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Why is the driver rarely motion sick? The role of controllability in motion sickness.

The central hypothesis of the work is that the dimension of control-no control plays an important role in motion sickness. Although it is generally agreed that having control over a moving vehicle greatly reduces the likelihood of motion sickness, few studies have addressed this issue directly, and the theoretical explanation for this phenomenon is not completely clear. In this study, we equated groups differing in controllability for head movement, vision, activity, and predictability, which have often been suggested in the literature as explanations for the driver's immunity to motion sickness. Twenty-two pairs of yoked subjects were exposed to nauseogenic rotation. One subject of each pair had control over the rotation and head movements, while the other was exposed passively to the same motion stimulus. Subjects who had control reported significantly fewer motion sickness symptoms and less of a decrement in their well-being, as compared to the yoked subject without control. The results are discussed in relation to Reason's sensory rearrangement theory and the concept of feed-forward mechanisms in motion perception.

Adult

Space motion sickness.

Space Motion Sickness (SMS) is the malady which frequently occurs shortly after attainment of sustained exposure to hypogravity. It is characterised by a variety of symptoms, which may proceed to nausea and eventually vomiting. Natural adaptation usually occurs if exposure to hypogravity is maintained. The condition appears to be the manifestation of motion sickness that is specific to hypogravity. It is associated with otolith-canal and otolith-eye conflict. SMS may have operational significance in impairing the performance of spacecraft crews. The condition is likely to be amenable to treatment with anti-motion sickness drugs. It may be possible to reduce any operational effects of SMS by suitable crew selection and training procedures.

Adaptation, Physiological

Optokinetic motion sickness: continuous head movements attenuate the visual induction of apparent self-rotation and symptoms of motion sickness.

Symptoms of motion sickness are sometimes experienced during exposure to optokinetic stimulation. Two experimetns were performed to compare the symptoms of motion sickness elicited when subjects were exposed to incremental changes in optokinetic stimulation while sitting passively and while continuously executing shoulder-to-shoulder head movements. In the first experiment, a fixed head-movement frequency (20 cpm) was used, wheras in the second the subjects varied the frequency of their head movements in order to maintain suppression of illusory self-rotation. In both experiments, subjects in the head-moving condition had fewer and less severe symptoms of motion sickness and experienced illusory self-rotation after longer exposure times and at higher optokinetic velocities than in the head-stationary condition. Subjects in th- head-movement condition of the second experiment increased the frequency of their head movements as the velocity of optokinetic stimulation increased. The symptoms of motion sickness elicited during optokinetic stimulation tended to be dizziness, headache, eye-strain, and stomach awareness appearing in no fixed order. The pattern and constellation of symptoms are unlike those elicited by vestibular stimulation.

Eye Movements

Vestibular and postural findings in the motion sickness syndrome.

The motion sickness syndrome constitutes varying degrees of subjective motion intolerance and three objective findings: hyperactive VOR (79%), hip sway strategy (60%), and positional nystagmus (42%). It is present in subjects who have a strong history of motion sickness. Vestibular rehabilitation appears to help control symptoms. The study also suggests an inheritance pattern, but a structured pedigree could not be constructed. Prospective studies are warranted to further establish the patterns of the motion sickness syndrome.

Adolescent

Increased secretion of growth hormone, prolactin, antidiuretic hormone, and cortisol induced by the stress of motion sickness.

The stress of motion sickness was experimentally provoked by Coriolis effect. Significant and reproducible increases from the basal serum level (delta mean +/- S.E.) of antidiuretic hormone delta - ADH: 48.2 +/- 4.6 pg/ml; p less than 0.0005), of growth hormone (delta - hGH: 10.0 +/- 1.2 ng/ml; p less than 0.0005), of prolactin (delta - hPRL: 186.5 +/- 29.9 muU/ml; p less than 0.0005), and of cortisol (delta - F; 12.3 +/- 0.9 microgram%; p less than 0.0005) were observed, whereas the luteinizing hormone levels did not change significantly. The stimulation of hormone secretion induced by different degrees of motion sickness seems to correlate with the severity of motion sickness. The secretion of antidiuretic hormones is the most sensitive indicator for the stress of motion sickness whereas growth hormone, prolactin, and cortisol responses to the stress of motion sickness are more delayed and less pronounced.

Blood Glucose

Therapeutic effects of antimotion sickness medications on the secondary symptoms of motion sickness.

