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All sourcesNASA NTRSDOE OSTI
NASA NTRS1987

Hormonal responses of metoclopramide-treated subjects experiencing nausea or emesis during parabolic flight

The concentrations of adrenocorticotropic hormone (ACTH), vasopressin (AVP), epinephrine (EPI), and norepinephrine (NE) in 22 subjects administered 10 to 20 mg of metoclopramide prior to parabolic flight are measured. The effect of metoclopramide on motion sickness is examined. It is observed that metoclopramide is ineffective in the modulation of motion sickness due to stressful linear and angular acceleration and orbital flight, and it does not affect serum hormones prior to parabolic flight. It is detected that the serum level of AVP declines following emesis induced by parabolic flight and stressful angular acceleration; the serum levels of ACTH and EPI are elevated by parabolic flight and stressful angular acceleration; and serum NE is significantly elevated immediately following emesis. The possible roles of these hormones in the etiology of space motion sickness are discussed.

Kohl, Randall L.↗
NASA NTRS2017

Stroboscopic Goggles as a Countermeasure for Dynamic Visual Acuity and Landing Sickness After Long-Duration Spaceflight

Gravity transitions cause changes in the vestibulo-occular reflex (VOR), which manifests as poor gaze control, a decrement in dynamic visual acuity (the ability to maintain gaze while in motion), both of which are caused by retinal slip. Retinal slip, the inability to keep an image focused on the retina, can drive or worsen sensory conflict, resulting in motion sickness (MS). Currently 100% of returning crewmembers report MS symptoms, which might affect their ability to perform mission critical tasks immediately after landing. Reschke et al. (2007) demonstrate that stroboscopic vision goggles improve motion sickness onset and symptom severity in motion sickness driven by retinal slip.

Rosenberg, M. J. F.↗
NASA NTRSDate not supplied

Neuro-Vestibular Examination During and Following Spaceflight (Vestibular Health)

BACKGROUND Adaptation to microgravity during spaceflight causes neurological disturbances that are either directly or indirectly mediated by the vestibular system. These disturbances can include space motion sickness, spatial disorientation, and cognitive impairment, as well as changes in head-eye coordination, vestibulo-ocular reflexes, and control of posture and locomotion. Otolith-mediated reflex gains appear to adapt rapidly during spaceflight and after landing. However, animal studies have shown that structural modifications of the vestibular sensory apparatus develop during long-duration spaceflight. To date, no studies have characterized the severity of vestibular syndromes experienced by astronauts as a function of the duration of spaceflight or whether the effects are caused by changes at the peripheral end organs, midbrain, cerebellum, or vestibular cortex. OBJECTIVES We are investigating temporal vestibular changes in crewmembers of short, 6-month, and one-year missions to identify trends in adaptation of vestibular health and performance in orbit and after landing. We are also differentiating between peripheral and central vestibular forms of vertigo and oculomotor disorders. METHODS Recordings of eye, head, and body movements, as well as subjective reports of perception of motion, are being used to determine the presence of abnormal eye movements, dysmetria, motion sickness symptoms, and illusions of motion during head or body movements. This includes characterization of temporal trends in central compensation for vestibular (otolith) asymmetry. In-flight examinations are being performed early in the mission (Flight Days 1 and 30) and once every 2-3 months thereafter. Postflight examinations are performed after return (R) from the mission on R+0, R+4, R+9, and R+30. The inflight and postflight motion sickness questionnaires are customized to support data sharing across related studies. Ground-based control testing has been performed on healthy volunteers(18 females, 14 males;38.6 ± 9.2 years) in the laboratory to estimate mean normative responses, and on patients with bilateral vestibulopathy (BVP) (17 females, 13 males; 60.6 ± 13.0 years) at the University of Caen. RESULTS As of September 2024, two crewmembers have completed all preflight, inflight, and postflight testing. Additional crewmembers are currently enrolled and data collection is currently ongoing. For ground testing, BVP patients performed similarly to previous postflight astronauts on R+0 in various walking performance tasks. Three additional body movement perception tasks have been tested. For the Triangle Completion Task, BVP patients had a larger mean angle of deviation and longer mean distance than healthy controls. For the Self-Rotation Task and Distance Perception Task, BVP patients had larger errors than healthy controls. These data suggest that vestibular deficiencies impact all aspects of body movement perception tested; whereas previous studies suggest that vestibular deficiencies are only associated with directional errors, not with overall trajectories/path lengths. These data will be compared to those of crewmembers during early postflight readaptation. RELEVANCE If the observed symptoms in crewmembers are more deleterious after the year-long missions than those documented after 6-month missions, then relevant countermeasures will be required to maintain the health and operational performance of astronauts during longer missions. Depending on the etiology of the vestibular syndrome revealed by these tests, countermeasures will be proposed based on vestibular rehabilitation therapies currently used in patients with vestibular disorders, such as habituation, gaze stabilization, and/or balance training exercises. ACKNOWLEDGEMENT This work is supported by NASA’s Human Research Program Human Health Countermeasures Element.

