Susceptibility to acute motion sickness in blind person

Graybiel, A.

English

NASA Technical Reports Server

https://ntrs.nasa.gov/search.jsp?R=19700014219 2020-03-12T02:46:36+00:00Z
This document has been approved for public release and sale; 
i t s  distribution i s  unlimited. 
OACUTE MO ION SICKNESS IN BLIND PERSONS* 
Ashton Graybiel 
Bureau of Medicine and Surgery 
MR005 e 01.01 -01 208 
NASA Order R-93 
Released by - 
Captain M. D. Courtney, MC USN 
Commanding Officer 
18 February 1970 
h was conducted under the sponsorship of the Office of Advanced Research 
gy, National Aeronautics and Space Administration e 
NAVAL AEROSPACE ME 
SUMMARY PAGE 
HE PROBLEM 
A comparison between blind and normally sighted persons was made to investigate 
the role of vision in  the genesis of motion sickness. 
FINDINGS 
A group of twelve persons selected only on the basis of their visual defects were ex- 
posed to stressful Coriolis accelerations under standardized conditions. AI I demonstrated 
differences in  susceptibility to acute motion sickness that bore no relation to their rank 
order of visual deprivation. Insofar as comparison with a group of normal subjects was 
made possible, no significant differences in susceptibility were demonstrable. 
It was concluded that vision i s  not an essential but rather a secondary etiologic 
factor in  the genesis of motion sickness. This i s  not incompatible with the fact that 
symptoms characteristic of motion sickness may be visually induced in  the absence of 
"motion e 'I 
ACKNOWLEDGMENTS 
We are grateful not only to the participants, but also to the administrators at the 
Florida School for the Deaf and the Blind for their splendid cooperation in  making the 
subjects available. It is a pleasure to acknowledge the contribution of Dr. S. Deeson 
Bond, ophthalmologist, who conducted the eye examinations, and Mr. Robert Upchurch 
who assisted with the experiment. 
INTRODUCTION 
This report deals with the role of vision in the genesis of motion sickness based on 
a comparison between blind and normally sighted persons who were exposed to stressful 
Coriolis accelerations under standardized conditions. Statements to the effect that 
blind persons aresusceptible to motion sickness appear in  the scientific I iterature 
(1,2,13), but we have not found any reference to systematic observations conducted on 
blind but otherwise normal persons. A reason for this neglect i s  found in  the ease with 
which the visual environment can be controlled i n  sighted subjects; yet, important 
differences exist especially between persons born blind and sighted persons with eyes 
covered. These include: 1) the anatomical and functional organization in the central 
nervous system, 2) past conditioning based on visual experience, and 3) any immediate 
influences based on visual memory. 
PROCEDURE 
SUBJECTS 
Twelve blind and sixteen normal persons participated in this experiment. All re- 
ceived a thorough medical examination, the details of which wi l l  be published else- 
where, and were in  a satisfactory state of health, although the physical fitness of the 
blind was below that of the normal group. 
The normal subjects, six women and ten men, were between 16 and 20 years of 
age. All had normal visual acuity. Two had a history of middle-ear infection without 
sequellae. All had normal hearing except for four men who had a slight high-frequency 
loss. The threshold caloric test (8) values and ocular counterrolling indices (10) were 
within the normal range, indicating normal function of the canalicular and otolithic 
systems, respectively a 
The blind subjects, five women and seven men, were between '16 and 44 years of 
age. The important optic findings of the twelve, along with their past history of ex- 
