Disturbances of vestibular origin comprising motion sickness resulting from rotating tilted chai

Graybiel, A.

Miller, E. F., II

English

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ON: A CONVENIEN 
HE PASSIVE HUMAN SUBJECT TO A RO 
Ashton Graybiel and Earl F, Miller II 
Bureau of Medicine and Surgery 
MR005.0 1 e 0 1 -0 1 20B 
NASA Order R-93 
NASA Order T-8 1633 
Released by - 
Captain Me D. Courtney, MC USN 
Commanding Officer 
17 October 1969 
* 
This research was conducted under the sponsorship of the Office of Advanced Research 
and Technology, and the Biomedical Research Office, Manned Spacecraft Center, 
National Aeronautics and Space Administration e 
NAVAL AEROSPACE MEDICAL INS 
NAVAL AEROSPACE MEDICAL CENTER 
PENSACOLA, FLORIDA 32512 
E P R O B E  
ances of vestibular origin comprising the clinical picture of 
lting from exposu to a rotating linear acceleration vector was 
ng chair modified to permit t i l t ing up to 20" away from the up- 
constant velocity at a given angle of tilt, the subject was thus 
exposed to a continual change with reference to the g 
increases i n  the level of stress were effected through 
chair's angular velocityy. Subjects were exposed until either they expe 
motion sickness (the predetermined endpoint), or the cut-off point, a t 
itational upright. Stepwise 
matic programming of the 
pm at 10" tilt, was reached. 
FINDINGS 
Of the group of 100 healthy men, 88 reached the predetermined endpoint; a l l  but 
mainder reached it only when the angle of tilt was increased to 20". Thus, 
ranked 95 subjects i n  terms of their susceptibility to this unusual gmvitoinertial 
force environment and demonstrated that 5 were highly insusceptible 
flexibil i ty of the method should prove it to be useful, not only as a provocative test of 
susceptibility to motion sickness but also a means of studying the symptomatology and 
underlying mechanisms. 
he accuracy and 
ROD UCT ION 
n a previous report (7) mention was made of a tilt chai device which, when 
rotating at constant velocity, exposed the subject to an unusual gravitoinertial force in  
the nature of a rotating linea acceleration vector (RLAV). The use of this type of stim- 
ulation has a brief history (2,3,6,9) which is notable for the discussion aroused as to 
whether the sensory receptors in  the semicircular canals are stimulated i n  addition to 
those in  the otolith organs, The fact that nystagmus is evoked at critical temporal and 
ai patterns of stimulation implicates the canals by "associution, I' although the mode 
imulation must be other than the manner i n  which the cupula-endolymph mechanism 
n view of the uncertainties unctions i n  response to angular or Coriolis accelerations, 
garding the possibility of canalicular stimulation, the co bin ing term "vest ibu lar " 
rather than otolithic stimulation wi l l  be used. 
When a person i s  exposed to a RLAV,the turbances of vestibular origin which 
e comprises reflex phenomena which are evoked full into two main categories (4). 
consti tu te perturba ti 
priate eye motions. ises a wide variety of re onses including the clini- 
cal picture of motion sickness with which this report i s  conce 
in  or perversions of normal vestibular functions, e.g., inappro- 
PROCEDURE 
One hundred volunteer male subjects 37 to 32 years of age participated. 