T R Macaulay↗
NASA NTRSDate not supplied

The Examination of Individual Factors and AFTE Training Outcomes

Introduction: Motion sickness is common among military aviators. It describes a specific group of symptoms that include epigastric awareness, nausea, pallor, sweating, salivation, and fatigue. Occurrences of these symptoms can pose a significant risk to safety and adversely impact mission success. Accordingly, researchers have developed specific interventions to act as countermeasures. For example, Autogenic Feedback Training Exercise has been empirically validated as a training method that mitigates the impact of motion sickness. However, it remains unclear the extent to which individual factors moderate (or mediate) the effects of this intervention. The examination of individual factors such as interoceptive accuracy (IA) and specific personality traits might provide insight into whom may benefit most from AFTE. Methods: Participants were administered the Big Five Inventory (BFI) and State Trait Anxiety Inventory (STAI). In addition, they were given an interoceptive accuracy task (i.e., heartbeat counting task). The participants’ reported value was then compared to the actual number of heart beats obtained via ECG. Completion of the IA task was followed by pre- AFTE and Post-AFTE rotating chair tests to evaluate motion sickness and the effects of AFTE training. Results: Participants (n=16) were evaluated on IA, personality factors (i.e., BFI & STAI) and performance on the rotating chair. IA was unrelated to personality traits (p > .05), but inversely related to state anxiety post training (p < .05). Finally, IA did not predict performance (i.e., rotations or minutes tolerated ?) on rotating chair F (1, 14) = 1.18, p> .05). Discussion:(1) IA is unrelated to personality traits as measured by BFI and STAI. (2) Individual factors are unrelated to AFTE training outcome. (3) AFTE training can be beneficial for all.

motion sickness↗
NASA NTRS1987

Mechanisms of antimotion sickness drugs

Eight subjects, male and female, were rotated using the step method to progressively increase the speed of rotation (+2 rpm) after every 40 head movements to a maximum of 35 rpm. The end point for motion sickness was the Graybiel Malaise III total of symptoms short of frank nausea. The drug treatments were placebo, scopolamine 0.6 mg and 1 mg, scopolamine 0.6 mg/d-amphetamine 10 mg, scopolamine 1 mg/d-amphetamine 10 mg, and amphetamine 10 mg. Scopolamine increased tolerated head movements over placebo level by + 81; scopolamine 1 mg + 183; d-amphetamine by + 118; scopolamine 0.6/d-amphetamine by + 165; and scopolamine 1 mg/d-amphetamine 10 mg by + 201. The drugs effective in preventing motion sickness are considered to be divided into those with central acetylcholine blocking activity and those which enhance norepinephrine activity. A combination of both of these actions produces the most effective antimotion sickness medications. It is concluded that the balance between the acetylcholine and norepinephrine activity in the CNS appears to be responsible for motion sickness.

Wood, C. D.↗
NASA NTRS1992

Therapeutic effectiveness of medications taken during spaceflight

The therapeutic effectiveness of medications during spaceflight is considered in light of extensive anecdotal and experimental evidence. Attention is given to a range of medications for space motion sickness, sleeplessness, and physical discomfort. About 70 individual cases are reviewed in which crewmembers used such medications as: (1) scopolamine hydrobromide, dextroamphetamine sulfate, and promethazine hydrochloride for motion sickness; (2) metoclopramide hydrochloride and naloxone hydrochloride for bowel motility; and (3) aspirin and acetaminophen for headache and back pain. The effectiveness of orally ingested medications for space motion sickness is shown to be very low, while promethazine hydrochloride is effective when administered intramuscularly. The medications for pain are shown to be generally effective, and the use of sleep-inducing medications is limited by potentially detrimental performance effects.

