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Project Title:  Non-Pharmaceutical Motion Sickness Mitigation Reduce
Images: icon  Fiscal Year: FY 2022 
Division: Human Research 
Research Discipline/Element:
HRP HHC:Human Health Countermeasures
Start Date: 10/01/2020  
End Date: 09/30/2022  
Task Last Updated: 09/16/2021 
Download report in PDF pdf
Principal Investigator/Affiliation:   Wood, Scott J. Ph.D. / NASA Johnson Space Center 
Address:  2101 NASA Parkway 
Mail code SD2 
Houston , TX 77058 
Email: scott.j.wood@nasa.gov 
Phone: (281) 483-6329  
Congressional District: 36 
Web:  
Organization Type: NASA CENTER 
Organization Name: NASA Johnson Space Center 
Joint Agency:  
Comments: NOTE: PI returned to NASA JSC in January 2017. PI was at Azusa Pacific University from August 2013 – January 2017; prior to August 2013, PI was at NASA JSC. 
Co-Investigator(s)
Affiliation: 
Pradhan, Gaurav  Ph.D. Mayo Clinic Arizona 
Reschke, Millard  Ph.D. NASA Johnson Space Center 
Stepanek, Jan  M.D. Mayo Clinic Arizona 
Cevette, Michael  Ph.D. Mayo Clinic Arizona 
Key Personnel Changes / Previous PI: September 2021 report: None
Project Information: Grant/Contract No. Internal Project 
Responsible Center: NASA JSC 
Grant Monitor: Stenger, Michael  
Center Contact: 281-483-1311 
michael.b.stenger@nasa.gov 
Solicitation / Funding Source: 2019 HERO 80JSC019N0001-FLAGSHIP & OMNIBUS: Human Research Program Crew Health. Appendix A&B 
Grant/Contract No.: Internal Project 
Project Type: GROUND 
Flight Program:  
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HHC:Human Health Countermeasures
Human Research Program Risks: (1) Sensorimotor:Risk of Altered Sensorimotor/Vestibular Function Impacting Critical Mission Tasks (Revised as of IRP Rev M)
Human Research Program Gaps: (1) SM-203:Develop and test SMS countermeasures (IRP Rev L/M)
Flight Assignment/Project Notes: NOTE: End date changed to 9/30/2022 per PI (Ed., 7/7/21)

Task Description: Motion sickness represents one of the greatest clinical challenges impacting crew activities following G-transitions. Our project seeks to validate a non-pharmaceutical tool using galvanic vestibular reduction (GVR) by transcutaneously delivering bilateral inhibitory signals to suppress vestibular sensitivity and reduce post-landing motion sickness. Our first specific aim is to evaluate the effect of timing and magnitude on the administration of our non-pharmaceutical treatment to motion sickness. While we have previously demonstrated that our approach can mitigate motion sickness if introduced prior to provocative stimuli, one of the goals of this study is to determine the efficacy if we administer the treatment following the onset of symptoms. Validating the efficacy following symptom onset would greatly enhance flexibility to implement this treatment during recovery operations. Using a repeated measures counter-balanced design exposing subjects to provocative Coriolis cross-coupling stimuli on a rotating chair, we will compare motion sickness severity across three treatment interventions: prior to stimulus (symptom) onset, following symptom onset, and placebo control. Symptom severity will be assessed using both subjective reports and objective autonomic measures (e.g., electrogastrography). We expect that the most effective administration will be GVR delivered prior to the onset of symptoms, but that it will continue to be more effective relative to placebo control even if delivered following symptom onset. In order to leverage our non-pharmaceutical technique that allows continuous adjustments in “dosage” level throughout recovery, we must map changes in GVR level with functional performance. Our second specific aim is to characterize the dose response of GVR amplitude to functional fitness task performance. We will measure performance on a sensorimotor and cognitive test battery in steps ranging from 0mA (control) to the level of GVR thought to provide maximal motion sickness protection. The advantages of our non-pharmaceutical countermeasure approach will be to provide rapid therapeutic effect while allowing continuous titration of GVR amplitude during recovery to minimize side effects while enhancing performance.

Research Impact/Earth Benefits: Our project will deliver a non-pharmaceutical countermeasure approach using galvanic vestibular reduction (GVR) that can be customized to mitigate G-transitional induced motion sickness while optimizing sensorimotor and cognitive performance. The ability to treat motion sickness with non-pharmaceutical approaches has the benefit to not only avoid sedative side effects of the medication but also allow for flexibility to turn the treatment on and off without residual effects associated with drug metabolism. Understanding the operational impacts of each device will provide a more informed evidence base for implementing this tool into crew recovery operations.