jority, 58, were naval flight personnel, and al l  but three of the remainder were also 
in the Navy. Al l  were hea hy, and a medical evaluation revealed no significant de- 
fect, disorder, or disease. he sensory organs of the inner ear were evaluated with the 
aid of audiometry, ocular c nterrolling, and the threshold oculogy al illusion (OGI) 
test e 
Audiometric findings were within normal limits. he ocular counterrol I ing index 
inutes of arc; there were three 
values below 200, usually taken as the lower end of the normal range. The oculogyral 
illusion (OGI) test, de bed in detail elsewhere (5), required the subject to indicate 
rightward or leftward a rent movement of i~ dimly illuminated target while he was 
subjected to clockwise or counterclockwise angular accelerations. This procedure i s  a 
test of semicircular canal function, and the values obtained ranged from < 0.113' per 
sec2 (the lowest obtainable with present equipment) to 0.821' per sec2 e The upper 
normal threshold value i s  not firmly established; in  any case, only five values were 
above 0.475' per sec2 e Inasmuch as considerable practice i s  sometimes requi 
fore the lowest values are regularly obtained, the likelihood is that none was abnormal 
), a test of otolith function, ranged from 933 to 573 
1 
US AND 
el RS-3, was modified (Figure 
was mounted on a 
y an electric mot0 
use as an off- 
uld be tilted up 
gree of tilt could be 
against the headrest 
e top of the subject's head could be cen- 
ed on a time axis involving periods of 
nd smooth rotation was ensured by p 
lowed by periods of c 
int, described below, was reached 
int, In effect, this p epresented unit in- 
ndpoint could be ex- 
i ty  or as total elapsed time which 
served as an index of susceptibility to motion sickness. 
With each revolution of the OVR device the subject continually changed position 
with respect to the gravitational upright. Thus, receptors in  the paired maculae of utri- 
cle and saccule and nonvestibula ptors were continually exposed to an unusual 
he semicircular canals also we he uncertainty w 
entioned in  the 
ect was carefully inst ucted in the best man 
imating the endpoint ermed "moderate Ma! 
by the diagnostic crite ia previously described (8) e 
mild" motion sickness, nd subjects may be exposed repe 
ing. Although overt symptoms soon disappear, a second 
same day. 
n conducting the tests, t e subject's eyes were covered with a 
he appraisal of the symptomat ogy was made d ing the run and reco 
as reached, the hair was quickly ti l ted to the up- 
imuli, and deceleration was accomplished at the same 
rate as acceleration e 
R 
ON SICKNESS 
During the period of exposure to the stressor, overt symptoms of motion sickness 
ached. Conse- usually absent or minimal until shortly before the endpoint was 
quently, to avoid overshooting the endpoint, close attention was required on the 
of subject and observer .,
2 
3 
reached the endpoint in 
tion i s  heavily skewed 
n the more "sus- 
eriod of rotation, and 
insufficient to pre- 
station of motion 
significant but un- 
nce by the fact that, 
continuation of 
ring susceptibili 
function of the 
ion sickness with scores 
ular canals and otolith 
at significant re ationships were not found between 
t ibi l i ty to moti n sickness, it is worth adding that when 
sceptibisity was highe in  subiects with low rather than 
and susceptibii I i ty was lower in  subjects with high rathe 
t the conclusion that functional test scores within 
rolling index. Inasmuch as one would predict the con- 
in predicting susceptib;lity to motion sickness, 
An unselected portion of the group (N = 38) we 
ity to motion sickness using another provocative test (12) in  which the subjects, while 
rotating at constant velocity in an upright Stille chai 
head out of the plane of passive rotation, thus generating Coriolis a 
stimulated the vestibular organs, notably, the semicircular canals, 
grammed stimulus pattern was different in the two tests, and a comm 
impossible to attai the comparative nkings i n  Figure 5 are of int 
of subjects demons ted similar susceptibility i n  the two different 
environments whet their basic susceptibility was high or low. 
to differences in  the accele tions to which they were exposed. 
also ranked in  their susceptibil- 
cent, demonstrated striking differences i n  susceptibility, most likely attributable 
No attempt was made to obtain data on the complex 
ienced by any of the 100 subjects during OVR, A fe 
made previously on other subjects (7). Normal subjects felt as i f  they were revolving, 
tating, and that the upper part of their body was continually, but to a- 
degree, tilted away from the upright. Chamcteristical ly, except momentarily at onset, 
ttern of "sensations" 
uch observations had been 
4 
U. 
