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Concept: Motion sickness


Nausea and vomiting in early pregnancy (NVEP) is commonly encountered in family medicine. Ginger (Zingiber officinale) is a popular nonpharmacological treatment but consensus of its use is lacking.

Concepts: Vomiting, Nausea, Ginger, Morning sickness, Zingiberaceae, Zingiber, Motion sickness, Seasickness


BACKGROUND: The increasing popularity of commercial movies showing three dimensional (3D) images has raised concern about possible adverse side effects on viewers. METHODS AND FINDINGS: A prospective carryover observational study was designed to assess the effect of exposure (3D vs. 2D movie views) on self reported symptoms of visually induced motion sickness. The standardized Simulator Sickness Questionnaire (SSQ) was self administered on a convenience sample of 497 healthy adult volunteers before and after the vision of 2D and 3D movies. Viewers reporting some sickness (SSQ total score>15) were 54.8% of the total sample after the 3D movie compared to 14.1% of total sample after the 2D movie. Symptom intensity was 8.8 times higher than baseline after exposure to 3D movie (compared to the increase of 2 times the baseline after the 2D movie). Multivariate modeling of visually induced motion sickness as response variables pointed out the significant effects of exposure to 3D movie, history of car sickness and headache, after adjusting for gender, age, self reported anxiety level, attention to the movie and show time. CONCLUSIONS: Seeing 3D movies can increase rating of symptoms of nausea, oculomotor and disorientation, especially in women with susceptible visual-vestibular system. Confirmatory studies which include examination of clinical signs on viewers are needed to pursue a conclusive evidence on the 3D vision effects on spectators.

Concepts: Symptoms, Nausea, 3-D film, Motion sickness, Dimenhydrinate


Despite the widespread treatment of motion sickness symptoms using drugs and the involvement of the vestibular system in motion sickness, little is known about the effects of anti-motion sickness drugs on vestibular perception. In particular, the impact of oral promethazine, widely used for treating motion sickness, on vestibular perceptual thresholds has not previously been quantified. We examined whether promethazine (25 mg) alters vestibular perceptual thresholds in a counterbalanced, double-blind, within-subject study. Thresholds were determined using a direction recognition task (left vs. right) for whole-body yaw rotation, y-translation (interaural), and roll tilt passive, self-motions. Roll tilt thresholds were 31 % higher after ingestion of promethazine (P = 0.005). There were no statistically significant changes in yaw rotation and y-translation thresholds. This worsening of precision could have functional implications, e.g., during driving, bicycling, and piloting tasks. Differing results from some past studies of promethazine on the vestibulo-ocular reflex emphasize the need to study motion perception in addition to motor responses.

Concepts: Psychology, Cognition, Perception, Vestibular system, Vestibulo-ocular reflex, Rotation matrix, Reflex, Motion sickness


To find and analyze descriptions of motion sickness in Chinese historical sources.

Concepts: China, Motion sickness, Ancient history


Seasickness, fear of heights, and adverse effects of alcohol were the major areas where descriptions of vertigo and dizziness were found in Roman, Greek, and Chinese texts from about 730 BC-600 AD. A few detailed accounts were suggestive of specific vestibular disorders such as Menière’s attacks (Huangdi Neijing, the Yellow Thearch’s Classic of Internal Medicine) or vestibular migraine (Aretaeus of Cappadocia). Further, the etymological and metaphorical meanings of the terms and their symptoms provide fascinating historical insights, e.g. Vespasian’s feelings of dizzy exultations when becoming Emperor (69 AD) after Nero’s suicide or the figurative meaning of German “Schwindel” (vertigo) derived from English “swindle” to express “financial fraud” in the Eighteenth century. The growth of knowledge of the vestibular system and its functions began primarily in the Nineteenth century. Erasmus Darwin, however, was ahead of his times. His work Zoonomia, or The Laws of Organic Life in 1794 described new dizziness syndromes and concepts of sensorimotor control including the mechanism of fear of heights as well as made early observations on positional alcohol vertigo. The latter is beautifully illustrated by the German poet and cartoonist Wilhelm Busch (1832-1908) who also documented the alleviating effect of the “morning after drink”. The mechanism underlying positional alcohol vertigo, i.e., the differential gravities of alcohol and endolymph, was discovered later in the Nineteenth century. The first textbook on neurology (Lehrbuch der Nervenkrankheiten des Menschen, 1840) by Moritz Romberg contained general descriptions of signs and symptoms of various conditions having the key symptom of vertigo, but no definition of vestibular disorders. Our current knowledge of vestibular function and disorders dates back to the seminal work of a group of Nineteenth century scientists, e.g., Jan Evangelista Purkinje, Ernst Mach, Josef Breuer, Hermann Helmholtz, and Alexander Crum-Brown.