Pool, Sam L.↗
NASA NTRS2007

Relative Bioavailability of Scopolamine Dosage Forms and Interaction with Dextroamphetamine

The NASA Reduced Gravity Office (RGO) uses scopolamine (SCOP) and in combination with dextoamphetamine (DEX) to manage motion sickness symptoms during parabolic flights. The medications are dispensed as custom dosage forms as gelatin capsules. Anecdotal evidence of efficacy suggests that these formulations are unreliable and less efficacious for the treatment of motion sickness. We estimated bioavailability of four different oral formulations used by NASA for the treatment of motion sickness. Twelve healthy, non-smoking subjects between 21and 48 years of age received four treatments on separate days in a randomized fashion; the treatments were 0.8 mg SCOP alone as tablet, 0.8 mg SCOP alone in gel cap, 0.8 mg SCOP and 10 mg DEX as tablets, and 0.8 mg SCOP and 10 mg DEX in gel cap. After each treatment, blood, saliva, and urine samples were collected at scheduled time intervals for 24 h after dosing. Bioavailability and pharmacokinetic parameters were calculated and compared using ANOVA. After administration of SCOP tablets alone, maximum concentration (C(sub max)) and time for maximum concentration (t(sub max)) were 0.26 plus or minus 0.04 ng/mL and 0.71 plus or minus 0.02 h, respectively; volume of distribution, and clearance were 47.6 plus or minus 4.72 L/kg and 23.0 plus or minus 4.58 L/h/kg, respectively. SCOP t(sub max) after administration as gelcaps was significantly longer than that with tablets (1.04 h, p less than 0.05), but no significant differences in other pharmacokinetic parameters of SCOP were observed between the two dosage forms. When coadministered with DEX, the area underneath the concentration versus time curve (AUC) of SCOP was significantly reduced to 0.61 plus or minus 0.09 and 0.64 plus or minus 0.11 ng (raised dot) h/mL after administration as a tablet or gelcap formulation, respectively; SCOP C(sub max) was lower after coadministration with DEX, this difference, however, was not statistically significant. Delayed absorption with gelcaps coupled with reduced bioavailability with DEX coadministration may have resulted in the observed treatment failure with some of these formulations. This could result from failure to reach minimum effective concentrations after treatment with gelcap formulations before parabolic flights. A new nomogram for dosing is proposed for treatment with SCOP gelcaps or SCOP-DEX combination.

Boyd, Jason L.↗
NASA NTRS1981

Vestibular experiments

Spacelab experiments designed to investigate space motion sickness, any associated changes in otolith-mediated responses occurring during weightlessness, and the carryover of any such changes to postflight conditions are described. The experiments aimed at assessing otolithic responses in space are intended to clarify presumed alterations in vestibular function during weightlessness. Vestibular function will be investigated at several levels: vestibulo-ocular reflexes, vestibulo-spinal pathways, cortical functions involving perception of motion and spatial orientation, visual vestibular interaction, and motion sickness susceptibility. A second major objective relates to space motion sickness and man's well-being and productivity in space.

Young, L. R.↗
NASA NTRS1998

Bioavailability of intranasal promethazine dosage forms in dogs

Intramuscular promethazine (PMZ) is used aboard the US Space Shuttle to ameliorate symptoms of space motion sickness. Bioavailability after an oral dose of PMZ during space flight is thought to be impaired because of gastrointestinal disturbances associated with weightlessness and space motion sickness. In an attempt to find an alternative dosage form for use in space, we evaluated two intranasal (i.n.) dosage forms of PMZ in dogs for absorption and bioavailability relative to that of an equivalent intramuscular dose. Promethazine (5 mg kg-1) was administered as two intranasal dosage forms and as an intramuscular (i.m.) dose to three dogs in a randomised cross-over design. Serial blood samples were taken and analysed for PMZ concentrations and the absorption and bioavailability of PMZ were calculated for the three dosage forms. PMZ absorption from the carboxymethyl cellulose microsphere i.n. dosage form was more rapid and complete than from the myverol cubic gel formulation or from an i.m. injection. Bioavailability of the microsphere formulation was also greater than that of the gel formulation (AUC 3009 vs 1727 ng h ml-1). The bioavailability of the two i.n. dosage forms (relative to that of the i.m. injection) were 94% (microsphere) and 54% (gel). The i.n. microsphere formulation of PMZ offers great promise as an effective non-invasive alternative for treating space motion sickness due to its rapid absorption and bioavailability equivalent to the i.m. dose.