0 
E 
c r - _ _ _  
t 
E 
l------ 
I I I t 
0 
N 
5 
In 0 
Figure 3 
ison of Motion Sickness ~ u s c e p t ~ b ~ ~ i ~  w i  
unction (the Ocu 
6 
I 
e 
Q 
B 
a 
600 
5 5 0  
5 0 0  
450 
00 
3 00 
5 0  
e 
N =  100 
r = - 0.019 8 
e 
8 Q 
8 
a, 
8 
8 e 
e 
e 
0 
Q 8 
8 8 
e 
8 
8 
0 Q 
(B 
8 
8 
B Q  
Q Q  
8 
8 
8 
8 
8 
e ( B  
8 8 e 
Q 
B 
8 
8 8 
0 e 
8 e ( B  
8 
8 
Q 
rn 
a 
8 8 
8 
e 
e 
e 
Q 
8 
0 
IO0  
I O  2 0  30 40 0 60 >65 
UTES), WI ENDPOI 
/ 
Figure 4 
Comparison of Motion Sickness Susceptibility with Scores on Test 
of Otolith Function (Counte 
7 
8 
8 
Q 
B, 
B 
8 
Figure 5 
Comparative Ranking Among 38 of the 100 Subjects in Two 
otion Sickness Susceptibility. 
ndex, a product of the average 
e head movement by the number 
of head movements required to Peach the predetermined 
endpoint (ref. 12). 
,/- ~ 
,” 
8 
volving in the direction opposite to that in which they were roo- 
rences between the normal and labyrinthine-defective sub iects were 
mainlly of a quantitative nature* 
CONCLUSIONS 
The OVR device, conside 
the vestibular systems, has irnpo 
advantages include:: I )  the effectiveness of this bizarre stimulus in evoking unusual 
as a means of investigating the effects 
t advantages and some disadvantages e 
; 2) the precision with which the stirnulus can be.controlled and manipu 
ssive participation of the subiect; and 4) the relatively low "cost" in te 
e, and technical skill The disadvantages include: ?) uncertainty 
circular canals as well as the otolith apparatus are stimulated; 2) limited 
direct accessibility to the subject d ing rotation; 3) the abnormal visual environment un- 
less the subject's eyes are  closed or covered; and 4) the 'impossibility of exposing mo 
than one subject at a time. 
cticai standpoint, the OVR device i s  useful as  a means of 
tion sickness using precise and reproducible stimulation e 
a t  susceptibility to motion sickness m 
ining ( I ) ,  and the Soviet invest 
ty to what we term aviato 
vidual ranking of subjects or placing them in graduate ges of susceptib i I ity 
e value in predicting 
sider i t  to have value 
e method is a useful 
means of ~ n v e s t ~ g a t ~ n g  the role of "secondary influences, I' including physiological and 
environmental variables and antimotion sickness drugs 
om the theoretical standpoint, th device has many uses in  studying t 
tomatology of motion sickness and such d ived phenomena as individual dif 
the t i m e  course of adaptation, and transfer of adaptation effects. 
9 
REFERENCES 
1 .  
2. 
3. 
4. 
5. 
6. 
7. 
8, 
9. 
Ambler, R. K., and Guedry, F. E., Jr., The validity of a brief vestibular dis- 
orientation test in  screening pilot trainees. Aerospace Med., 37: 124-126, 1966. - -  
Benson, A. J., and Bodin, N1. A., Interaction of linear and angular accelerations 
on vestibular receptors in  man. Aerospace Med., 37: 
_ _ . -  
Correia, M. J. , and Guedry, F. E e , Jr. , Modification of vestibular responses as 
a function of rate of rotation about an Earth-horizontal axis. Acta otolaryng,, 
Stockh. , 62: 297-308, 1967. - 
Graybiel, A., ~ t ~ c t u r a ~  elements in the concept of motion sickness. Aerospace 
Med . , 40: 359 -367, 71 969. - -  
Graybiel, A,, and Hupp, D he oculogyral illusionl:: A form of apparent motion 
which may be observed 
uviat. Med., 17~3-27, 
owing stimulation of the semicircular canals. J. - 
- - -  
Graybiel, A e , and Johnson, W e  H . , A comparison of the symptomatology experi- 
enced by healthy persons and subjects with loss of labyrinthine function when 
exposed to unusual patterns of centripetal force in  a counterrotating room. 
