Sudden emesis following parabolic flight maneuvers: implications for space motion sickness

Episodes of emesis unaccompanied by the usual prodromal signs of motion sickness have been reported by astronauts in the space shuttle program (10). Such reports have raised the issue whether space motion sickness has different characteristics from terrestrial motion sickness. We present evidence here from parabolic flight experiments that sudden vomiting can occur in response to a provocative vestibular stimulus even when no premonitory symptoms are being experienced. Accordingly, in chronic exposure conditions, the absence of prominent signs or symptoms of motion sickness does not necessarily mean an absence of sensitization.     

Treatment of motion sickness in parabolic flight with buccal scopolamine.

Treatment of acute motion sickness induced by parabolic flight with a preparation of scopolamine placed in the buccal pouch was investigated. Twenty-one subjects flew aboard a KC-135 aircraft operated by the National Aeronautics and Space Administration (NASA) which performed parabolic maneuvers resulting in periods of 0-g, 1-g, and 1.8-g. Each subject flew once with a tablet containing scopolamine and once with a placebo in a random order, crossover design. Signs and symptoms of motion sickness were systematically recorded during each parabola by an investigator who was blind to the content of the tablet. Compared with flights using placebo, flights with buccal scopolamine resulted in significantly lower scores for nausea (31%-35% reduction) and vomiting (50% reduction in number of parabolas with vomiting). Side effects of the drug during flight were negligible. We conclude that buccal scopolamine is more effective than a placebo in treating ongoing motion sickness.     

Prediction of space motion sickness susceptibility by disconjugate eye torsion in parabolic flight

The hypothesis of asymmetric otolith function asserts that physiological or anatomical differences in the two sides of the bilateral gravity-sensing otolith apparatus of the inner ear may be well compensated on Earth, but when exposed to novel gravitational states, the prior compensatory stratagems may be ineffective, leading to unstable vestibular responses and causing the phenomenon of space motion sickness. To investigate this hypothesis, spontaneous eye torsion, a reflex governed by the otolith organs, was examined in the upright position during the hypo- and hypergravity of parabolic flight aboard NASA's KC-135 aircraft in nine former astronauts whose history of space motion sickness was revealed after data analysis had been completed. Results showed that astronauts who had been sick in space had significantly higher scores of disconjugate eye torsion in parabolic flight, and that their responses were consistently different in 1.8 G relative to 0 G compared to astronauts who had not been sick in space. In 1 G, there were no differences in disconjugate eye torsion between the subjects. The results support the asymmetry hypothesis and offer a possible predictive test of space motion sickness.     

Elicitation of motion sickness by head movements in the microgravity phase of parabolic flight maneuvers

During parabolic flight maneuvers in a Boeing KC-135 aircraft 44 college students were tested for motion sickness susceptibility. These subjects were categorized as 1) insusceptible, 2) moderately susceptible, or 3) highly susceptible to motion sickness during exposure to varying gravitoinertial force levels. After categorization, they were tested in the microgravity phase of parabolic flight to see how three types of head movements affected their baseline susceptibility. The head movements evaluated included side-to-side swivel, shoulder-to-shoulder roll, and front-up head and trunk movements; each type of head movement was used on a separate test day for eyes-open and eyes-covered conditions. Ten cycles of head movements were made in each parabola until a motion sickness endpoint, nausea, was reached or 40 parabolas had been completed. All types of head movements significantly increased susceptibility for subjects in all categories; eyes-open conditions were always more stressful than eyes-closed for each kind of head movement. These findings show unequivocally that natural head movements in microgravity can elicit symptoms of motion sickness. They suggest that head movements play an important etiological role in space motion sickness. In ground based studies where head movements are necessary to elicit symptoms, they are also necessary to elicit adaptation. We describe the use of paced and incremented head movement schedules as a possible way of partially alleviating space motion sickness.     

Motion sickness susceptibility in parabolic flight and velocity storage activity

In parabolic flight experiments, we have found post-rotary nystagmus to be differentially suppressed in free fall (OG) and in a high gravitoinertial force (1.8G) background relative to 1G. In addition, the influence of postrotary head movements on nystagmus suppression was found to be contingent on G level. The nature of this pattern indicated a G-dependency of the velocity storage and dumping mechanisms. Here, we have rank-correlated susceptibility to motion sickness during head movements in OG and 1.8G with the following: a) the decay time constant of the slow phase velocity of post-rotary nystagmus under 1G, no head movement, baseline conditions, b) the extent of time constant reduction elicited in OG and 1.8G; c) the extent of time constant reduction elicited by head tilts in 1G; and d) changes in the extent of time constant reduction in OG and 1.8G over repeated tests. Susceptibility was significantly correlated with the extent to which a head movement reduced the time constant in 1G, was weakly correlated with the baseline time constant, but was not correlated with the extent of reduction in OG or 1.8G. This pattern suggests a link between mechanisms evoking symptoms of space motion sickness and the mechanisms of velocity storage and dumping. Experimental means of evaluating this link are described.     

