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All sourcesNASA NTRSDOE OSTI
NASA NTRS1980

A heuristic mathematical model for the dynamics of sensory conflict and motion sickness

The etiology of motion sickness is explained in terms of a qualitatively formulated sensory conflict hypothesis. By consideration of the information processing task faced by the central nervous system in estimating body spatial orientation and in controlling active body movement using an internal model referenced control strategy, a mathematical model for sensory conflict generation is developed. The model postulates a major dynamic functional role for sensory conflict signals in movement control, as well as in sensory-motor adaptation. It accounts for the role of active movement in creating motion sickness symptoms in some experimental circumstances, and in alleviating them in others. The relationship between motion sickness produced by sensory rearrangement and that resulting from external motion disturbances is explicitly defined. A nonlinear conflict averaging model is proposed which describes dynamic aspects of experimentally observed subjective discomfort sensation, and suggests resulting behaviors.

Oman, C. M.↗
NASA NTRS1982

A heuristic mathematical model for the dynamics of sensory conflict and motion sickness

The etiology of motion sickness is now usually explained in terms of a qualitatively formulated sensory conflict hypothesis. By consideration of the information processing task faced by the central nervous system in estimating body spatial orientation and in controlling active body movement using an internal model referenced control strategy, a mathematical model for sensory conflict generation is developed. The model postulates a major dynamic functional role for sensory conflict signals in movement control, as well as in sensory motor adaptation. It accounts for the role of active movement in creating motion sickness symptoms in some experimental circumstances, and in alleviating them in others. The relationship between motion sickness produced by sensory rearrangement and that resulting from external motion disturbances is explicitly defined. A nonlinear conflict averaging model describes dynamic aspects of experimentally observed subjective discomfort sensation, and suggests resulting behavior.

Oman, C. M.↗
NASA NTRS1992

Comparison of treatment strategies for Space Motion Sickness

Treatment strategies for Space Motion Sickness were compared using the results of postflight oral debriefings. Standardized questionnaires were administered to all crewmembers immediately following Space Shuttle flights by NASA flight surgeons. Cases of Space Motion Sickness were graded as mild, moderate or severe based on published criteria, and medication effectiveness was judged based on subjective reports of symptom relief. Since October 1989, medication effectiveness is reported inflight through Private Medical Conferences with the crew. A symptom matrix was analyzed for 19 crewmembers treated with an oral combination of scopolamine and dextroamphetamine (scopdex) and 15 crewmembers treated with promethazine delivered by intramuscular (IM) or suppository routes. Scopdex has been given preflight as prophaxis for Space Motion Sickness but analysis showed delayed symptom presentation in 9 crewmembers or failed to prevent symptoms in 7. Only three crewmembers who took scopdex had no symptoms inflight. Fourteen out of 15 crewmembers treated with IM promethazine and 6 of 8 treated with promethazine suppositories after symptom development had immediate (within 12 h) symptom relief and required no additional medication. There were no cases of delayed symptom presentation in the crewmembers treated with promethazine. This response is in contrast to untreated crewmembers who typically have slow symptom resolution over 72-96 h. We conclude that promethazine is an effective treatment of Space Motion Sickness symptoms inflight. NASA policy currently recommends treating crewmembers with Space Motion Sickness after symptom development, and no longer recommends prophylaxis with scopdex due to delayed symptom development and apparent variable absorption of oral medications during early flight days.

STS Shuttle Project↗
NASA NTRS2024

Transfer of NASA Technology to the DoD: Mitigating Motion Sickness with Autogenic Feedback Training Exercise

