facemask, which produced feelings of claustrophobia and anxiety. We therefore tested the hypothesis that supplemental oxygen inhaled from a new oxygen delivery device OxyArm, which avoids direct contact with the patient's skin, may reduce the incidence of motion sickness and increase patient satisfaction. Forty patients suffering from minor trauma were included in a prospective, randomised trial. Twenty patients received oxygen administered using a conventional Venturi mask (group 1), and 20 patients received oxygen using the new OxyArm device (group 2). Measurements made included oxygen saturation (SaO2), heart rate, systolic and diastolic blood pressures, and patients' subjective score of satisfaction with smell of the device, claustrophobia, inconvenience produced by the oxygen inhalation device and nausea were scored using a visual analogue scale. All patients were haemodynamically stable and comparable between the two groups. Peripheral SaO2 increased in both groups. The scores of nausea and claustrophobia were significantly lower in the OxyArm group, in addition, satisfaction with the OxyArm device was significantly higher. In conclusion, the use of OxyArm device produced a lower incidence of motion sickness combined with the additional benefit of greater patient satisfaction, when compared with a conventional facemask, during prehospital transfer of trauma patients.

Adult↗

Eye movement, vection, and motion sickness with foveal and peripheral vision.

BACKGROUND: Both motion sickness and the illusion of self-motion (i.e., vection) can be induced by moving visual scenes. The results of a previous study imply that motion sickness is primarily dependent on visual motion in foveal vision while vection is primarily dependent on motion in peripheral vision. HYPOTHESIS: It was hypothesized that similar motion sickness would be produced when tracking a single moving dot and a full screen of moving dots, but that vection would be greater when tracking multiple moving dots. METHOD: Sixteen subjects viewed moving images presented on a virtual reality head-mounted display. In one condition a single dot moved from left to right at 27 degrees x s(-1) over a distance of 18 degrees before returning instantly to its starting point. This motion was repeated continuously. In a second condition, five horizontal rows of dots, each 18 degrees apart, moved continuously across the screen at 27 degrees x s(-1); subjects were instructed to track each dot in the central row as it passed. RESULTS: In both conditions, there were nystagmic eye movements with an approximate amplitude of 18 degrees at 27 degrees x s(-1). Vection differed significantly between the two conditions, with more vection in the condition with five rows of dots. Subjects experienced motion sickness symptoms with both the single moving dot and the five rows of dots, with no significant difference in sickness between the two conditions. Subject ratings of motion sickness and vection were not correlated with each other in either of the two conditions. CONCLUSIONS: Motion sickness and vection can vary independently. Vection appears to be influenced by peripheral vision, as there was an increase in vection with full-field stimulation. Motion sickness induced by moving visual scenes may be influenced by foveal visual stimulation or by eye movements, as these were the same in both conditions.

Eye Movements↗