Hormonal status and fluid electrolyte metabolism in motion sickness

In the first experimental series, 10 healthy male test subjects with a high susceptibility to motion sickness showed a significant increase of ACTH, cortisol, STH, prolactin, ADH, aldosterone concentrations, and plasma renin activity after vestibular tests. The 10 subjects with a moderate susceptibility exhibited a still higher increase of the hormones, except plasma renin. The 8 test subjects with a low susceptibility displayed a considerable increase in ACTH, cortisol, and STH after vestibular stimulation. In the second experimental series, the increase of STH, cortisol, ADH, aldosterone and renin occurred immediately after rotation in the moderate susceptibility subjects and an hour after exposure in the high susceptibility subjects. This may be indicative of specific immediate adaptation mechanisms or excitation transfer in the CNS in high susceptibility persons. In the third experimental animal series, the permeability of the blood-brain barrier for 125I and IgG increased after rotation. Greater concentrations of potassium, chloride, and urea in CSF are suggestive of an inhibition process activation in the CNS and, probably, of an active urea transport by the vascular plexus epithelium which maintains constant osmotic pressure of cerebral extracellular fluid and prevents hyper-hydration of CNS neurons.     

Head movements in non-terrestrial force environments elicit motion sickness: implications for the etiology of space motion sickness

Space motion sickness has become an operational concern in manned space flight. Considerable evidence exists that head movements in free fall, especially pitch movements, are provocative until adaptation occurs (3,4,8,9,11,17,18,22,26). The question arises whether space motion sickness is an unique nosological entity or is due to body movements in a nonterrestrial force environment, a force environment for which the body's dynamic sensory-motor adaptions to 1 G are no longer appropriate (14,16,18-21). To evaluate this issue, we had subjects make controlled head movements during exposure to high gravitoinertial force levels, 1.8-2.0 G, in parabolic flight maneuvers. Head movements in pitch with eyes open were most evocative of motion sickness, yaw movements with eyes covered were least provocative. This pattern is identical to that which occurs when the same types of head movements are made in the free fall phase of parabolic maneuvers (17,18). It appears that space motion sickness is the consequence of prolonged exposure to a non-terrestrial force background rather than of exposure to free fall per se.     

Study of the flight work capacity of pilots during simulated motion sickness]

With the aid of a modified procedure of reading instrumental indications of an aircraft the professional performance of pilots was studied during simulated motion sickness. A ball system was developed to assess the results of reading the instrumental indications. After five exposures to double rotation statokinetically stable pilots developed a latent form and statokinetically unstable pilots developed an overt form of motion sickness. The latent form of motion sickness manifested itself in deteriorated professional performance. The overt form of motion sickness was preceded by a decline of professional performance.     

Instability of ocular torsion in zero gravity: possible implications for space motion sickness

Inherent asymmetries of the gravity-sensitive otolith organs of the inner ear may be well-compensated in ordinary 1 G, but rendered unstable in novel gravitational states. Several aspects of ocular counterrolling and spontaneous eye torsion, reflexes governed by the otoliths, were examined during the hypo- and hypergravity in parabolic flight on the NASA KC-135 aircraft. Among the subjects were two astronauts, one who had suffered space motion sickness during his mission and one who had not. Using an observed separation of scores of torsional instability at 0 G as the criterion, we divided our 10 subjects into the 5 highest and 5 lowest scorers, reminiscent of the approximately 50% who do and the 50% who do not experience space motion sickness (SMS). The astronaut who had had SMS was in the high group; and the one who had not was in the low group. At 1.8 G, the groups defined at 0 G were significantly different in the instability measure. They were also significantly different at both 0 G and 1.8 G in another measure, that of torsional variability. There were no differences between the groups in amplitude of eye torsion in 0 G or 1.8 G. None of the tests were significantly different in 1 G. The results suggest that these tests of eye torsion on the KC-135 might differentiate those who would experience SMS from those who would not. Proof of this speculation awaits replication of the study using only astronaut subjects.     