Motion sickness poses a significant safety risk, particularly in the context of aviation. Given its prevalence among aviators and its detrimental impact on performance, researchers have attempted to identify effective mitigation strategies for motion sickness. Currently, many of the existing interventions are pharmacological, and while effective, they present a problem due to their associated adverse side effects. The primary goals of the current research were 1) demonstrate the value of the application of Autogenic-Feedback Training Exercise (AFTE), a physiological training program developed by NASA to mitigate the impact of operational stressors such as motion sickness and spatial disorientation on human physiology and performance and 2) evaluate a new enhanced version of AFTE training software and demonstrate the ability to apply it remotely and train other personnel to administer it. AFTE combines principles of autogenic therapy, and biofeedback in training individuals to control their physiological reactions through a series of relaxation and arousal exercises. This study included twenty-six participants, 17 men and 9 women. On day 1 participants were tested in a rotating chair (pre-test) to determine their motion sickness tolerance (measured as minutes of rotation); days 2-5 consisted of four AFTE training sessions, each 30-min. in duration for a total of 2 hours; and on day 6 the participants were re-tested in the rotating chair. Results revealed a significant increase in motion sickness tolerance with AFTE on the post-test when compared to pre-test, participants had significantly lower symptom diagnostic scores post-test, and there was no significant gender effect. In addressing the first goal it was concluded that the modified 2-hour version of AFTE significantly improved motion sickness tolerance with participants experiencing fewer symptoms. A second goal of this research was to refine and transfer a NASA technology, software and methods for applications within DOD by training other personnel to administer AFTE. A comparison of NASA and NAMRU-D trainers on AFTE outcome for improving participants’ motion sickness tolerance revealed no significant difference indicating the successful transfer of methods to DOD. In addition, remote AFTE training of military aviators at distant sites was feasible. A third goal was to identify individual patterns of interoceptive abilities and related autonomic metrics able to predict stress response and training outcome. These data included measures of personality traits obtained from questionnaires and specific autonomic measures (e.g., heart rate variability) collected by NAMRU-D investigators. These results will be reported in a separate paper.

autonomic nervous system↗
NASA NTRS2024

Evaluation of Intranasal Scopolamine for the Prevention of Wave Motion Induced Motion Sickness While Maintaining Performance on Operationally Relevant Tasks

Motion sickness represents one of the greatest clinical challenges impacting crew activities during and following g-transitions. Our overall goal is to characterize the effectiveness of motion sickness countermeasures during controlled laboratory experiments using capsule wave motion simulation and during field testing in operational environments. This laboratory study focused on prevention of motion sickness using intranasal scopolamine using a double-blinded repeated measures design in 30 subjects (19M, 11F). Intranasal scopolamine was provided by Defender Pharmaceuticals, Inc. (DPI-386 Nasal Gel, referred to as Inscop) self-administered by a nasal pump (Aptar Pharma) that delivers 0.4 mg dose (0.2 mg / nostril). During each session, subjects were exposed to complex wave motion on a six degree-of-freedom platform that included pitch, roll and heave at provocative stimulus frequencies (0.1-0.25 Hz) while seated in an illuminated cabin deprived of external visual cues. Motion sickness symptoms were compared across treatment and placebo control sessions counterbalanced across subjects and separated by at least one week. The time-to-motion sickness endpoint was based on severe malaise, defined as symptom score of ≥8 points using the Pensacola Diagnostic Index [1]. The bioavailability of scopolamine for each session was estimated from plasma concentrations obtained every 15 min[2]. Side effects during the treatment session were minimal, and performance was not impaired on a test battery including motion perception tracking, tablet-based eye-hand coordination and psychomotor vigilance testing. The plasma concentration remained near-peak levels throughout the 45 min motion sickness testing for most subjects. The percentile ranking on the Motion Sickness Susceptibility Questionnaire [MSSQ, 3]was moderately correlated with the motion sickness time-to-endpoint during the placebo control session (rho = –0.3, p=0.056). Seventeen subjects did not reach an endpoint during their placebo session and were eliminated from subsequent analysis. Another subject was excluded due to insufficient plasma concentration during the treatment session. For the remaining 12 subjects, the change in time-to-motion sickness endpoint between placebo and treatment sessions was moderately correlated with plasma concentration (rho =0.48, p = 0.056), improving on average 4.4 ± 18.4 min, mean ± std with Inscop versus placebo. Our results are consistent with previous findings that intranasal delivery of scopolamine can be effective at reducing motion sickness symptoms with minimal cognitive or sedative side effects. Future work is needed to optimize the delivery of Inscop for rescue (treatment) of symptoms following g-transitions as one of the key advantages of this formulation is self-administration in a suited environment. We will also explore how the combination of Inscop with non-pharmaceutical sensory aids, e.g., vibrotactile feedback of Earth vertical, may further mitigate motion sickness and improve task performance.

S J Wood↗
NASA NTRS1985

A stimulator for laboratory studies of motion sickness in cats

A motion sickness device is described which produces motion sickness in about 40 percent of an unselected population of unrestrained female cats during a 30-min exposure at 0.28 Hz. The apparatus provides a gentle wave stimulus, similar to that provided by an amusement park Ferris Wheel. Two cats may be tested at the same time. This device is useful for studies of putative antimotion sickness drugs or the biochemical basis of the emetic response to motion.

