Vestibular Testing Abnormalities in Individuals with Motion Sickness

Hoffer, Michael E.; Gottshall, Kim R.; Kopke, Richard D.; Weisskopf, Peter A.; Moore, Robert R.; Allen, Keith; Wester, Derin

doi:10.1097/00129492-200307000-00017

Cited by 33 publications

(25 citation statements)

References 3 publications

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“…It has not been possible to predict the level of motion sickness susceptibility in particular subjects from the absolute value of the VOR time constant since two subjects with the same time constant may have different levels of susceptibility (Shupak et al 1990;Gordon et al 1996;Bos et al 2002;Hoffer et al 2003). However, this and our previous study show that whatever the level of susceptibility in a single individual, reduction in their time constant reduces their motion sickness sensitivity.…”

Section: Possible Mechanisms For Reduction Of Motion Sickness Susceptmentioning

confidence: 71%

Labyrinthine lesions and motion sickness susceptibility

2007

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The angular vestibulo-ocular reflex (aVOR) has a fast pathway, which mediates compensatory eye movements, and a slow (velocity storage) pathway, which determines its low frequency characteristics and orients eye velocity toward gravity. We have proposed that motion sickness is generated through velocity storage, when its orientation vector, which lies close to the gravitational vertical, is misaligned with eye velocity during head motion. The duration of the misalignment, determined by the dominant time constant of velocity storage, causes the buildup of motion sickness. To test this hypothesis, we studied bilateral labyrinthine-defective subjects with short vestibular time constants but normal aVOR gains for their motion sickness susceptibility. Time constants and gains were taken from rotational responses. Motion sickness was generated by rolling the head while rotating, and susceptibility was assessed by the number of head movements made before reaching intolerable levels of nausea. More head movements signified lower motion sickness susceptibility. Labyrinthine-defective subjects made more head movements on their first exposure to roll while rotating than normals (39.8 ± 7.2 vs 13.7 ± 5.5; P < 0.0001). Normals were tested eight times, which habituated their time constants and reduced their motion sickness susceptibility. Combining data from all subjects, there was a strong inverse relationship between time constants and number of head movements (r = 0.94), but none between motion sickness susceptibility and aVOR gains. This provides further evidence that motion sickness is generated through velocity storage, not the direct pathway, and suggests that motion sickness susceptibility can be reduced by reducing the aVOR time constant.

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Section: Possible Mechanisms For Reduction Of Motion Sickness Susceptmentioning

confidence: 71%

Labyrinthine lesions and motion sickness susceptibility

2007

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“…The cerebellar nodulus and uvula are responsible for the orientation properties of the velocity storage [19,33,34] and destruction of the nodulus and uvula substantially reduces or abolishes motion sickness susceptibility in dogs [35,36]. Previously, some individuals with motion sickness also showed markedly increased VOR TC during step velocity rotation [13]. Recently, another study demonstrated an inverse relationship between the VOR TC and the number of head movements enough to develop motion sickness [16].…”

Section: Vestibular Dysfunction In Migrainementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Since motion sickness per se may affect the results of vestibular function tests, the abnormal vestibular findings in migraine-related dizziness should be interpreted in the context of co-morbid motion sickness [12,13]. For example, compared with normal controls, the motion sickness group may show increased gain, decreased phase lead, and increased or decreased time constant (TC) of the vestibulo-ocular reflex (VOR) [12,13]. However, previous studies did not attempt to analyze migraine-related vestibular dysfunction according to co-morbid dizziness/vertigo or motion sickness, and did not correlate the vestibular dysfunction with severity of motion sickness using quantitative assessment.…”

Section: Introductionmentioning

confidence: 99%

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Vestibular dysfunction in migraine: effects of associated vertigo and motion sickness

et al. 2009

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The mechanisms of vestibular migraine and motion sickness remain unknown. The aims of this study were to determine interictal vestibular dysfunction in migraineurs according to associated dizziness/vertigo and motion sickness, and to find out whether impaired uvulonodular inhibition over the vestibular system underlies the vestibular symptoms and signs by measuring tilt suppression of the vestibulo-ocular reflex (VOR). One hundred and thirty-one patients with migraine [65 with vestibular migraine (MV), 41 with migrainous dizziness (MD), and 25 with migraine only (MO)] and 50 normal controls underwent evaluation of vestibular function. Motion sickness was assessed using the motion sickness susceptibility questionnaire (MSSQ) and subjective scale. Compared with normal controls and MO group, patients with MV/MD showed increased VOR time constant (TC) and greater suppression of the post-rotatory nystagmus with forward head tilt. The mean MSSQ score and subjective scale were highest in MV group, followed by MD, MO, and controls (p = 0.002, p < 0.001). Multiple linear regression model analyses revealed that motion sickness is an independent factor of TC prolongation (p = 0.024). Twenty-eight (21.4%) patients with migraine also showed perverted head shaking nystagmus and 12 (9.2%) had positional nystagmus. In view of the increased tilt suppression of the VOR, we speculate that dysfunction of the nodulus/uvula may not account for the prolonged TCs in MD/MV. Instead, innate hypersensitivity of the vestibular system may be an underlying mechanism of motion sickness and increased TC in MD/MV. The increased tilt suppression may be an adaptive cerebellar mechanism to suppress the hyperactive vestibular system in migraineurs.

