Vestibular findings in motion sickness

  • Mehrnaz Hosseini Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Saeid Farahani Mail Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Mansoureh Adel Ghahraman Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Shohreh Jalaie Biostatistics, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Aboulfazl Khademi Department of Aerospace Medicine, AJA University of Medical Sciences, Tehran, Iran
Motion sickness, vestibular test, electronystagmography, vestibular evoked myogenic potentials


Background and Aim: Motion sickness (MS) is usually generated when there is a mismatch between the senses which serve balance. One of these senses is related to vestibular system, so it is highly possible that MS reflects in vestibular test results. But there are some conflicts in correlation between vestibular findings and MS. Thus, the objective of this study was to provide an overview of vestibular tests findings in individuals with MS.
Recent Findings: It has been demonstrated that susceptible subjects to different types of MS have more pathologic results in vestibular tests, such as eye movement recordings and vestibular evoked myogenic potentials (VEMPs) results, asymmetry ratios and posturography results in particular.
Conclusion: Based on abnormalities in various vestibular tests related to MS, possible contribution of signals from any part of the vestibular organ is likely in sensory conflict and triggering MS. Vestibular test results apparently can separate subjects with different susceptibilities to MS, but it seems difficult to differentiate susceptibilities to various types of MS.


Reason JT, Brand JJ. Motion sickness. vii 310 pp. Oxford: Academic press; 1975.
2. Ventre-Dominey J, Luyat M, Denise P, Darlot C. Motion sickness induced by otolith stimulation is correlated with otolith-induced eye movements. Neuroscience. 2008;155(3):771-9.
3. Bos JE, Bles W, Groen EL. A theory on visually induced motion sickness. Displays. 2008;29(2):47-57.
4. Cuthbert SC. Proposed mechanisms and treatment strategies for motion sickness disorder: a case series. J Chiropr Med. 2006;5(1):22-31.
5. Schmäl F. Neuronal mechanisms and the treatment of motion sickness. Pharmacology. 2013;91(3-4):229-41.
6. Spinks AB, Wasiak J, Villanueva EV, Bernath V. Scopolamine (hyoscine) for preventing and treating motion sickness. Cochrane Database Syst Rev. 2007;(3):CD002851.
7. Pethybridge R. Sea sickness incidence in Royal Navy ships. INM Report. 1982;37:82.
8. Antuñano MJ, Hernandez JM. Incidence of airsickness among military parachutists. Aviat Space Environ Med. 1989;60(8):792-7.
9. Cowings PS, Toscano WB, DeRoshia C, Tauson RA. The effects of the command and control vehicle (C2V) operational environment on soldier health and performance. No. ARL-MR-468. Army Research Lab Aberdeen Proving Ground MD, 1999.
10. Lawther A, Griffin M. A survey of the occurrence of motion sickness amongst passengers at sea. Aviat Space Environ Med. 1988;59(5):399-406.
11. Stanney KM, Hale KS, Nahmens I, Kennedy RS. What to expect from immersive virtual environment exposure: Influences of gender, body mass index, and past experience. Hum Factors. 2003 ;45(3):504-20.
12. Turner M. Motion sickness in public road transport: passenger behaviour and susceptibility. Ergonomics. 1999;42(3):444-61.
13. Turner M, Griffin MJ, Holland I. Airsickness and aircraft motion during short-haul flights. Aviat Space Environ Med. 2000;71(12):1181-9.
14. Klosterhalfen S, Kellermann S, Pan F, Stockhorst U, Hall G, Enck P. Effects of ethnicity and gender on motion sickness susceptibility.
15. Dobie T, McBride D, Dobie Jr T, May J. The effects of age and sex on susceptibility to motion sickness. Aviat Space Environ Med. 2001;72(1):13-20.
16. Flanagan MB, May JG, Dobie TG. Sex differences in tolerance to visually-induced motion sickness. Aviat Space Environ Med. 2005;76(7):642-6.
17. Cooper C, Dunbar N, Mira M. Sex and seasickness on the Coral Sea. Lancet. 1997;350(9081):892.
18. Shupak A, Gordon CR. Motion sickness: advances in pathogenesis, prediction, prevention, and treatment. Aviat Space Environ Med. 2006;77(12):1213-23.
19. Reavley CM, Golding JF, Cherkas LF, Spector TD, MacGregor AJ. Genetic influences on motion sickness susceptibility in adult women: a classical twin study. Aviat Space Environ Med. 2006 ;77(11):1148-52.