Crampton, G. H.↗
NASA NTRSDate not supplied

Evaluating Sensory Augmentation as A Non-Pharmaceutical Tool to Mitigate Motion Sickness and Enhance Sensorimotor Task Performance: A Pilot Study Using Simulated Capsule Wave Motion

Wave motion during capsule recovery operations can result in motion sickness and performance decrements exacerbating reentry sickness following long duration spaceflight. The purpose of this pilot study was (1) to validate a capsule wave motion simulation as a platform to evaluate motion sickness countermeasures and (2) to evaluate a sensory augmentation belt providing vibrotactile feedback of gravitational upright. Ten healthy subjects ages 38.0 ± 10.1 (6M|4F) were exposed to complex wave motions on a six degree-of-freedom platform that included pitch, roll, and heave at provocative stimulus frequencies (0.1-0.25 Hz) while seated in an illuminated cabin deprived of external visual cues. Subjects reported acute symptoms for up to three consecutive 15 min trials or until they reached a motion sickness endpoint of 8 pts on the Pensacola Diagnostic Index (PDI). Five subjects were randomly assigned to the Sensory Augmentation (SA) group while the other five served as controls (CN group). Based on a Motion Sickness Susceptibility Questionnaire, the two groups had similar motion sickness histories (susceptibility percentile ranking of CN group = 27.5 ± 63.6 in the CN group versus 27.5 ± 37.0 in the SA group, median ± IQR). The vibrotactile feedback consisted of a single array of 8 electromechanical tactors positioned around the torso on an adjustable belt (Engineering Acoustics, Inc) that utilized an integrated inertial measurement unit (IMU) to indicate the direction of upright (e.g., subject’s back tactor on during forward tilt). During each wave motion trial subjects performed a battery of four different tasks: tracking Earth vertical using a joystick with and without a secondary task (Paced Auditory Serial Addition Test), an eye-hand target acquisition task on a cabin-fixed tablet, and the psychomotor vigilance test (PVT). All ten subjects reported varying levels of motion sickness with 6 of 10 reaching a symptom endpoint. Interestingly, subjects anecdotally reported that engagement in the joystick tracking task was less provocative than tasks involving the cabin-fixed tablet or periods of no activity. Sensory augmentation appeared to delay symptom onset, with 2 of 5 subjects reaching an endpoint within the first 15 min trial in the CN group versus none in the SA group (PDI after 15 min = 6.0 ± 2.5 in the CN group versus 3.4 ± 2.5 in the SA group, mean ±std). Sensory augmentation also improved performance on the joystick tracking task at lower stimulus frequencies (0.1 Hz in roll and 0.2 Hz in pitch). Both CN and SA groups maintained a consistent level of performance on the eye-hand target acquisition and PVT throughout the baseline (no motion) and wave motion periods. Our results validated that the simulated capsule wave motion paradigm provides an effective motion sickness stressor. This paradigm is currently being used to investigate the efficacy of intranasal scopolamine to mitigate motion sickness. Sensory augmentation using vibrotactile feedback appears to improve spatial awareness and delay symptom onset during complex passive motion. One advantage of this portable belt design is that it incorporates all tactor drive and IMU circuitry and therefore could continue to be worn by crewmembers and serve as a balance aid during egress and ambulation with recovery operations.

A M Bollinger↗
NASA NTRS1983

Motion sickness - Acquisition and retention of adaptation effects compared in three motion environments

The acquisition and retention of adaptation effects in motion sickness was invetigated using a sudden-stop vestibulovisual interaction test for measuring susceptibility to motion sickness (Graybiel and Lackner, 1980). The test procedure included four successive assessments that provide not only an index of susceptibility to motion sickness but also the rates of acquisition and decay of adaptation effects. The 14 subjects who had participated in this test had previously served as subjects in parabolic flight experiments and seven of them had also taken part in the assessment of antimotion-sickness remedies in a slow rotation room. A study was conducted to determine whether these subjects' rates of acquisition and decay of adaptation to stressful motion represent consistent general features of their response across motion environments. It is found that an individual's rates of acquiring and losing adaptation are quite consistent in very different situations. In addition, the pattern of results indicate modifications of the sudden-stop vestibulovisual test that should increase its effectiveness as a motion-sickness screening procedure, both for orbital flight and for terrestrial conditions.