In addition to nausea and vomiting, motion sickness involves slowing of brain waves, loss of performance, inhibition of gastric motility and the Sopite Syndrome. The therapeutic effects of antimotion sickness drugs on these reactions were evaluated. The subjects were rotated to the M-III end-point of motion sickness. Intramuscular (IM) medications were then administered. Side effects before and after rotation were reported on the Cornell Medical Index. Brain waves were recorded on a Grass Model 6 Electroencephalograph (EEG), and gastric emptying was studied after an oral dose of 1 mCi Technetium 99m DTPA in 10 oz. isotonic saline. An increase in dizziness and drowsiness was reported with placebo after rotation. This was not prevented by IM scopolamine 0.1 mg or ephedrine 25 mg. EEG recordings indicated a slowing of alpha waves with some thea and delta waves from the frontal areas after rotation. IM ephedrine and dimenhydrinate counteracted the slowing while 0.3 mg scopolamine had an additive effect. Alterations of performance on the pursuit meter correlated with the brain wave changes. Gastric emptying was restored by IM metoclopramide. Ephedrine IM but not scopolamine is effective for some of the secondary effects of motion sickness after it is established.

Adolescent

Nystagmus, turning sensations, and illusory movement in motion sickness susceptibility.

The relationships of motion sickness susceptibility to nystagmic eye movements, sensations of turning, and duration of the spiral aftereffect were determined with 48 subjects separated into groups on the basis of sex and extremes of motion sickness susceptibility. When subjective alertness levels were controlled, there was no enhancement of elicited nystagmus nor turning sensations in susceptible individuals. However, spiral aftereffect durations were significantly longer in susceptible individuals than in nonsusceptible individuals. The results are interpreted as favoring Graybiel's model of the structural elements in motion sickness.

Adolescent

[Clinical study on the mechanism of motion sickness--clinical examination based on trigger factors].

This report deals with factors which trigger motion sickness. The author has focused on the clinical examinations applied to motion sickness cases. Relationships between clinical data and susceptibility to motion sickness were investigated. The following results were obtained: 1. CV R-R(coefficient of variation of R-R intervals on EGG)in the frequent motion sickness group showed higher values than in the occasional motion sickness group. This result suggests a hyperfunction of the vagus nerve. 2. In caloric testing with ENG, the motion sickness group showed lower values of duration and eye speed than the occasional motion sickness group. On the other hand, the frequent group showed higher values of laterality in eye speed than the occasional group. 3. With the visual suppression test, the frequent motion sickness group showed higher values than the occasional motion sickness group. On the other hand, there was a significant difference between the frequent motion sickness group and the occasional motion sickness group in terms of laterality of visual suppression values. 4. In testing fluctuation of CV R-R in response to optokinetic stimuli, the frequent motion sickness group showed elevation of CV R-R values after optokinetic load. On the other hand, the occasional motion sickness group showed depression of CV R-R values after the same load. 5. Among clinical examinations designed to diagnose susceptibility to motion sickness, CV R-R, the caloric test, the visual suppression test and OKP testing can produce sufficiently accurate results for clinical investigation.

Electrocardiography

Phasic skin conductance activity and motion sickness.

Sweating is commonly associated with motion sickness. Previous studies have attempted to relate sweating or the associated electrodermal activity to the degree of motion sickness symptoms. This study was aimed at improving methodology by study of 1) recording site--palmar finger versus forehead; and 2) signal analysis--tonic skin conductance level (SCL) versus phasic skin conductance responses (SCRs). Eleven subjects were exposed to a cross-coupled motion challenge, produced by repeated head movements (16 per minute) during rotation around the Earth vertical axis in which rotational velocity was incremented on a staircase profile from 3 degrees to 99 degrees.s-1 to an end point of moderate nausea. Six subjects underwent additional control conditions of rotation only and head movements only. A group of 12 subjects underwent sessions of vertical and horizontal sinusoidal linear motion through the head z-axis at 0.3 Hz, 1.8 ms-2 rms. Sweating responses were recorded in a further three subjects by mass spectrometry for water vapor from the skin using a dry N2 gas flow method. Phasic skin conductance activity at the forehead site provided the best correlate of motion sickness onset and recovery. Other combinations of signal analysis or recording site were less useful.

Adult

Rotation at 30 RPM about the A axis after 6 hours in the 10 degree head-down position: effect on susceptibility to motion sickness.

