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Visually induced motion sickness (VIMS) is a common side-effect of exposure to virtual reality (VR). Its unpleasant symptoms may limit the acceptance of VR technologies for training or clinical purposes. Mechanical stimulation of the mastoid and diverting attention to pleasant stimuli-like odors or music have been found to ameliorate VIMS. Chewing gum combines both in an easy-to-administer fashion and should thus be an effective countermeasure against VIMS. Our study investigated whether gustatory-motor stimulation by chewing gum leads to a reduction of VIMS symptoms. 77 subjects were assigned to three experimental groups (control, peppermint gum, and ginger gum) and completed a 15-min virtual helicopter flight, using a VR head-mounted display. Before and after VR exposure, we assessed VIMS with the Simulator Sickness Questionnaire (SSQ), and during the virtual flight once every minute with the Fast Motion Sickness Scale (FMS). Chewing gum (peppermint gum: M = 2.44, SD = 2.67; ginger gum: M = 2.57, SD = 3.30) reduced the peak FMS scores by 2.05 (SE = 0.76) points as compared with the control group (M = 4.56, SD = 3.52), p < 0.01, d = 0.65. Additionally, taste ratings correlated slightly negatively with both the SSQ and the peak FMS scores, suggesting that pleasant taste of the chewing gum is associated with less VIMS. Thus, chewing gum may be useful as an affordable, accepted, and easy-to-access way to mitigate VIMS in numerous applications like education or training. Possible mechanisms behind the effect are discussed.

Visually induced motion sickness (VIMS) is a common side effect in virtual environments and simulators. Several countermeasures against VIMS exist, but a reliable method to prevent or ease VIMS is unfortunately still missing. In the present study, we tested whether olfactory cues can alleviate VIMS. Sixty-two participants were exposed to a 15-min-long video showing a first-person-view bicycle ride that had successfully induced VIMS in previous studies. Participants were randomly assigned to one of three groups; the first group was exposed to a pleasant odor (rose) while watching the video, the second group was exposed to an unpleasant odor (leather), and the third group was not exposed to any odor. VIMS was measured using a verbal rating scale (0–20) and the Simulator Sickness Questionnaire. Results showed that only half of the participants who were exposed to the odor did notice it ( n  = 21), whereas the other half failed to detect the odor. However, among those participants who did notice the odor, the rose scent significantly reduced the severity of VIMS compared to the group that did not notice the odor. A moderate positive correlation between odor sensitivity and VIMS showed that participants with higher odor sensitivity also reported stronger VIMS. Our results demonstrate that olfaction can modulate VIMS and that a pleasant odor can potentially reduce VIMS. The relationship between olfactory perception, olfactory sensibility, and VIMS is discussed.

Motion sickness is the cause of major physical discomfort and impaired performance in many susceptible individuals. Some habituate to sea conditions, whereas others remain chronically susceptible, requiring lifelong pharmaceutical treatment. The present study sets out to investigate whether galvanic vestibular stimulation (GVS) coupled with rotatory chair stimulation could mimic sea conditions and alleviate motion sickness symptoms in individuals deemed chronically susceptible. Thirty seasickness susceptible subjects, after at least six months of regular sailing, were enrolled in a prospective, single-blind, randomised controlled study. The treatment group underwent GVS coupled with inverse phase rotatory chair impulse in sinusoidal harmonic acceleration protocol. The control group underwent a sham procedure. All subjects performed repeated velocity step tests to determine the vestibular time constant (Tc) and completed a seasickness questionnaire. The GVS rotatory chair procedure decreased the prevalence of severe seasickness. The number of motion sickness clinic visits and anti-motion sickness drug consumption were reduced in the treatment group three-month post intervention as compared to control. In addition, there was significant reduction of Tc in the treatment group. GVS coupled with rotatory chair impulse could decrease motion sickness severity, induce neurophysiological learning processes and promote habituation to seasickness in chronic susceptible subjects. This is a novel and promising non-pharmacological method to treat motion sickness susceptible individuals. Furthermore, the investigation demonstrated that adaptation to sea conditions may take place even after years of susceptibility to seasickness. This study was retrospectively registered on August 10th 2021 and assigned the identifier number NCT05004818.