20. Marcus DA, Furman JM, Balaban CD. Motion sickness in migraine sufferers. Expert Opin Pharmacother. 2005;6(15):2691-7.
21. Bosser G, Caillet G, Gauchard G, Marçon F, Perrin P. Relation between motion sickness susceptibility and vasovagal syncope susceptibility. Brain research bulletin.Brain Res Bull. 2006;68(4):217-26.
22. Treisman M. Motion sickness: An evolutionary hypothesis. Science. 1977;197(4302):493-5.
23. Crampton GH. Motion and space sickness. 1st ed. Boca Raton: CRC Press; 1990.
24. Oman CM. Motion sickness: a synthesis and evaluation of the sensory conflict theory. Can J Physiol Pharmacol. 1990;68(2):294-303.
25. Reason JT. Motion sickness adaptation: a neural mismatch model. J R Soc Med. 1978 ;71(11):819-29.
26. Keshavarz B, Hecht H. Validating an efficient method to quantify motion sickness. Hum Factors. 2011;53(4):415-26.
27. Flanagan MB, May JG, Dobie TG. The role of vection, eye movements and postural instability in the etiology of motion sickness. J Vestib Res. 2004;14(4):335-46.
28. Dai M, Raphan T, Cohen B. Labyrinthine lesions and motion sickness susceptibility. Exp Brain Res. 2007;178(4):477-87.
29. DiZio P, Lackner JR. Motion sickness susceptibility in parabolic flight and velocity storage activity. Aviat Space Environ Med. 1991;62(4):300-7.
30. Thornton WE, Uri JJ. Oculomotor function during space flight and susceptibility to space motion sickness. Acta Astronaut. 1991;23:53-61.
31. Nachum Z, Gordon CR, Shahal B, Spitzer O, Shupak A. Active high-frequency vestibulo-ocular reflex and seasickness susceptibility. Laryngoscope. 2002 Jan;112(1):179-82.
32. Gordon C, Spitzer O, Doweck I, Shupak A, Gadoth N. The vestibulo-ocular reflex and seasickness susceptibility. J Vestib Res. 1996;6(4):229-33.
33. Kolev O, Tibbling L. Vestibular and cardiac reactions to open-sea exposure. J Vestib Res. 1992;2(2):153-7.
34. Norfleet W, Peterson R, Hamilton R, Olstad C. Susceptibility of divers in open water to motion sickness. Undersea Biomed Res. 1992;19(1):41-7.
35. Cha YH, Brodsky J, Ishiyama G, Sabatti C, Baloh RW. Clinical features and associated syndromes of mal de debarquement. J Neurol. 2008;255(7):1038-44.
36. Teramoto K, Sakata E, Ohtsu K. Visual suppression test using post-rotatory nystagmus: clinical course in patients with motion sickness. Acta Otolaryngol Suppl. 1991;481:498-501.
37. Stern RM, Hu S, Anderson RB, Leibowitz HW, Koch KL. The effects of fixation and restricted visual field on vection-induced motion sickness. Aviat Space Environ Med. 1990;61(8):712-5.
38. Diamond SG, Markham CH. Prediction of space motion sickness susceptibility by disconjugate eye torsion in parabolic flight. Aviat Space Environ Med. 1991;62(3):201-5.
39. Markham C, Diamond S. Further evidence to support disconjugate eye torsion as a predictor of space motion sickness. Aviat Space Environ Med. 1992;63(2):118-21.
40. Markham C, Diamond S. A predictive test for space motion sickness. J Vestib Res. 1993 ;3(3):289-95.
41. Peterka RJ. Torsional vestibulo-ocular reflex measurements for identifying otolith asymmetries possibly related to space motion sickness susceptibility. Acta Astronaut. 1994;33:1-8.
42. Wang L. Ocular counterrolling as an indicator of vestibular otolith function. Space Med Med Eng (Beijing). 1999;12(3):231-4. Chinese.
43. Parker DE. The relative roles of the otolith organs and semicircular canals in producing space motion sickness. J Vestib Res. 1998;8(1):57-9.
44. Gurovskiy NN, Bryanov II, Yegorov AD. Changes in the vestibular function during space flight. Acta Astronaut. 1975;2(3-4):207-16.
45. Matsnev E, Kuz'min M, Zakharova L. Comparative assessment of vestibular, optokinetic, and optovestibular stimulation in the development of experimental motion sickness. Aviat Space Environ Med. 1987;58(10):954-7.