NASA Center JSC↗
NASA NTRS1989

Studies of the horizontal vestibulo-ocular reflex in spaceflight

Changes in the vestibulo-ocular reflex (VOR) during space flight have been suspected of contributing to space motion sickness. The horizontal VOR was studied in nine subjects on two space shuttle missions. Active unpaced head oscillation at 0.3 Hz was used as the stimulus to examine the gain and phase of the VOR with and without visual input, as well as the visual suppression of the reflex. No statistically significant changes were noted inflight in the gains or phase shifts of the VOR during any test condition, or between space motion sickness susceptible and nonsusceptible populations. Although VOR suppression was unaffected by spaceflight, the space motion sickness-susceptible group tended to exhibit greater error in the suppression than the nonsusceptible group. It is concluded that at this stimulus frequency, VOR gain is unaffected by space-flight, and any minor individual changes do not seem to contribute to space motion sickness.

Thornton, William E.↗
NASA NTRS1991

Recovery of the vomiting reflex following area postrema ablation in squirrel monkeys

Current theory and recent evidence suggest that motion sickness occurs under conditions of sensory input in which the normal motor programs for producing eye, head, and body movements are not functionally effective, i.e. under conditions in which there are difficulties in maintaining posture and controlling eye movements. Conditions involving conflicting or inconsistent visual-vestibular (VV) simulation should thus result in greater sickness rates since the existing motor programs do not produce effective control of eye-head-body movements under such conditions. We feel that the relationship of postural control to motion sickness is an important one and one often overlooked. We reported the results of a study which showed that when postural requirements were minimized by fully restraining squirrel monkeys during hypogravity parabolic flight, no animals became motion sick, but over 80% of the same 11 animals became sick if they were unrestrained and maintained control of their posture.

Nancy G Daunton↗
NASA NTRS1982

Conditioned feeding suppression in rats produced by cross-coupled and simple motions

Results are presented of an experiment on the induction of motion sickness in rats by the use of cross-coupled accelerations of magnitudes similar to those used in human experiments. Accelerations were produced in a seesaw apparatus with rotating disks supporting the animal cages mounted on each seesaw arm, and motion sickness was assessed according to the consumption of a sweet food previously offered to the animals immediately before the motion treatment. During a 1-hour test session 72 h after motion treatment and after a 24-h fast, rats having undergone cross-coupled vertical sinusoidal and rotational motion are observed to consume less food than those having experienced either type of motion alone, or no motion. The ordering of the conditioned suppressive feeding effects is consistent with the amounts of vestibular stimulation produced by the respective motions. The results support the existence of motion sickness effects in rats, even though they are unable to vomit.

Fox, R. A.↗
NASA NTRS1973

Findings on American astronauts bearing on the issue of artificial gravity for future manned space vehicles

Findings for American astronauts are reviewed that may indicate some alteration in vestibular response related to exposure to zero gravity. Of 25 individuals participating in Apollo missions 7 through 15, nine have experienced symptomatology that could be related to motion sickness. The apparent divergence between these results and those from the Soviet space program, which initially appears great, may reflect the greater emphasis given by Soviet investigators to vestibular aberrations. Presently the incidence of motion sickness, long known as an indicator of vestibular disturbance, seems too low to warrant any positive statement regarding inclusion of an artificial gravity system in future long term space missions. Where motion sickness has occurred, adaptation to weightlessness has always resulted in abatement of symptoms. In the absence of biomedical justification for incorporating artificial gravity systems in long term space flight vehicles, engineering considerations may dictate the manner in which the final ballot is cast.

Berry, C. A.↗
NASA NTRS2002

Changes in gastric myoelectric activity during space flight

The purpose of the present study was to examine postprandial myoelectric activity of the stomach and gastric activity associated with space motion sickness using electrogastrography. Three crewmembers participated in this investigation. Preflight, subjects exhibited normal postprandial responses to the ingestion of a meal. Inflight, crewmembers exhibited an abnormal decrease in the power of the normal gastric slow wave after eating on flight day 1, but had a normal postprandial response by flight day 3. Prior to and during episodes of nausea and vomiting, the electrical activity of the stomach became dysrhythmic with 60-80% of the spectral power in the bradygastric and tachygastric frequency ranges. These findings indicate that gastric motility may be decreased during the first few days of space flight. In addition, changes in the frequency of the gastric slow wave associated with space motion sickness symptoms are consistent with those reported for laboratory-induced motion sickness.