posure to motion and subsequent symptomatology, are shown in  Table I .  AI I except 
one (AL) were born with their visual affliction. Three subgroups were identified: no 
light perception in either eye (two subjects); no light perception in one eye and mini- 
mal light perception with (one subiect) and without (two subjects) projection in  the 
other; and seven who were partially sighted and could perceive horizontal and vertical 
elements in a well-structured visual environment. 
Functional evaluation of the vestibular organs in  these blind subjects posed diffi- 
culties in some instances due to the presence of spontaneous eye movements and in- 
ability to fixate satisfactorily. Nystagmography was impossible in one (SL) because 
the oculi bulbae did not generate an electrical field; visual observation of nystagmus, 
however, indicated he had a normal threshold of response to angular acceleration and 
a good response to thermal stimulation. In the remaining eleven, nystagmography re- 
vealed that the threshold nystagmus response to thermal stimulation of the canals was 
1 
normal in  three and slightly above normal i n  eight. The ocular counterrolling index was 
well within the normal range in ten and within the normal range in two, If a small al- 
lowance i s  made for the difficulties encountered in  carrying out the vestibular tests, a l l  
of the results may be regarded as within the normal range. 
The twelve blind and fourteen of the sixteen normal subjects had no experience in  
the slow rotation room (SRR) prior to the present experiment. The remaining two sub- 
jects (BRO and GR) had had much experience in the room. 
APPARATUS 
The new Pensacola slow rotation room, described elsewhere in detail (3), i s  a 
windowless circular structure without any central supports, 20 feet in diameter and 10 
feet high 
in  the present experiment. 
I t s  excel lent operational characteristics and instrumentation were not taxed 
THE PROVOCATIVE PEST 
A slight modification of the Dial Test (6) was used. The Coriolis accelerations 
were generated by simultaneous rotations of room and subject. In this experiment ve- 
locity of the room was either 7.5 or 20 rpm. The head movements (H-M) were carried 
out according to taped instructions in sequences of five, requiring 25 seconds, followed 
by a rest period of 6 seconds. These movements involved flexion of the head (and, to 
some extent, the upper trunk) and return to the upright: 1) forward, 2) leftward, 
.3) backward, 4) rightward, and 5) forward. Past experience has indicated that, with 
few exceptions, even the highly insusceptible wil  I experience symptoms at the higher 
angular velocity. Although a cut-off at 300 H-M's has often been employed, only 
100 H-M*s were used in  this experiment. 
The severity of the symptoms was graded according to the diagnostic criteria 
summarized in  Table 11 (4). It should be mentioned that these criteria include the re- 
liable responses; some are unreliable, others are covert. Stated differently, the evi- 
dence used in making a diagnosis may be less than the total symptomatology. Due to 
the cumulative effects of the stressful accelerations, subjects tend to underestimate 
rather than overestimate the severity of symptoms until these become prominent; hence, 
the endpoint may be overshot. Past experience (1 1) has indicated that when subjects 
areacutelystressed, M IIA i s  as reliable a criterion as M 111, and even M l l B  i s  highly 
assessment of an overt symptom. The designated endpoint in this study was either "severe 
malaise" (M 111) or 20 sequences (100 H-M's). 
, however, i s  unreliable as an endpoint even though it may be anaccurate 
METHOD 
Prior to each test an open-ended questionnaire termed "subject' s preexperimenta- 