46. Nooij S, Vanspauwen R, Bos J, Wuyts F. A re-investigation of the role of utricular asymmetries in space motion sickness. J Vestib Res. 2011;21(3):141-51.
47. Woodman PD, Griffin MJ. Effect of direction of head movement on motion sickness caused by Coriolis stimulation. Aviat Space Environ Med. 1997;68(2):93-8.
48. Denise P, Etard O, Zupan L, Darlot C. Motion sickness during off-vertical axis rotation: prediction by a model of sensory interactions and correlation with other forms of motion sickness. Neurosci Lett. 1996;203(3):183-6.
49. Zupan L, Droulez J, Darlot C, Denise P, Maruani A. Modelization of vestibulo-ocular reflex (VOR) and motion sickness prediction. In: Mariano M, Morasso PG, editors. ICANN ’94; Proceedings of the International Conference on Artificial Neural Networks Sorrento, Italy, 26-29 May 1994 Volume 1, Parts 1 and 2: New York: Springer; 1994. p. 106-9.
50. O'Hanlon JF, McCauley ME. Motion sickness incidence as a function of the frequency and acceleration of vertical sinusoidal motion. Aerosp Med. 1974;45(4):366-9.
51. Ji JT, So RH, Cheung RT. Isolating the effects of vection and optokinetic nystagmus on optokinetic rotation-induced motion sickness. Hum Factors. 2009;51(5):739-51.
52. Park AH, Hu S. Gender differences in motion sickness history and susceptibility to optokinetic rotation-induced motion sickness. Aviat Space Environ Med. 1999;70(11):1077-80.
53. Quarck G, Etard O, Oreel M, Denise P. Motion sickness occurrence does not correlate with nystagmus characteristics. Neurosci Lett. 2000;287(1):49-52.
54. Lentz JM. Nystagmus, turning sensations, and illusory movement in motion sickness susceptibility. Aviat Space Environ Med. 1976;47(9):931-6.
55. Gupta VK. Motion sickness is linked to nystagmus-related trigeminal brain stem input: a new hypothesis. Med Hypotheses. 2005;64(6):1177-81.
56. Bukhtiiarov I, Chistov S, Ponomarenko K, Rybachenko T. Interocular asymmetry of nystagmus and motion sickness. Aviakosm Ekolog Med. 2011;45(3):34-9. Russian.
57. Dai M, Raphan T, Cohen B. Prolonged reduction of motion sickness sensitivity by visual-vestibular interaction. Experimental brain research. 2011;210(3-4):503-13. Exp Brain Res. 2011;210(3-4):503-13.
58. Tanguy S, Quarck G, Etard O, Gauthier A, Denise P. Vestibulo-ocular reflex and motion sickness in figure skaters. Eur J Appl Physiol. 2008;104(6):1031-7.
59. Bos J, Bles W, de Graaf B. Eye movements to yaw, pitch, and roll about vertical and horizontal axes: adaptation and motion sickness. Aviat Space Environ Med. 2002;73(5):436-44.
60. Matsnev EI, Iakovleva IIa, Serebrennikov MI, Gavrilin BK, Zakharova LN, Nichiporuk IA, et al. Characteristics of motion sickness during prolonged otolith stimulation in anti-orthostatic position. Vestn Otorinolaringol. 1990;(1):8-14. Russian.
61. Nishiike S, Okazaki S, Watanabe H, Akizuki H, Imai T, Uno A, et al.The effect of visual-vestibulosomatosensory conflict in-duced by virtual reality on postural stability in humans. J Med Invest. 2013;60(3-4):236-9.
62. Stoffregen TA, Smart LJ Jr.Postural instability precedes motion sickness. Brain Res bull. 1998;47(5):437-48.
63. Takada H, Fujikake K, Miyao M, Matsuura Y. Indices to detect visually induced motion sickness using stabilometry. Proc. VIMS. 2007:178-83.
64. Gibbs CR, Commons KH, Brown LH, Blake DF. 'Sea legs': sharpened Romberg test after three days on a live-aboard dive boat. Diving Hyperb Med. 2010;40(4):189-94.
65. Hoffer ME, Gottshall K, Kopke RD, Weisskopf P, Moore R, Allen KA, et al.Vestibular testing abnormalities in individuals with motion sickness. Otol Neurotol. 2003;24(4):633-6.
66. Ma Y, Ou Y, Chen L, Zheng Y. Vestibular testing abnormalities in individuals with motion sickness. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009;23(16):728-30.
67. Tal D, Bar R, Nachum Z, Gil A, Shupak A. Postural dynamics and habituation to seasickness. Neurosci Lett. 2010;479(2):134-7.