STS Shuttle Project↗
NASA NTRS1994

Use of promethazine to hasten adaptation to provocative motion

In an earlier study, the authors found that severely motion sick individuals could be greatly relieved of their symptoms by intramuscular injections of promethazine (50 mg) or scopolamine (.5 mg). Comparable 50-mg injections of promethazine also have been found effective in alleviating symptoms of space motion sickness. The concern has risen, however, that such drugs may delay or retard the acquisition of adaptation to stressful environments. In the current study, we controlled arousal using a mental arithmetic task and precisely equated the exposure history (number of head movements during rotation) of a placebo, control group and an experimental group who had received promethazine. No differences in total adaptation or in rates of adaptation were present between the two groups. Another experimental group also received promethazine and was allowed to make as many head movements as they could, before reaching nausea, up to 800. This group showed a greater level of adaptation than the placebo group. These results suggest a strategy for dealing with space motion sickness that is described.

Non-NASA Center↗
NASA NTRS1988

Ground-based training for the stimulus rearrangement encountered during spaceflight

Approximately 65-70% of the crew members now experience motion sickness of some degree during the first 72 h of orbital flight on the Space Shuttle. Lack of congruence among signals from spatial orientation systems leads to sensory conflict, which appears to be the basic cause of space motion sickness. A project to develop training devices and procedures to preadapt astronauts to the stimulus rearrangements of microgravity is currently being pursued. The preflight adaptation trainers (PATs) are intended to: demonstrate sensory phenomena likely to be experienced in flight, allow astronauts to train preflight in an altered sensory environment, alter sensory-motor reflexes, and alleviate or shorten the duration of space motion sickness. Four part-task PATs are anticipated. The trainers are designed to evoke two adaptation processes, sensory compensation and sensory reinterpretation, which are necessary to maintain spatial orientation in a weightless environment. Recent investigations using one of the trainers indicate that self-motion perception of linear translation is enhanced when body tilt is combined with visual surround translation, and that a 270 degrees phase angle relationship between tilt and surround motion produces maximum translation perception.

Non-NASA Center↗
NASA NTRS1977

Successful trnasfer of adaptation environments in navy flight training

Two flight students, grounded for the reason they were highly susceptible to motion sickness, completed their training after gradually adapting 10 rpm, achieved by executing head movements during small stepwise increases in angular velocity. Subject 1 executed a total of about 77,000 head movements within a period of five months and Subject 2 executed about 108,000 head movements within a period of 42 days. The transfer of the adaptation acquired in the laboratory to most motion environments aloft was good; the notable exception involved weightless maneuvers in the case of Subject 1. Both were on flight status when contacted recently. The current motion sickness susceptibility in Subject 1 in the fall of 1975 was assessed. He reached a (mild) motion sickness endpoint, in the rotating room, at 17 rpm; the average endpoint is 7 to 8 rpm. Some practical and theoretical implications are discussed.

Cramer, D. B.↗
NASA NTRS1992

Catecholaminergic responses to stressful motion stimuli, scopolamine plus amphetamine, and dexamethasone

Peripheral levels of epinephrine (EPI) and neoepinephrine (NE) generally rise following stressful motion stimuli. Effective anti-motion sickness drugs, scopolamine plus, d-amphetamine (S/D) and dexamthasone (DEX) modulate release of EPI and NE. This modulation may be of etiological relevance. Methods: Severe nausea was induced by exposure to coriolis simulation using a rotating chair. Chronic administration of S/D (0.4 and 5 mg/da) DEX (3 mg/day) and placebo preceded coriolis simulation. EPI and NE were measured immediately before and after simulation. A double-blind crossover design was used. Results: Nausea-induced elevations of EPI (2.5 fold, p less than .01) and NE were not diminished upon repeated exposure and adaptation to the stressor. Subjects with more pronounced elevations of EPI following simulation displayed higher resistance to stressful motion (p less .05). Alteration of peripheral catechlomaine levels following drug suggested that motion sickness was not mediated by peripheral catechlolamine receptor simulation. EPI and NE levels were 2.8 and 3.6-fold higher (p less than .03 and .01) after nausea without DEX treatment. DEX loading halved pre-stress levels of EPI and NE (p less than .05). Conclusions: Marked differences were noted in individual responses to drug and systematic responses of EPI and NE. It is possible that the responses of EPI to motion sickness may predict resistance to stressful motion and represent a peripheral manifestation of some as yet unknown central event of etiologic relevance.

Kohl, R. L.↗