Concepts: Neurology, Vestibular system, Labyrinthitis, Motion sickness, Jan Evangelista Purkyně, Ernst Mach, Josef Breuer, Wilhelm Busch


Dissolving microneedle (DMN) is an attractive, minimally invasive transdermal drug delivery technology. The drugs encapsulated in the DMNs are exposed to a series of thermal, chemical, and physical stresses during the fabrication process, decreasing their therapeutic activity. Current DMN fabrication methods, such as micro-molding, drawing lithography, droplet-born air blowing, and centrifugal lithography, undergo different manufacturing processes involving differing stress conditions. Among the methods, we compared the effects of two droplet-based methods, droplet-born air blowing and centrifugal lithography, on the activity of encapsulated drugs using epidermal growth factor and ascorbic acid as model drugs. Although the appearance and physical properties of DMNs fabricated by the two methods were similar, the immunoreactivity of encapsulated epidermal growth factor in centrifugal lithography and droplet-born air blowing was 92.08±2.86% and 80.67±8.00%, respectively, at baseline, and decreased to 75.32±19.40% and 41.75±16.17%, respectively, 24h after drug-loading. The free-radical scavenging activity of ascorbic acid was maintained at 88.24±0.78% in DMNs fabricated by centrifugal lithography, but decreased over time to 67.02±1.11% in DMNs fabricated by droplet-born air blowing. These findings indicate that the manufacturing conditions of centrifugal lithography exert less stress on the drug-loaded DMNs, minimizing activity loss over time, and therefore that centrifugal lithography is suitable for fabricating DMNs loaded with fragile biological drugs.

Concepts: Pharmacology, Acid, Epidermal growth factor, Chemical reaction, Minimally invasive, Vitamin C, Ascorbic acid, Motion sickness


We investigated relations between experience driving physical automobiles and motion sickness during the driving of virtual automobiles. Middle-aged individuals drove a virtual automobile in a driving video game. Drivers were individuals who had possessed a driver’s license for approximately 30 years, and who drove regularly, while non-drivers were individuals who had never held a driver’s license, or who had not driven for more than 15 years. During virtual driving, we monitored movement of the head and torso. During virtual driving, drivers became motion sick more rapidly than non-drivers, but the incidence and severity of motion sickness did not differ as a function of driving experience. Patterns of movement during virtual driving differed as a function of driving experience. Separately, movement differed between participants who later became motion sick and those who did not. Most importantly, physical driving experience influenced patterns of postural activity that preceded motion sickness during virtual driving. The results are consistent with the postural instability theory of motion sickness, and help to illuminate relations between the control of physical and virtual vehicles.