68. Shahal B, Nachum Z, Spitzer O, Ben‐David J, Duchman H, Podoshin L, et al. Computerized dynamic posturography and seasickness susceptibility. Laryngoscope. 1999;109(12):1996-2000.
69. Balter SG, Stokroos RJ, Van De Laar MM, Hendrice N, Kingma H. Habituation to galvanic vestibular stimulation for analysis of susceptibility to carsickness. Acta Otolaryngol. 2004;124(6):690-4.
70. Séverac CA, Dupui P, Costes SM, Bessou P, Güell A. Unusual vestibular and visual input in human dynamic balance as a motion sickness susceptibility test. Aviat Space Environ Med. 1997;68(7):588-95.
71. Cevette MJ, Stepanek J, Cocco D, Galea AM, Pradhan GN, Wagner LS, et al. Oculo-vestibular recoupling using galvanic vestibular stimulation to mitigate simulator sickness. Aviat Space Environ Med. 2012;83(6):549-55.
72. Fowler CG, Sweet A, Steffel E. Effects of motion sickness severity on the vestibular-evoked myogenic potentials. J Am Acad Audiol. 2014;25(9):814-22.
73. Buyuklu F, Tarhan E, Ozluoglu L. Vestibular functions in motion sickness susceptible individuals. Eur Arch Otorhinolaryngol. 2009 ;266(9):1365-71.
74. Tal D, Gilbey P, Bar R, Shupak A. Seasickness pathogenesis and the otolithic organs: vestibular evoked myogenic potentials study-preliminary results. Isr Med Assoc J. 2007;9(9):641-4.
75. Tal D, Hershkovitz D, Kaminski G, Bar R. Vestibular evoked myogenic potential threshold and seasickness susceptibility. J Vestib Res. 2006;16(6):273-8.
76. Xie S-J, Chen W, Jia H-B, Wang Z-J, Yao Q, Jiang Y-Y. Ocular vestibular evoked myogenic potentials and motion sickness susceptibility. Aviat Space Environ Med. 2012;83(1):14-8.
77. Bos JE, Bles W. Modelling motion sickness and subjective vertical mismatch detailed for vertical motions. Brain Res Bull. 1998;47(5):537-42.
78. Clément G, Deguine O, Bourg M, Pavy-LeTraon A. Effects of vestibular training on motion sickness, nystagmus, and subjective vertical. J Vestib Res. 2007;17(5-6):227-37.
79. Dornhoffer J, Chelonis JJ, Blake D. Stimulation of the semicircular canals via the rotary chair as a means to test pharmacologic countermeasures for space motion sickness. Otol Neurotol. 2004;25(5):740-5.
80. Morales Jr R. A New Perspective in the Etiology, Treatment, Prevention and Prediction of Space Motion Sickness. No. AFIT/GSO/ENG/88D-2. Air Force Inst Of Tech Wright-Patterson AFB OH School Of Engineering, 1988.
81. Furman JM, Marcus DA, Balaban CD. Rizatriptan reduces vestibular-induced motion sickness in migraineurs. J Headache Pain. 2011;12(1):81-8.
82. Doweck I, Gordon CR, Spitzer O, Melamed Y, Shupak A. The vestibulo-ocular reflex (VOR) under the influence of cinnarizine. J Vestib Res. 1994;4(3):215-20.
83. Vanspauwen R, Weerts A, Hendrickx M, Buytaert KI, Blaivie C, Jorens PG, et al. No effects of anti-motion sickness drugs on vestibular evoked myogenic potentials outcome parameters. Otol Neurotol. 2011;32(3):497-503.
84. Murdin L, Chamberlain F, Cheema S, Arshad Q, Gresty MA, Golding JF, et al. Motion sickness in migraine and vestibular disorders. J Neurol Neurosurg Psychiatry. 2015;86(5):585-7.
85. Boldingh MI, Ljøstad U, Mygland A, Monstad P. Vestibular sensitivity in vestibular migraine: VEMPs and motion sickness susceptibility. Cephalalgia. 2011;31(11):1211-9.
86. Jeong S-H, Oh S-Y, Kim H-J, Koo J-W, Kim JS. Vestibular dysfunction in migraine: effects of associated vertigo and motion sickness. J Neurol. 2010;257(6):905-12.
How to Cite
Hosseini M, Farahani S, Adel Ghahraman M, Jalaie S, Khademi A. Vestibular findings in motion sickness. Aud Vestib Res. 24(3):120-127.
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