Graybiel, A.↗
NASA NTRS1994

Assessment of Psychophysiological Responses During Motion Sickness Testing

The purpose of this investigation is to evaluate a methodology designed to accurately trace the temporal progression of motion sickness and space motion sickness symptoms. With this method, subjects continuously monitor their own motion sickness symptoms during exposure to a provocative stimulus as symptoms occur, in contrast to previous methods during which subjects report symptoms verbally at discrete time intervals. This method not only is comparable to previous methods in the type of symptoms that subjects report, but subjects report symptoms more frequently. Frequent reporting of motion sickness symptoms allows researchers to detail the waxing and waning of motion sickness symptoms for each individual. Previous research has shown that physiological responses to motion sickness stimuli are characterized by unique individual differences in response patterns. By improving our assessment of motion sickness symptoms with continuous monitoring of symptoms, the relationship between specific physiological responses and sickness levels can be more accurately determined for each individual. Results from this study show significant positive relationships between skin conductance levels and symptom levels for ten individuals; a significant positive relationship between temperature and symptom levels for 5 of 10 individuals; and both positive and negative relationships between respiration, heart rate, blood volume pulse and symptom levels. Continuous monitoring of motion sickness symptoms can be used to more accurately assess motion sickness to aid in the evaluation of countermeasures. In addition, recognition of the onset of symptoms that are strongly related to specific physiological responses could be used as cues to initiate procedures (e.g., Autogenic Feedback Training) to prevent the development of severe motion sickness symptoms.

Stoud, Cynthia S.↗
NASA NTRS2020

Motion Sickness and Concerns for Urban Air Mobility Vehicles: A Literature Review

Motion sickness is a general term for a constellation of signs and symptoms, generally due to exposure to abrupt, periodic, or unnatural accelerations, especially when traveling in a vehicle. Motion sickness results from a mismatch of the visual and nonvisual (vestibular and kinesthetic) information, the observed scene and the motion felt or lack of it. Motion sickness onset is associated with a pattern of physiological changes in heart rate, peripheral blood flow, respiration, and skin conductance and the pattern is repeatable for a particular subject but variable between subjects. Demographic factors such as gender and age that affect motion sickness are well known with children, women, and older adults more likely to be susceptible. Often motion sickness is assessed and quantified using variations of the motion sickness susceptibility questionnaires including the Pensacola Diagnostic Rating Scale and the Simulator Sickness Questionnaire. Even though symptoms are easily identified by such questionnaires, they commonly are subjective. Tools such as these questionnaires for screening individuals susceptible to motion sickness are useful, however, they are only mildly predictive. Moreover, models for predicting motion sickness, which have largely been developed for sea sickness, do not consider task characteristics. Predictions of motion sickness rates and prevalence for Urban Air Mobility (UAM) vehicles are not possible at present because data from actual flight or full-fidelity simulation are simply not yet available. Extrapolation from other modes of transportation (i.e., automobiles, buses, trains, boats, other types of aircraft) is difficult because of differences in the motion stimulus experienced, trip duration, and other factors. How UAM vehicles will change the social dynamics of passenger interaction and vehicle interior design changes (e.g., seat orientations) is unknown. Should motion sickness prove to be an issue, vehicle design modifications such as having passengers face forward, providing additional seat recline, giving each person their own climate control for airflow, perhaps ensuring the horizon is visible to all passengers (reducing visual occlusion by the headrest) and visually stabilizing displays on carry-on devices (smart phones, tablets, etc.) may benefit passengers. Several commercial companies provide wearable devices for physiological monitoring that have been validated and are suitable for use with passengers in UAM vehicles or high-fidelity simulators. Potential countermeasures for motion sickness include user-worn devices, anti-motion sickness medications, and non-pharmacological approaches such as biofeedback and Autogenic Feedback Training Exercise. Both simulator and in-vehicle UAM research is needed to evaluate the effectiveness of any potential countermeasure.

motion sickness↗
NASA NTRS1988

The relationship between preflight underwater training and space motion sickness

SMS (Space Motion Sickness) severity was compared to WETF - (Weightless Environment Training Facility) trained and non-trained astronauts. Based on postflight medical debriefings, SMS severity was categorized as none, mild, moderate, and severe. The results showed 63% of all crewmembers on their first shuttle flight experienced some level of SMS. Of those, 55% had symptoms ranked moderate to severe. From the non-trained group, 35% had no SMS, 18% had mild, 29% had moderate, and 18% had severe. From the trained group, 41% had no SMS, 41% had mild, 19% had moderate, and 3% had severe SMS. These results indicate an inverse relationship (p <0.01) between WETF training and SMS severity. Preflight WETF training may have operations significance as a viable countermeasure to SMS.