Intraindividual differences in susceptibility to motion sickness were measured in 14 subjects for two conditions of rotation at 30 rpm in the 10 degree head-down position. In one condition, subjects were in the 10 degree head-down position for 6 h prior to the onset of rotation; in the other condition, the delay was only 15 min. In both conditions, there were changes in vital capacity, indicating a redistribution of movable body fluids. Subjects tended to be less susceptible to motion sickness when they were recumbent for 6 h prior to rotation. These results are countervidence for the hypothesis that shifts of body fluid are responsible in large part for the motion sickness elicited in orbital space flight.

Aerospace Medicine

Motion sickness--key to neurobiologic variation.

Individual variation in motion sickness susceptibility correlates with a wide variety of perceptual, cognitive, and personality variables suggesting that it may be a unique index of individual difference in fundamental mechanisms of the orientation process. Data from a large ongoing clinical study involving over 1,500 psychiatric inpatients indicate a clear-cut association between a number of the MMPI scales (including Social Isolation, Ego Strength and Schizophrenia) and motion sickness susceptibility. Marked difference across the motion sickness susceptibility spectrum in the condition on discharge of lithium and antidepressant treated patients was also found, when compared to other drug therapies, suggesting specific drug responses by the motion sick group.

Ego

Sopite syndrome: a sometimes sole manifestation of motion sickness.

Drowsiness is one of the cardinal symptoms of motion sickness; therefore, a symptom-complex centering around "drowsiness" has been identified which, for convenience, has been termed the sopite syndrome. Generally, the symptoms characterizing this syndrome are interwoven with other symptoms but under two circumstances the sopite syndrome comprises the main or sole overt manifestation of motion sickness. One circumstance is that in which the intensity of the eliciting stimuli is closely matched to a person's susceptibility, and the sopite syndrome is evoked either before other symptoms of motion sickness appear or in their absence. The second circumstance occurs during prolonged exposure in a motion environment when adaptation results in the disappearance of motion sickness symptoms, except for responses characterizing the sopite syndrome. Typical symptoms of the syndrome are: 1) yawning, 2) drowsiness, 3) disinclination for work, either physical or mental, and 4) lack of participation in group activities. Phenomena derived from an analysis of the symptomatology of the sopite syndrome are qualitatively similar but may differ quantitatively from abstractions derived in other motion sickness responses. One example is the sometimes unique time course of the sopite syndrome. This implies that the immediate eliciting mechanisms not only differ from those involved in evoking other symptoms, but, also, that they must represent first order responses. Diagnosis is difficult unless the syndrome under discussion is kept in mind. Prevention poses a greater problem than treatment.

Adolescent

[The motion sickness under reversing goggles (1st report)].

We observed locomotion and motion sickness in 10 normal adults wearing reversing goggles while moving outdoors. Horizontal reversal of the visual field produced moderate to severe ataxia and motion sickness in all subjects except one. There was marked variability in the sensitivity among different subjects. In contrast, vertical reversal produced no symptoms. Confusion of information relation to spatial orientation possibly caused both the motion sickness and abnormal locomotion. Horizontal reversal of visual information produces disorientation because visual information is equal in importance to that from the semicircular canals. In the case of vertical reversal of visual information, orientation may be assured by gravity. The present study suggests that motion sickness is a biological signal alerting the organism to loss of spatial orientation rather than a mere autonomic symptom produced by mismatched sensory information. It appears that motion sickness is accompanied by dysequilibrium and abnormality of locomotion.

Adult

Investigation of anti-motion sickness drugs in the squirrel monkey.

