Clinical characteristics of visual motion hypersensitivity: a systematic review

Abstract

This qualitative systematic review presents an overview of the state of the research relating to visual motion hypersensitivity (VMH) and offers a reference tool for future studies in the field. The study set out to identify and collate articles investigating risk groups with aberrant responses to visual motion as compared to healthy control groups, presenting evidence for risk factors associated with visual motion hypersensitivity. Data were synthesized into the state of the research and analyzed in the context of the clinical characteristics of each risk factor. Literature searches were performed on Medline Ovid, EMBASE, Web of Science, and Cinahl, identifying a total of 586 studies of which 54 were finally included. Original articles published between the dates of commencement for each database and 19th January 2021 were included. JBI critical appraisal tools were implemented for each corresponding article type. In total, the following number of studies was identified for each respective risk factor: age (n = 6), migraines (n = 8), concussions (n = 8), vestibular disorders (n = 13), psychiatric conditions (n = 5), and Parkinson’s disease (n = 5). Several studies described VMH as the primary concern (n = 6), though these primarily included patients with vestibulopathies. There were considerable differences in the nomenclature employed to describe VMH, depending largely on the investigating group. An overview of investigated risk factors and their evaluation methods was presented in a Sankey diagram. Posturography was the most implemented methodology but due to diverse measurements meta-analyses were not possible. One may however note that while the easily implemented Vestibular Ocular Motor Screening (VOMS) was designed for concussed patients, it may prove useful for other risk groups.

Advances in diagnosis and treatment of vestibular migraine and the vestibular disorders it mimics

“…The current updated and revised diagnostic criteria for definite VM published in 2022 consist of the following: either a current or past history of migraine with or without aura, at least five attacks of vertigo of moderate to severe intensity that last between 5 ​min and 72 ​h, at least half of these attacks must be associated with at least one of three migraine features including 1) migraine headaches, 2) photophobia and phonophobia, or 3) a visual aura, and finally the description of these attacks cannot better fit into an alternative vestibular disorder [ 13 ]. While VM is traditionally thought of as a spontaneous episodic dizziness, it is also known to be either triggered by or exacerbated by visual stimuli and/or self-motion [ 14 ]. Some common examples of visual stimuli include scrolling on a phone, prolonged exposure to computer screens, action movies, or certain stimulating environments such as grocery or department stores.…”

“…a bright computer screen), or complex visual cues (e.g. watching an action movie) [ 14 , 48 ]. Symptoms that are present more often than not and vary throughout the day (e.g., worse toward the end of the day) are suggestive of PPPD, whereas VM is an episodic condition lasting minutes, hours, or sometimes days in duration.…”

“…While post-concussive dizziness is common, a variety of other treatable etiologies of dizziness should be considered including VM, BPPV, and PPPD [ 84 ]. It is recognized that post-traumatic headache can include migraine [ 85 ], and there can be significant overlap between PCS and VM given symptoms of headache, photophobia, phonophobia, fatigue, and visual complaints in both [ 13 , 14 , 78 ]. This makes the history especially important with particular attention to identifying classic migraine triggers and understanding the temporal relationship between dizziness, headaches, photophobia, and phonophobia.…”

Investigating cortical activity during cybersickness by fNIRS

“…The human nervous system maintains balance and perceives body movements based on vestibular, visual, and somatosensory information 3 , 4 . For instance, if vision is fixed on one place when speed changes while moving in a boat or car, the brain receives conflicting vestibular and visual information, which can cause motion sickness 2 , 5 . The degree of motion sickness varies from person to person and is determined by family history, nervous system diseases, sensitivity to movement, and visual stimulation 5 .…”