Concepts: Driving, Driver's license, Vehicle, Driver's education, Automobile, Driving test, Motion sickness, Chauffeur


The data presented in this article are related to the research article entitled “The use of transdermal scopolamine to solve methodological issues raised by gender differences in susceptibility to simulator sickness” (Chaumillon et al., 2017) [1]. In an outstanding first demonstration, Kennedy et al. [2] showed that the Simulator Sickness Questionnaire (SSQ) is an appropriate tool to suit the purposes of characterizing motion sickness experienced in virtual environments. This questionnaire has since been used in many scientific studies. Recently, Balk et al. [3] suggested that the proposed segregation of SSQ scores into three subclasses of symptoms might limit the accuracy of simulator sickness assessment. These authors performed a factor analysis based on SSQ scores obtained from nine studies on driving simulators. Although their factor analysis resulted in the same three orthogonal classes of symptoms as Kennedy et al. [2], unlike this pioneering study, no items were attributed to more than one factor and five items were not attributed to any class of symptoms. As a result, they claimed that an exploration of each item score should give additional cues on individual profiles. To gain a better characterization of such item-by-item exploration, data utilised in this research are shown using a radar chart visualisation.

Concepts: Scientific method, Transdermal patch, Psychometrics, Motion sickness, Charts, Chart, Scopolamine, Radar chart


Considering the emerging advantages related to virtual reality implementation in clinical rehabilitation, the aim of the present study was to discover possible (i) improvements achievable in unilateral vestibular hypofunction patients using a self-assessed head-mounted device (HMD)-based gaming procedure when combined with a classical vestibular rehabilitation protocol (HMD group) as compared with a group undergoing only vestibular rehabilitation and (ii) HMD procedure-related side effects. Therefore, 24 vestibular rehabilitation and 23-matched HMD unilateral vestibular hypofunction individuals simultaneously underwent a 4-week rehabilitation protocol. Both otoneurological measures (vestibulo-ocular reflex gain and postural arrangement by studying both posturography parameters and spectral values of body oscillation) and performance and self-report measures (Italian Dizziness Handicap Inventory; Activities-specific Balance Confidence scale; Zung Instrument for Anxiety Disorders, Dynamic Gait Index; and Simulator Sickness Questionnaire) were analyzed by means of a between-group/within-subject analysis of variance model. A significant post-treatment between-effect was found, and the HMD group demonstrated an overall improvement in vestibulo-ocular reflex gain on the lesional side, in posturography parameters, in low-frequency spectral domain, as well as in Italian Dizziness Handicap Inventory and Activities-specific Balance Confidence scale scores. Meanwhile, Simulator Sickness Questionnaire scores demonstrated a significant reduction in symptoms related to experimental home-based gaming tasks during the HMD procedure. Our findings revealed the possible advantages of HMD implementation in vestibular rehabilitation, suggesting it as an innovative, self-assessed, low-cost, and compliant tool useful in maximizing vestibular rehabilitation outcomes.

Concepts: Statistics, Variance, Vestibular system, Vestibulo-ocular reflex, Normal distribution, Analysis of variance, Reflex, Motion sickness


This randomized cross-over study tested the hypothesis that exposure to short-wavelength light induces symptoms of motion sickness (MS). The study participants were 28 healthy adults (14 women; mean age±SD, 25.96±3.11 years). Two stimuli oscillating within a range of 0.4-0.6 Hz were used to induce MS: a blue wave stimulus with short-wavelength light (460 nm) and a green wave stimulus with middle-wavelength light (555 nm). All participants were exposed to both stimuli throughout two separate periods. After a baseline period, participants were exposed to each stimulus three times for 4 min. The Simulator Sickness Questionnaire, a self-report checklist composed of three subscales (Oculomotor, Disorientation, and Nausea), heart rate variability, and electrogastrography were used to measure the degree of symptoms related to MS. A linear mixed-effects model was used for statistical analysis. The results showed significant main effects for Period (P<0.01), Color (P<0.01), and Time Point (P<0.01) scores on the Simulator Sickness Questionnaire Nausea subscale. A post-hoc test indicated that scores on the Nausea subscale were significantly higher after the third exposure to blue light than after the first and second exposures. The linear mixed-effects model showed significant main effects for Color (P<0.01) with respect to the normogastria/tachygastria ratio. These findings suggest that short-wavelength light induces symptoms of MS, especially gastrointestinal symptoms.

Concepts: Time, Statistics, Light, Wave, Nausea, Metoclopramide, Motion sickness, Dimenhydrinate