运动病的研究进展

该文从运动病病因与发病机制、预测与评估等相关方面评述运动病的研究进展,为运动病的深入研究及采取相应对策,预防其发生、发展提供理论基础。     

Labyrinthine and extralabyrinthine mechanisms of the development of motion sickness in weightlessness

This paper describes an important problem of aerospace medicine, i. e. space motion sickness. The review surveys relevant Soviet and foreign publications. On their basis, including their own data, the authors discuss possible mechanisms of the sickness symptom-complex in the weightless state. The authors put forth their own ideas concerning current hypotheses of space motion sickness and discuss potential applicability of the theoretical concepts with respect to the prevention of this adverse symptom-complex. The authors describe selected outlines in the study of mechanisms of space motion sickness and in the development of specific countermeasures.     

Reduction of visually-induced motion sickness elicited by changes in illumination wavelength

This experiment was undertaken to assess the degree of stimulus generalization in visually-induced motion sickness. Sixteen subjects participated in six sessions in which they were exposed to a rotating field of vertical stripes for five 4-min trials. This stimulus elicited the perception of self-vection. In the first three sessions, the stripes were illuminated by one monochromatic light (red or green) and in the last three sessions, the stripes were illuminated by the other monochromatic light. Magnitude estimates of motion sickness increased significantly within sessions, but the rate at which this measure increased was significantly diminished across trials in the last three-session block. Magnitude estimates of vection increased within sessions and decreased across sessions, but did not increase with color change. These results can be explained in terms of a model of stimulus generalization and have implications for the reduction of motion sickness in applied settings.     

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.     

Slow deep breathing prevents the development of tachygastria and symptoms of motion sickness

BACKGROUND: The purpose of this study was to see if slow deep breathing, a non-pharmacological procedure known to increase parasympathetic nervous system (PNS) activity, would prevent the development of gastric dysrhythmias and symptoms of motion sickness when subjects were exposed to a rotating optokinetic drum. METHODS: Participating in this study were 46 healthy males and females aged 17-26 who were pre-tested in the rotating drum and found to be susceptible to motion sickness. They were randomly placed into one of the following three conditions: Slow Deep Breathing (n = 18), Counting Breaths (subjects were asked to count their breaths and asked for the count every 3 min, n = 16), and Control (subjects breathed normally, n = 12). Electrogastrograms were recorded from all subjects during a 6-min baseline and a 16-min rotation period. Subjects were asked about their symptoms every 3 min. RESULTS: A significant difference in percent tachygastria from baseline to rotation was found between the three conditions. Percent tachygastria increased during rotation for the Counting Breaths group and the Control group, but remained the same as baseline for the Slow Deep Breathing group. The Slow Deep Breathing group (5.3) reported significantly fewer symptoms than the Counting Breaths group (9.0), but not the Control group (7.8). CONCLUSION: In conclusion, slow deep breathing in a situation previously demonstrated to provoke tachygastria prevented the development of gastric dysrhythmias and decreased symptoms of motion sickness.     

Naloxone enhances motion sickness: endorphins implicated

This study evaluated the time course to Malaise III in human subjects given naloxone and placebo with a double-blind cross-over protocol in the prevention of motion sickness induced by exposure to coriolis stimulation in a rotating chair. During naloxone tests, subjects reached the designated level of sickness sooner than during the placebo testing (significance greater than 0.05) and their discomfort lingered for up to 3 d--a feature not seen with the placebo. This implicates endogenous opiates with an endogenous protective or adaptive role in the control of motion sickness. It is suggested that when subjects experience endogenous opioid withdrawal, such as post exercise, they could be in a state of neuron hypersensitivity, and thus more prone to any form of exogenous emetic stimuli. Greater tolerance to motion stresses could be experienced in subjects whose endorphins were repeatedly elevated, thus avoiding a hypersensitivity state from endogenous opiate withdrawal. Subjects whose endorphins have not been elevated in the first instance cannot secondarily suffer opioid abstinence.     

诱发运动病期间面剖微循环变化评价方法的比较

为提高运动病评定标准的科学性，采用红外热象仪及激光多普勒微循环血流仪，分别测试了６０名健康男性青年，在电动秋千摆动刺激前、秋千实验后即刻、休息２０ｍｉｎ后，三次的面部皮肤温度及微循环血流量，将测试数据与肉眼观察判断的面色苍白程度进行了对照分析。     

Habituation of motion sickness in the cat

We subjected 30 female cats to a motion sickness stimulus in three series of tests. A series consisted of five tests given bi-weekly, weekly, or daily. Each test consisted of 30 min of stimulation followed by 1 min of rest, and series were separated by a period of not less than 14 d. Retching was the dependent variable. No habituation (reduction in the incidence of retching) was found with biweekly testing but pronounced habituation was observed with weekly and daily testing. The 30 cats were divided evenly into high and low susceptibility groups based on the results of the biweekly tests. The rate of habituation was the same for the two susceptibility groups in both the weekly and daily series.