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“…These include apathy, general discomfort, headache, stomach awareness, increased salivation, fatigue, drowsiness, depression, warmth, dizziness, yawning, cardiac palpitations, and inability to concentrate or perform tasks. 6,7 We hypothesized that women at high risk for PONV would benefit from P6 acupressure administered prior to nauseogenic stimuli. The primary outcome was the time to moderate nausea (3 or more on a Lickert type scale 0-6) provoked by head movements in an eccentrically rotating chair.…”

Section: Objectif : Nous Avions Expérimenté Déjà Que L'acupression Enmentioning

confidence: 99%

P6 acupressure increases tolerance to nauseogenic motion stimulation in women at high risk for PONV

Alkaissi

Ledin

Ödkvist

et al. 2005

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : In a previous study we noticed that P6 acupressure decreased postoperative nausea and vomiting (PONV) more markedly after discharge. As motion sickness susceptibility is increased by, for example, opioids we hypothesized that P6 acupressure decreased PONV by decreasing motion sickness susceptibility. We studied time to nausea by a laboratory motion challenge in a group of volunteers, during P6 and placebo acupressure.M Me et th ho od ds s: : 60 women with high and low susceptibilities for motion sickness participated in a randomized and double-blind study with an active P6 acupressure, placebo acupressure, and a control group (n = 20 in each group). The risk score for PONV was over 50%. The motion challenge was by eccentric rotation in a chair, blindfolded and with chin to chest movements of the head. The challenge was stopped when women reported moderate nausea. Symptoms were recorded. R Re es su ul lt ts s: : Mean time to moderate nausea was longer in the P6 acupressure group compared to the control group. P6 acupressure = 352 (259-445), mean (95% confidence interval) in seconds, control = 151 (121-181) and placebo acupressure = 280 (161-340); (P = 0.006). No difference was found between P6 and placebo acupressure or placebo acupressure and control groups. Previous severity of motion sickness did not influence time to nausea (P = 0.107). The cumulative number of symptoms differed between the three groups (P < 0.05). Fewer symptoms were reported in the P6 acupressure compared to the control group P < 0.009. Overall, P6 acupressure was only marginally more effective than placebo acupressure on the forearms. C Co on nc cl lu us si io on n: : In females with a history of motion sickness P6 acupressure increased tolerance to experimental nauseogenic stimuli, and reduced the total number of symptoms reported. OSTOPERATIVE nausea and vomiting (PONV) can be exacerbated by movement such as transport on a trolley, change in position in bed and, after day-case surgery, transport home or activity at home. Objectif1 A history of motion sickness is also an independent predictor of PONV.2 Recent evidence suggests that P6 acupressure may decrease symptoms of motion sickness, 3 and that these effects may be particularly beneficial after day case surgery. 4,5 Could it be that P6 stimulation is mainly effective on movement-induced nausea?The main signs and symptoms of motion sickness are nausea, pallor, cold sweating, and vomiting. However, many other symptoms of motion sickness are reported to varying degrees. These include apathy, general discomfort, headache, stomach awareness, increased salivation, fatigue, drowsiness, depression, warmth, dizziness, yawning, cardiac palpitations, and inability to concentrate or perform tasks. 6,7 We hypothesized that women at high risk for PONV would benefit from P6 acupressure administered prior to nauseogenic stimuli. The primary outcome was the time to moderate nausea (3 or more on a Lickert type scale 0-6) provoked by head movements in an eccentrically rotating c...

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Vestibular Testing Abnormalities in Individuals with Motion Sickness

Cited by 33 publications

References 3 publications

Labyrinthine lesions and motion sickness susceptibility

Labyrinthine lesions and motion sickness susceptibility

Vestibular dysfunction in migraine: effects of associated vertigo and motion sickness

P6 acupressure increases tolerance to nauseogenic motion stimulation in women at high risk for PONV

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