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Pathophysiology and treatment of motion sickness

Golding, John F.a; Gresty, Michael A.b

doi: 10.1097/WCO.0000000000000163
NEURO-OPHTHALMOLOGY AND NEUROOTOLOGY: Edited by Jose-Alain Sahel and Joseph Furman

Purpose of review: Motion sickness remains bothersome in conventional transport and is an emerging hazard in visual information technologies. Treatment remains unsatisfactory but advances in brain imaging, neurophysiology, and neuropharmacology may provide insights into more effective drug and behavioural management. We review these major developments.

Recent findings: Recent progress has been in identifying brain mechanisms and loci associated with motion sickness and nausea per se. The techniques have included conventional neurophysiology, pathway mapping, and functional MRI, implicating multiple brain regions including cortex, brainstem, and cerebellum. Understanding of the environmental and behavioural conditions provocative of and protective against motion sickness and how vestibular disease may sensitize to motion sickness has increased. The problem of nauseogenic information technology has emerged as a target for research, motivated by its ubiquitous applications. Increased understanding of the neurophysiology and brain regions associated with motion sickness may provide for more effective medication in the future. However, the polysymptomatic nature of motion sickness, high interindividual variability, and the extensive brain regions involved may preclude a single, decisive treatment.

Summary: Motion sickness is an emerging hazard in information technologies. Adaptation remains the most effective countermeasure together with established medications, notably scopolamine and antihistamines. Neuropharmacological investigations may provide more effective medication in the foreseeable future.

aDepartment of Psychology, University of Westminster

bDivision of Brain Sciences (Neuro-Otology Unit), Imperial College London, Charing Cross Hospital, London, UK

Correspondence to Prof John F. Golding, Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK. Tel: +44 2079115000; e-mail: goldinj@westminster.ac.uk

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