tion intewiew" was completed to ensure that the subject was fit at the time of testing. 
hen he was secured in  the chair, the room was brought up to the desired velocity, and, 
2 
after 60 seconds at constant velocity, the taped instructions were played and the subject 
began the head movements. 
Each subject was tested individually, and at least one day separated consecutive 
experimental trials. The blind subjects were tested with eyes open, f i rst  at 7.5 rprn, 
then at 20 rpm. Subject GI, who experienced frank motion sickness (S) at 7.5 rpm 
after 70 H-MIS, was not exposed to 20 rpm. The sighted subjects were tested first with 
eyes covered by an opaque patch, then with eyes open, both at 7.5 and 20 rpm; a few 
did not participate in  a l l  four experimental trials. 
RESULTS 
The symptomatology was quite similar in subjects with and those without visual de- 
fects. The principal findings are summarized in  Table 1 1 1 .  Among the twelve blind sub- 
jects eight reached or exceeded the designated endpoint M 111; one each experienced 
M IIA and M I, and two were symptom free. Of the two who were "totally blind" one 
reached the endpoint at 7.5, indicating high susceptibility, and the other at 20 rpm. 
Of the three who were "virtually blind" none reached the designated endpoint; one 
each reached M IIA and M I, and the third was symptom free. Of the seven who were 
partially sighted six reached the designated endpoint and one was symptom free. 
When the sixteen normal subjects were tested with eyes covered, six reached the 
designated endpoint, three reached M IIA, one reached M IIB, three reached M I ,  and 
three were symptom free. Only thirteen of the sixteen were properly tested with eyes 
open; eleven reached the designated endpoint, and one each, M IlB and M I .  Of the 
remaining three, one did not participate, subject TI  reached M JIB at 7.5 but was not 
exposed at 20 rpm, GR was symptom free at 7.5 and was exposed at 20 rpm on an earlier 
(reaching the designated endpoint) but not on the present occasion. 
In Table IV the findings on the two groups are compared, using not only the desig- 
nated but also a reliable endpoint described above under Procedure. With the designated 
endpoint, i t  is seen that, as a group, the normal subjects with eyes covered were less 
susceptible than the blind, but not with eyes open when there was a tendency toward 
lower susceptibility i n  the blind subjects. The same conclusions were demonstrated 
using the reliable endpoint. 
A comparison between the virtually blind and the normal persons with eyes covered 
and between the partially sighted and the normals with eyes open revealed insignificant 
differences in susceptibi I i ty . 
DISCUSSION 
The fact that the susceptibility of the two subjects with total absence of light per- 
ception since birth was similar to that of the six most susceptible normal subjects with 
eyes covered i s  the best evidence that vision i s  not essential in  the genesis of motion 
sickness. A person completely blind since birth would, h a l l  likelihood, suffer 
3 
morphological changes and functional deterioration along the visual pathways similar to 
those observed in kittens deprived of sight at birth (14). Such abnormalities would re- 
duce the optic connections in  the central nervous system, rendering it less complex and, 
conceivably, less I ikely to be "disturbed" by unusual vestibular inputs. 
functionally there would be no visual contribution to the intersensory organization in 
the CNS, and visual-nonvisual "conflicts" or interactions would be impossible. If this 
were generally applicable, the corollary could be drawn that sighted persons with eyes 
covered have the same innate susceptibility to motion sickness as those completely blind. 
