Role of plasma vasopressin as a mediator of nausea and gastric slow wave dysrhythmias in motion sickness

Abstract

The possible role of vasopressin in nausea and gastric dysrhythmias in motion sickness was tested by electrogastrography in 14 subjects during circular vection (60 degrees/s) and vasopressin infusion. Tachygastria was expressed as the signal percent >4.5 cycles/min. Vection evoked nausea scores of 2.6 +/- 0.2 (0 = none to 3 = severe) in 10 subjects with increases in tachygastric activity (15 +/- 2 to 45 +/- 3%) and plasma vasopressin (4.5 +/- 1.5 to 8.4 +/- 2.5 pg/ml) that were blocked by atropine but not indomethacin. Four asymptomatic subjects had no tachygastria or vasopressin release. Vasopressin at 0.2 U/min (plasma level = 322.1 +/- 10.3 pg/ml) evoked nausea (2.6 +/- 0.4) and increases in tachyarrhythmic activity (41 +/- 5%) that were blunted by atropine but not indomethacin. There were no differences in nausea or dysrhythmias with vasopressin infusion in subjects who noted nausea during vection versus those who did not. To conclude, vection evokes nausea, dysrhythmias, and vasopressin release in motion sickness-susceptible humans via cholinergic prostaglandin-independent pathways. Supraphysiological vasopressin infusions evoke nausea and dysrhythmias by similar pathways to equal degrees in motion sickness-susceptible and -resistant subjects. Thus central but not peripheral actions of vasopressin may contribute to nausea and slow wave disruption with vection. Blunting of both the release and action of vasopressin by atropine may explain its beneficial action in motion sickness.

Selective Reversal of Hyperglycemia-Evoked Gastric Myoelectric Dysrhythmias by Nitrergic Stimulation in Healthy Humans

“…Specifically, indomethacin does not prevent induction of tachygastria by circular vection indicating the lack of participation by endogenous prostaglandins (Hasler et al, 1995a). Rather, gastric myoelectric rhythm disturbances in motion sickness may be mediated in part by cholinergic pathways and vasopressin release (Kim et al, 1997). In the present investigation, nitroglycerin and sildenafil had no prophylactic effect on circular vection-induced dysrhythmias.…”

Signals for nausea and emesis: Implications for models of upper gastrointestinal diseases

“…Although this does not exclude a role for vasopressin in the genesis of nausea in intact individuals, it is a clear that a rise in plasma vasopressin is not essential for the production of nausea under all circumstances and taken together with the studies of vasopressin infusion and plasma levels could indicate that vasopressin requires an additional factor(s) to be present for the induction of nausea when it is released at a lower concentration. This appears to be particularly likely in the case of the circular vection model of motion sickness (Kim et al, 1997). …”

“…Plasma vasopressin levels appear to increase slightly before or at the onset of nausea (Miaskiewicz et al, 1989;Koch et al, 1990b). Administration of vasopressin at supraphysiological doses produced nausea in humans, but when vasopressin was infused to match the plasma level during nausea induced by motion nausea was not reported (Kim et al, 1997). Additionally, apomorphine induces nausea in patients with idiopathic diabetes insipidus despite the absence of an increase in plasma vasopressin (Nussey et al, 1988).…”

Gastric Electrical Activity and Gastrointestinal Hormones in Dyspeptic Patients

“…Myoelectrical abnormalities of the stomach have been recorded in patients with unexplained nausea and vomiting, during pregnancy, in motion sickness, and in patients with anorexia nervosa; this dysrhythmia seems to correlate with antral hypomotility and delayed gastric emptying [11]. Several peptide hormones induce gastric dysrhythmia, including glucagon [12], gastrin, secretin, somatostatin [13], CCK [14], vasopressin [15], and epinephrine [16]. Finally, gastric emptying is usually studied by means of scintigraphy, although ultrasound has been demonstrated to be a reliable, noninvasive method [17].…”