Visually induced motion sickness (VIMS) is a well-known sensation in virtual environments and simulators, typically characterized by a variety of symptoms such as pallor, sweating, dizziness, fatigue, and/or nausea. Numerous methods to reduce VIMS have been previously introduced; however, a reliable countermeasure is still missing. In the present study, the effect of airflow and seat vibration to alleviate VIMS was investigated. Eighty-two participants were randomly assigned to one of four groups (airflow, vibration, combined airflow and vibration, and control) and then exposed to a 15 min long video of a bicycle ride shot from first-person view. VIMS was measured using the Fast Motion Sickness Scale (FMS) and the Simulator Sickness Questionnaire (SSQ). Results showed that the exposure of airflow significantly reduced VIMS, whereas the presence of seat vibration, in contrast, did not have an impact on VIMS. Additionally, we found that females reported higher FMS scores than males, however, this sex difference was not found in the SSQ scores. Our findings demonstrate that airflow can be an effective and easy-to-apply technique to reduce VIMS in virtual environments and simulators, while vibration applied to the seat is not a successful method.

Previous literature suggests that the motion sickness susceptibility questionnaire (MSSQ) is inadequate for prediction of motion sickness under naturalistic driving conditions. In this study, we investigated whether visually induced motion sickness using a virtual reality headset could be used as a quick and reliable way to predict participant susceptibility. We recruited 22 participants to complete a two-part experiment. In randomised order, we determined their susceptibility to visual motion sickness and their susceptibility to car sickness. To determine visual susceptibility, the visual scene was sequentially rotated at constant velocity around an earth-vertical yaw axis and rolled about the nasiooccipital axis, in 30 s intervals. Car sickness, on the other hand, was elicited under completely naturalistic conditions, being driven in the backseat of a car in the city of Delft, performing a visual task on a laptop. Sickness ratings were collected at regular intervals in both parts of the experiment. We found that the frequencies excited by naturalistic driving are very low, which has important consequences for motion sickness modelling and mitigation in automated vehicles. We found that individual car sickness correlated positively with visual motion sickness. This indicates that both are influenced by a common sickness susceptibility factor. Car sickness correlated similarly with visual motion sickness and MSSQ. Overall, our results indicate that combining measurements of sickness responses to a visual stimulus and MSSQ can yield a reliable method for determining individual sickness susceptibility. To this end the visual stimulus and the weighting with MSSQ responses can be refined using a much larger sample and considering additional visual conditions in driving.

Objectives To evaluate effects of optokinetic and rotational stimulus in individuals with and without motion sickness (MS) using fHIT. Methods The study included subjects aged 18–40; 35 subjects with MS for MS group and 35 subjects without vertigo for control group. Percentage of the correct answer (% CA) with and without optokinetic stimulus (o-fHIT) in the frontal plane in the fHIT test was compared in both groups. In addition, both group subjects were seated on an ordinary rotating office chair. % CA was compared between groups by applying rotational fHIT (r-fHIT) test after the subjects were rotated randomly to the right and left and also simultaneously moved their heads in the vertical plane. Results There was no significant difference in % CA in fHIT o-fHIT and r-fHIT in the control group. Both groups showed a significant difference in % CA for fHIT, o-fHIT, and r-fHIT for all SCCs ( p  < 0.05). Conclusions Since individuals with MS are affected by optokinetic and rotational stimuli, fHIT performed after these stimuli can be used as an objective confirming test for diagnosing MS.

Anecdotal reports suggest that motion sickness may occur among users of contemporary, consumer-oriented head-mounted display systems and that women may be at greater risk. We evaluated the nauseogenic properties of one such system, the Oculus Rift . The head-mounted unit included motion sensors that were sensitive to users’ head movements, such that head movements could be used as control inputs to the device. In two experiments, seated participants played one of two virtual reality games for up to 15 min. In Experiment 1, 22% of participants reported motion sickness, and the difference in incidence between men and women was not significant. In Experiment 2, motion sickness was reported by 56% of participants, and incidence among women (77.78%) was significantly greater than among men (33.33%). Before participants were exposed to the head-mounted display system, we recorded their standing body sway during the performance of simple visual tasks. In both experiments, patterns of pre-exposure body sway differed between participants who (later) reported motion sickness and those who did not. In Experiment 2, sex differences in susceptibility to motion sickness were preceded by sex differences in body sway. These postural effects confirm a prediction of the postural instability theory of motion sickness. The results indicate that users of contemporary head-mounted display systems are at significant risk of motion sickness and that in relation to motion sickness these systems may be sexist in their effects.

Transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive form of electrical brain stimulation, has shown potent therapeutic potential for a wide spectrum of conditions. How taVNS influences the characterization of motion sickness – a long mysterious syndrome with a polysymptomatic onset – remains unclear. Here, to examine taVNS-induced effects on brain function in response to motion-induced nausea, 64-channel electroencephalography (EEG) recordings from 42 healthy participants were analyzed; collected during nauseogenic visual stimulation concurrent with taVNS administration, in a crossover randomized sham-controlled study. Cortical neuronal generators were estimated from the obtained EEG using exact low-resolution brain electromagnetic tomography (eLORETA). While both sham and taVNS increased insula activation during electrical stimulation, compared to baseline, taVNS additionally augmented middle frontal gyrus neuronal activity. Following taVNS, brain regions including the supramarginal, parahippocampal, and precentral gyri were activated. Contrasting sham, taVNS markedly increased activity in the middle occipital gyrus during stimulation. A repeated-measures ANOVA showed that taVNS reduced motion sickness symptoms. This reduction in symptoms correlated with taVNS-induced neural activation. Our findings provide new insights into taVNS-induced brain changes, during and after nauseogenic stimuli exposure, including accompanying behavioral response. Together, these findings suggest that taVNS has promise as an effective neurostimulation tool for motion sickness management.

Sensory conflicts are widely recognized as the primary drivers of motion sickness (MS), though the underlying integrative processes remain poorly understood. This study investigated sensory reweighting following exposure to two different sensory conflict paradigms. Visual and vestibular reflexes were assessed before and after sensory conflict. In the first paradigm, participants were exposed to a visuo‐vestibular conflict using visually induced illusory motion (vection) in two environments in immersive virtual reality. In the second paradigm, vestibular conflict was induced by gravitational changes in parabolic flight. Semi‐circular canal integration was measured via the vestibulo‐ocular reflex (VOR) suppression task, while visual weight was assessed through optokinetic nystagmus (OKN). Our findings revealed that, following virtual reality exposure, VOR response decreased by 12%, indicating a reduced reliance on vestibular inputs. Conversely, after parabolic flight, OKN performance was diminished by 13%, indicating a diminished weight of visual inputs. These findings suggest that the sensory modality failing to detect the motion was considered less reliable and therefore assigned a reduced contribution during the integration process, regardless of its actual accuracy. Additionally, visual sensitivity was associated with increased susceptibility to cybersickness, whereas vestibular sensitivity seemed to correlate MS severity in parabolic flight. Altogether, our data suggest that the sensitivity of the most stimulated sensory modality during a sensory conflict may predict an individual's susceptibility to MS. What is the central question of this study? How does brief exposure to different types of motion sickness influence sensory reweighting? What is the main finding and its importance? Sensory reweighting is elicited through brief and specific exposure to motion sickness, with adaptive responses varying between space‐induced and Earth‐like motion cues. Regardless of their reliability, motionless cues are consistently downweighted. Furthermore, the severity of motion sickness is modulated by individual sensitivity to the activated sensory inputs, which differs across various provocative sensory environments.

This article presents a review of the current findings related to neurovestibular physiology, aetiology, and proposed theories on space motion sickness (SMS) during acute and sustained exposure to microgravity. The review discusses the available treatment options including medication and nonpharmacological countermeasure methods that help to prevent the development of SMS in weightlessness. Ground-based simulations using virtual reality, flight simulations, and Barany's chairs can be applied to study SMS and demonstrate its signs and symptoms to space crew members. Space motion sickness has been observed in approximately 70% of astronauts within the first 72 h in microgravity, having in general an instantaneous onset of signs and symptoms. Stomach discomfort, nausea, vomiting, pallor, cold sweating, salivation, tachypnoea, belching, fatigue, drowsiness, and stress hormone release have been documented. This can have detrimental effects on the well-being of astronauts in the initial phase of a space mission. Mental and physical performance may be affected, jeopardizing operational procedures and mission safety.