Space Adaptation Syndrome (SAS)↗
NASA NTRS2003

The critical role of velocity storage in production of motion sickness

We propose that motion sickness is mediated through the orientation properties of velocity storage in the vestibular system that tend to align eye velocity produced by the angular vestibulo-ocular reflex (aVOR) with gravito-inertial acceleration (GIA). (GIA is the sum of the linear accelerations acting on the head. In the absence of translational accelerations, gravity is the GIA.) We further postulate that motion sickness produced by cross-coupled vestibular stimulation can be characterized by a metric composed of the disparity between the axis of eye rotation and the GIA, the strength of the response to angular motion, and the response duration, as determined by the central vestibular time constant, that is, by the time constant of velocity storage. The nodulus and uvula of the vestibulocerebellum are likely to be the central sites where the disparity is sensed, where the vestibular time constants are habituated, and where links are made to the autonomic system to produce the symptoms and signs.

Non-NASA Center↗
NASA NTRS1982

Neurochemical background and approaches in the understanding of motion sickness

The problems and nature of space motion sickness were defined. The neurochemical and neurophysiological bases of vestibular system function and of the expression of motion sickness wre reviewed. Emphasis was given to the elucidation of the neuropharmacological mechanisms underlying the effects of scopolamine and amphetamine on motion sickness. Characterization of the ascending reticular activating system and the limbic system provided clues to the etiology of the side effects of scopolamine. The interrelationship between central cholinergic pathways and the peripheral (autonomic) expression of motion sickness was described. A correlation between the stress of excessive motion and a variety of hormonal responses to that stress was also detailed. The cholinergic system is involved in the efferent modulation of the vestibular hair cells, as an afferent modulator of the vestibular nuclei, in the activation of cortical and limbic structures, in the expression of motion sickness symptoms and most likely underscores a number of the hormonal changes that occur in stressful motion environments. The role of lecithin in the regulation of the levels of neurotransmitters was characterized as a possible means by which cholinergic neurochemistry can be modulated.

Kohl, R. L.↗
NASA NTRS1991

Comparison of treatment strategies for space motion sickness

Treatment strategies for space motion sickness were compared using the results of postflight oral debriefings. Standardized questionnaires were administered to all crewmembers immediately following Space Shuttle flights by NASA flight surgeons. Cases of space motion sickness were graded as mild, moderate, or severe based on published criteria, and medication effectiveness was judged based on subjective reports of symptom relief. Since October 1989, medication effectiveness is reported inflight through private medical conferences with the crew. A symptom matrix was analyzed for nineteen crewmembers treated with an oral combination of scopolomine and dextroamphetamine (scopdex) and fifteen crewmembers treated with promethazine delivered by intramuscular or suppository routes. Scopdex has been given preflight as prophylaxis for space motion sickness but analysis showed delayed symptom presentation in nine crewmembers or failed to prevent symptoms in seven.

Davis, J. R.↗
NASA NTRS1983

Etiological factors in space motion sickness

The human susceptibility to motion sickness during exposure to sudden-stop stimulation as a function of gravitoinertial force level is studied. It is determined that susceptibility is greatly enhanced, both with eyes-closed and eyes-open, for zero-g and 2-g conditions in parabolic flight compared with 1-g test conditions. It is argued that this change in susceptibility is related to alterations in vestibulo-occular function which result from variations in gravitoinertial force level, the altered patterns of otolithic activity resulting during variations in gravitoinertial force level, and the altered canal-otolith response synergies that result during exposure to gravitoinertial force levels greater or less than terrestrial levels. These factors are found to be related to the etiology of space motion sickness and to the alterations in performance and vestibular function that are experienced by astronauts during reentry. An explanation is presented for the decrease in susceptibility to motion sickness exhibited by the Skylab astronauts inflight and for some period postflight during exposure to cross-coupled angular accelerations.

Lackner, J. R.↗
NASA NTRS1974

Susceptibility to motion sickness among Skylab astronauts

The mechanisms causing susceptibility to motion sickness in zero gravity are not well understood. Preflight and postflight motion sickness susceptibility tests conducted on the three Skylab crews are described. Under operational conditions, the first Skylab crew experienced no motion sickness, while the other two crews did. Susceptibility was greater in the Skylab workshop than in the command module. Weightlessness in itself is a unique motion environment. Changes occur in nonrigid body parts and in the response of macular receptors in the otolith organs. Tests in parabolic flight, where zero gravity is the only significant factor in motion sickness susceptibility, indicate that some people need to adapt to weightlessness and others do not. A comparison of all US and Soviet manned missions indicates that a headward shift of fluid on transition to zero gravity is not a predisposing factor in motion sickness. Under certain conditions after adaptation susceptibility was lower in the Skylab workshop than on the ground. The anti-motion sickness drugs used in Skylab are judged effective for prevention and treatment.

Graybiel, A.↗