A sighted person on closing his eyes, however, s t i l l  has visual memories, and he may 
respond to visual ly conditioned stimuli 
The great variation in susceptibility to motion sickness among unselected persons 
with normal function of the vestibular organs prevents firm conclusions to be drawn from 
comparisons between smal I groups. individual differences must account for the much 
lower susceptibility in the three subjects who were virtually blind compared with the 
two who did not have any light perception and the seven who were partially sighted. 
There is no doubt but that the normal group was more susceptible with eyes open 
compared with eyes covered. There were only two exceptions to this generality, and 
in one instance the difference was not substantial. This finding i s  in accord with pre- 
vious experience in an SRR (7) e The smal I differences noted when the five totally or 
almost totally blind were compared in  susceptibility to the sighted with eyes covered 
and when the seven partially sighted were compared to the sighted with eyes open are 
partly fortuitous but nevertheless point up the relatively great role of the vestibular 
organs compared with vision in the genesis of motion sickness. 
This study did not touch on the many other aspects of vision that directly or in- 
directly might influence susceptibility to motion sickness in particular people or under 
particular circumstances. Our findings are in no way incompatible, however, with the 
fact that symptoms of motion sickness may be visually induced in the absence of "motionk" 
(12) or that vision, by locking onto an Earth reference for example, may reduce suscep- 
tibil i ty to motion sickness (5,9). 
4 
RE FE RE NCE S 
*, and Smith, P. Ke, Motion sickness. Pharmacol. Rev., 7:33-82, - -  
1955. (Especially p. 48,) 
2. Desnoes, P. H., Seasickness, J. Amer. Med. ASSO., 86:319-324, 1926. (ESP- - - - - -  
cially p. 320.) 
3, Graybiel , A., and Wood, C. De,, Rapid vestibular adaptation in a rotating environ- 
ment by means of control led head movements, Aerospace Med e , 40r638-643, 
1969 e 
- -  
4, Graybiel, A., Wood, C. D., Miller, E. F. SI, and Cramer, D. Be, Diagnostic 
criteria for grading the severity of acute motion sickness, Aerospace Med., -
39 :453-455, 1 968 e - 
5. Johnson, W H ., and aylor, N .B e G e , Some experiments on the relative effec- 
tiveness of various types of accelerations on motion sickness. J. aviat. Med. , - - -  
32:205-208, 1961 a - 
6. Kennedy, R. S e , and Graybiel, A. , he Dial Test: A standardized procedure for 
the experimental production of canal sickness symptomatology iin a rotating 
environment. NSAM-930. NASA Order R-93, Pensacola, Fla. : Naval 
School of Aviation Medicine, 1965. 
7. Kennedy, R. S * ,  Polhurst, G. C., and Graybiel, A., The effects of visual de- 
privation on adaptation to a rotating environment. NSAM-918. NASA Order 
R-93. Pensacola, Fla. : Naval Aerospace Medical Institute, 1965, 
8. McLeod, M. E., and Meek, J. C., A threshold caloric test: Results in normal 
subjects. NSAM-834. NASA Order R-47. Pensacola, Fla. : Naval School 
of Aviation Medicine, 1962. 
9. Manning, G. W. , and Stewart, W. G., Effect of body position on incidence of 
motion sickness. 1, apple Physiol., - 1 :619-628, 1949. - -  
10. Miller, E. F. II, Evaluation of otolith organ function by means of ocular counter- 
rolling measurements. In: Stahle, J. (Ed.), Vestibular Function on Earth and 
-- in Space. Oxford, EngGd: Pergamon Press, 1970. P p m .  
---
11. Miller, E e F. !I, and Graybiel, A., Comparison of five levels of motion sickness 
severity as the basis for grading susceptibility ., NAMI-1098. NASA Orders 
T-81633 and R-93. Pensacola, Fla. : Naval Aerospace Medical Institute, 
1 970 e 
5 
12. Mi Iler, J W e  , and Goodson, J. E., A note concerning "motion sickness" in the 