Ann e Otol . , 72: 357-373, 1963. -- - 
Graybiel, A., and Miller, E. F. I , The otolith organs as a primary etiological 
factor i n  motion sickness: With a note on "off-vertical" rotation. In: Fourth 
Symposium on the Role of the Vestibular Organs in  Space Explorat ior  NASA 
Special Publication. Washington, D. C. t U. S .  Government Printing Office. 
In press. 
Graybiel, A., Wood, C. D e ,  Miller, E. F. I , and Crames, D. B. , Diagnostic 
criteria for grading the severity of acute motion sickness. Aerospace Med., -
39 ~453-455, 1 968. - 
Guedry, F. E., Jr., Orientation of the rotation-axis relative to gravity: i t s  in- 
fluence on nystagmus and the sensation of rotation. - Acta otolaryng . , Stockh., 
60 : 30-48, 1 964 e 
10, 
11 e 
12. 
Khilov, K. L., Function of the vestibular analyzes in  space flights. -7 Arch. Oto- 
laryng., - 90:152-160, 1969. 
Miller, E. F. II, Counterrolling of the human eyes produced by head tilt with re- 
spect to gravity. Acta otolaryng e , Stockh o , 54~479-501 , 1961 e - - 
Miller, E. F. I, and Graybiel, A., A simple laboratory means of determining the 
633 and R-93, Pensacola, Fla. : Naval Aerospace Medical 
index of susceptibility to Coriolis (motion) sickness. NAMI-1058. NASA 
10 
4 D E S C R I P T I V E  NOTES (Type of report and inclusive dates)  
Ashton Graybiel and Earl F. Miller I ?  
176. NO. O F  R E F S  6 R E P O R T D A T E  7s. T O T A L  NO. O F  PAGES 
17 October 1969 11 42 
ea. C O N T d A C T  O R  GRANT NO. Y d .  ORIGINATOR'S R E P O R T  NUMBERIS) 
NAM! -1 090 
b. P R O J E C T  NO 
BuMed MR005.01.01-b120B 
This document has been approved for public release and sale; i t s  distribution I s  unlimited. 
A rotating chair modified to permit tilting of a subject up to 20' from the upright was 
used to expose 100 normal men to an unusual vestibular stimulus, eliciting manifestations in- 
cluding the clinical picture of motion sickness. Through stepwise increases in angular velocity 
of the chair, subiects were rotated at 10' tilt until they experienced mi ld  motion sickness 
(a predetermined endpoint) or until a terminal velocity of 25 rpm was reached. Elghty-eight 
men reached the predetermined endpoint; seven additional men reached it only when the 
tilt angle was increased to 20'; the remaining five men were shown to be highly insusceptible. 
he accuracy and flexibility of the method should prove to be useful in wnking persons accord- 
g to their susceptibility to motion sickness and in  studying the symptomatology, including 
the underlying cent I nervous system mechanisms. 
FORM ' ( P A G E  1 )  
1 N O V 6 5  
S/ t l  0101-B07-GRO7 
t)nclassified 
Securitv Classification 
Unclassified 
Security Classification 
Motion sickness susceptibility 
Vestibular apparatus disturbances 
Vestibular apparatus tests 
Accelemtion stress 
L I N K  A -
R O L E  
- 
W T  
L I N K  B L I N K  C 
R O L E  - W T  - 


Off-vertical rotation - A convenient precise means of exposing the passive human subject to a rotating linear acceleration vector

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