Early attempts to develop an animal model for anti-motion sickness drugs, using dogs and cats; were unsuccessful. Dogs did not show a beneficial effect of scopolamine (probably the best single anti-motion sickness drug for humans thus far) and the findings in cats were not definitive. The authors have developed an animal model using the squirrel monkey (Saimiri sciureus) of the Bolivian phenotype. Unrestrained monkeys in a small lucite cage were tested in an apparatus that induces motion sickness by combining vertical oscillation and horizontal rotation in a visually unrestricted laboratory environment. Signs of motion sickness were scored using a rating scale. Ten susceptible monkeys (weighing 800-1000 g) were given a total of five tests each, to establish the baseline susceptibility level. Based on the anticholinergic activity of scopolamine, the sensitivity of squirrel monkey to scopolamine was investigated, and the appropriate dose of scopolamine for this species was determined. Then various anti-motion sickness preparations were administered in subsequent tests: 100 ug scopolamine per monkey; 140 ug dexedrine; 50 ug scopolamine plus 70 ug dexedrine; 100 ug scopolamine plus 140 ug dexedrine; 3 mg promethazine; 3 mg promethazine plus 3 mg ephedrine. All these preparations were significantly effective in preventing motion sickness in the monkeys. Ephedrine, by itself, which is marginally effective in humans, was ineffective in the monkeys at the doses tried (0.3-6.0 mg). The squirrel monkey appears to be a good animal model for antimotion sickness drugs. Peripherally acting antihistamines such as astemizole and terfenadine were found to be ineffective, whereas flunarizine, and an arginine vasopressin V1 antagonist, showed significant activity in preventing motion sickness.

Animals

Locomotion and motion sickness during horizontally and vertically reversed vision.

Locomotion and motion sickness during reversed vision were studied in ten normal subjects and a patient with bilateral labyrinthine loss. Whereas horizontal reversal produced moderate to severe gait disturbances as well as motion sickness in all normal subjects, vertical reversal failed to induce such symptoms. The patient, being free of motion sickness during both reversals, could not walk straight during horizontal reversal. The difference in the strength of sensory mismatch between both directions seemed to result from a difference in the role of vision for spatial orientation which is produced by the proprioceptive as well as otolithic inputs of gravity.

Adult

Motion sickness severity and physiological correlates during repeated exposures to a rotating optokinetic drum.

Fifty-two subjects were exposed to a rotating optokinetic drum. Ten of these subjects who became motion sick during the first session completed two additional sessions. Subjects' symptoms of motion sickness, perception of self-motion, electrogastrograms (EGGs), heart rate, mean successive differences of R-R intervals (RRI), and skin conductance were recorded for each session. The results from the first session indicated that the development of motion sickness was accompanied by increased EGG 4-9 cpm activity (gastric tachyarrhythmia), decreased mean successive differences of RRI, increased skin conductance levels, and increased self-motion perception. The results from the subjects who had three repeated sessions showed that 4-9 cpm EGG activity, skin conductance levels, perception of self-motion, and symptoms of motion sickness all increased significantly during the drum rotation period of the first session, but increased significantly less during the following sessions. Mean successive differences of RRI decreased significantly during the drum rotation period for the first session, but decreased significantly less during the following sessions. In conclusion, we have demonstrated that the development of motion sickness is accompanied by an increase in gastric tachyarrhythmia, and an increase in sympathetic activity and a decrease in parasympathetic activity, and that adaptation to motion sickness is accompanied by the recovery of autonomic nervous system balance.

Adaptation, Physiological

Motion sickness susceptibility and related behavioral characteristics in men and women.

The incidence of motion sickness in a large (N = 3,618) college population was determined by means of a questionnaire. The test-retest reliability coefficient (0.84) suggested that the motion sickness questionnaire (MSQ) for this particular population yields highly consistent information. Significantly greater proportions of men than women had low susceptibility scores and, conversely, significantly greater proportions of women had high susceptibility scores. The relationships between motion sickness susceptibility scores and several behavioral characteristics in men and women were also investigated. Specifically, comparisons of MSQ scores were made with other self-assessments, age changes, motion experiences, familial susceptibility, use of motion sickness medication, muscular coordination, willingness to participate in motion experiments, flying experience, phobias, visual motion effects, and use of alcohol.

Adolescent

[The spontaneous and evoked neuronal activity of the parietal associative cortex in cats during motion sickness].

In the experiments with the cats a spontaneous and induced activity of the neurons (57) of parietal associated cortex during motion sickness was studied. It was found that after a 15 min motion sickness 54 percent of the examined neurons displayed suppression, 20 percent of neurons did an increase of spontaneous activity. Twenty-six percent of neurons did not respond to motion sickness. The dynamics of induced neuronal responses under motion sickness effect was complex, a direction of the changes in induced responses frequently did not agree with that of alterations in a spontaneous cellular activity. The more stable changes of induced responses have been in the neurons with phase responses to the fight and electrocutaneous stimulation. After 45-min effect of motion sickness, the light-stimulated responses were characterized by an increase of early and suppression of late components of a response, and the responses to electrocutaneous stimulation displayed mainly a suppression of the early components of the responses.

Action Potentials