2-FH-2 Hoover trainer. NSAM-519. Pensacola, Fla.: Naval School of 
Aviation Medicine, 1958. 
13. Tyler, De Be, and Bard, P., Motion sickness. Physiol. Rev., 292311-369, 
- _ .  
(Especial ly p. 325.) 
4. Wiesel, T. Ne, and Hubel, D. He,  Extent of recovery from the effects of visual 
deprivation in kittens. - J. Neurophysiol , - 28:1060-1072, 1965. 
6 
* 
2 
0 
Q 
I) 
3 
v) 
W 
S 
.- 
.- - 
m 
$ -
I- 
Q 
S 
f 
E! 
? 
E i  
.- 
X 
w 
S 
0 .- 
c 
9 
Y- 
O 
c 6 
In .- 
I 
7 
B 
0 
S 
W 
S 
U 
0 
.- 
.- 
.- c 
o" 
Y- 
0 
0 
2 
E 
5 
v) 
v) 
4: 
u z  
v) 
Q 
U 
u'U 
a, 
S 
2 
4 
u' 
U 
Q Q  s s  
22 
44 
u'u' 
uu 
Q 
0 
3 n 
n 
v) 
In 
.- .- 
f 
1 n 
n 
I 
d 
2 
n 
I 
-I 
f: 
LL. 
0 
7 
v)v) 4 "  
I 
0 -
8 
h .. 
. .  .- .- 
.. 
a, 
a 
S 
W 
3 
S 
0 
0 
> 
I) 
I) 
* 
-
E 
x 
.- 
v) 
.- + .- 
2 
Q 
7 
c 
C .- 
8. 
c 
v) c
S .- on 
cu 
v) c
S 
0 
Q 
9 
.- 
v) c
S .- on 
00 
2 
S .- on 
-0 
7 
L. 
P 
8 
0 
c 
i 
I 
I 
I 
I 
I 
I 
I - -  - - I  
C I  .- N 0 0 1  
N I .- 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
I 
1 
I 
I 
I 
I 
I 
In c
C .- 
$i 
el 
I 
c 
v) c
S .- on 
w 
I 
c) 
v) c
c .- 
$i 
R 
I 
10 
v) 6
S .- on 
cn 
I 
co 
- 
u) c
S 
0 
Q 
9 
AI 
.- 
7 
8 
0 in0 0 oo 
in “e 03 030, 
m m  
o o o r o r  
- -  
0000000000000000 
2 2 2 2 z 2 2 2 z E 2 z 2 2 2 z  
4 
z z 0  
22z 
- -  
000 
000 
000 
2 2 2  
> O - l W  
- l v , a i  
0000000 z”2zz22 
9 
v) c
0 
Q) 
3 
v, 
m 
xi 
5 
E 
4 
In 
Q) 
S 
Y 
0 
v, 
.- 
5 .- 
c 
8 
; 
Q) 
3 
e 
0 c 
2 
Q 
2 
.- .- - 
c 
Q 
Q) 
2 
v, 
0 
S 
cc 
w .- 
L 
U 
Q 
E 
0 v 
e. 
TI c 
8 II g II 
Q) Q > - a -  
cv c 9 0 cv 
d- m 
Y 
h 
Ln 
I I  
Z 
.. 
'u 
Q) 
-(I w 
x 
U 
0 
Q 
c 
.- 
In 
- .- 
c L
n 
I I  
Z 
'u 
2 : s 
s x 
W 
I\ 
II 
P 
Z 
.. 
S 
Q) 
Q 
0 
x 3 
W 
2 
I! 
z 
c3 
9 
0 cv 
E '  
E 
m 
n d- .. 
-u 
S 
.K - 
.. Q 
2 
- x h  
c z  
-0 
I w .- 
In 
- I I  
U 
U 
0, 
.- 
L 
10 
Unclassified 
Sccuntv Class i f icat ion 
Unclassitied 
N/A 
Naval Aerospace Medical Institute 
Pensacola, Florida 32512 2b.  GROUP 
3. REPORT T I T L E  
SUSCEPTIBILITY TO ACUTE MOTION SICKNESS IN BLIND PERSONS 
7 8 .  T O T A L  NO. OF P A G E S  7 6 .  NO. O F  R E F S  6 .  REPORT D A T E  
18 February 1970 11 14 
8a. C O N T H A C T  O R  G R A N T  NO. 98. ORIGINATOR'S REPORT NUMBERIS) 
NASA Order R-93 
BuMed MR005.01.01-0120B. 
NAMI-1100 b. PROJECT NO. 
C.  Sb. O T H E R  REPORT N o i s )  (Any other numbers thatmay b e  assigned 
fh i s  report) 
d. 2 
10 .  D lSTRl8UTlON STATEMENT 
This document has been approved for public release and sale; i t s  distribution i s  unlimited. 
12. SPONSORING MIL ITARY ACTIV ITY 
I 
13. A8STRACT 
A group of twelve persons selected only on the basis of their visual defects were ex- 
posed to stressful Coriolis accelerations under standardized conditions. AI I demonstrated 
differences in  susceptibility to acute motion sickness that bore no relation to their rank order 
of visual deprivation. Insofar as comparison with a group of normal subjects was made possible, 
no significant differences in susceptibility were demonstrable. 
It was concluded that vision i s  not an essential but rather a secondary etiologic factor 
in the genesis of motion sickness. This i s  not incompatible with the fact that symptoms charac- 
teristic of motion sickness may be visually induced in the absence of "motion. I' 
Unclassified 
5/tt 010 1 - 807- 6 8 0  1 Securi tv Class i f icat ion 
L I N K  A 
Unclassified 
Motion sickness susceptibility of blind persons 
Role of vision in motion sickness 
Diagnostic criteria of motion sickness 
Cori 31 is-acceleration-stress effects 
.. _. 
Security Classification 
R O  L'd - W T  - R O L E  -
nclassified 


Susceptibility to acute motion sickness in blind persons

Abstract

Similar works

Full text

Available Versions

NASA Technical Reports Server