Task Progress & Bibliography Information FY2022 
Task Progress: We have tested 15 out of 30 total subjects to date, 12 of which have completed all four sessions required. The initial session is utilized to establish galvanic vestibular sensitivity measures to customize the GVR level, and to characterize performance on a sensorimotor-cognitive test battery as a function of GVR stimulus level. The next three sessions involve head movements during constant rotation as a motion sickness stressor. The efficacy of GVR to mitigate motion sickness is tested across three separate counterbalanced sessions: administration from the onset of testing, at a midpoint of testing, and placebo control. The rotation direction is alternated, and test sessions are separated by at least four days to minimize habituation effects.

Motion sickness stressor: During the three rotating chair sessions, subjects are accelerated (10 deg/s/s) to a constant velocity. Subjects then perform up to 10 sets of head movements. For each set, a head movement is cued every 10 seconds, alternating between pitch forward (chin resting to chest) and pitch backward (head upright). During each head movement subjects are asked to use a joystick to record the amplitude of their rotation sensation (yaw, pitch and/or roll). There were total of 7 forward and 7 backward movements per set lasting 2.5 mins. During the 2 min pause between head movement sets, symptom scoring is obtained using the Pensacola Diagnostic Index and a subject discomfort (0-20) ratings. If GVR effectively suppresses vestibular sensitivity, subjects should experience low symptom scores, be able to perform more head movements before reaching the endpoint, and have reduced motion illusions as quantified by the joystick.

There have been no adverse effects or dermal discomfort due to GVR stimulation. The rotation speed was 30 deg/s for the first 9 subjects. Subjects are tested until they reach the motion sickness endpoint of 8 symptom points or a maximum set of 10 head movements. Since several subjects did not reach a motion sickness endpoint, the rotation speed was increased to 60 deg/s to increase motion sickness stressor for the remaining 21 subjects. Given the repeated measures design, we do not plan to recruit replacement subjects for those reaching motion sickness endpoints at the lower speed.

Sensorimotor cognitive test battery: The purpose of this test battery is to assess how GVR may impair performance over the range of stimulus amplitudes used to treat motion sickness. This test battery utilizes both dynamic posturography as well as a modified timed up and go (TUG) locomotion task. The dynamic posturography is known as the modified Clinical Test of Sensory Integration on Balance (mCTSIB) measuring sway velocity during two 10-second trials for each of the following conditions: Standard -- eyes open on firm surface (EO-FI), Proprioception -- eyes closed on firm surface (EC-FI), vision -- eyes open on foam surface (EO-FO), and vestibular -- eye closed on foam surface (EC-FO). The modified TUG involved standing up upon on command, walking 4 meters, turning around, walking back to the chair, and sitting down. The subject is required to step over an obstacle (30 cm high, 10 cm wide) positioned midway between the chair and the turning point, once on the way toward the turning point and again on the return back. The time stops when the patient is seated.

We also conducted flight simulator performance in Virtual Reality (VR) and cognitive tasks in the form of the Oculo-Cognitive Addition Test (OCAT), which requires participants to look for numbers on a screen and add these numbers together. OCAT includes eye-tracking, and currently, we are analyzing cognitive and oculomotor performance measures. VR Flight performance provides simulator immersion and visuomotor function during flight. Data collection and analysis is still ongoing through the remainder of the calendar year.

Bibliography Type: Description: (Last Updated: 10/25/2021)  Show Cumulative Bibliography Listing
 
Abstracts for Journals and Proceedings Pradhan GN, Cevette MJ, Stepanek J, Reschke MF, Wood SJ. "Non-pharmaceutical motion sickness mitigation using galvanic vestibular reduction." 2021 NASA Human Research Program Investigators’ Workshop, Virtual, February 1-4, 2021.

Abstracts. 2021 NASA Human Research Program Investigators’ Workshop, Virtual, February 1-4, 2021. , Feb-2021

Project Title:  Non-Pharmaceutical Motion Sickness Mitigation Reduce
Images: icon  Fiscal Year: FY 2021 
Division: Human Research 
Research Discipline/Element:
HRP HHC:Human Health Countermeasures
Start Date: 10/01/2020  
End Date: 09/30/2022  
Task Last Updated: 12/05/2020 
Download report in PDF pdf
Principal Investigator/Affiliation:   Wood, Scott J. Ph.D. / NASA Johnson Space Center 
Address:  2101 NASA Parkway 
Mail code SD2 
Houston , TX 77058 
Email: scott.j.wood@nasa.gov 
Phone: (281) 483-6329  
Congressional District: 36 
Web:  
Organization Type: NASA CENTER 
Organization Name: NASA Johnson Space Center 
Joint Agency:  
Comments: NOTE: PI returned to NASA JSC in January 2017. PI was at Azusa Pacific University from August 2013 – January 2017; prior to August 2013, PI was at NASA JSC. 
Co-Investigator(s)
Affiliation: 
Pradhan, Gaurav  Ph.D. Mayo Clinic Arizona 
Reschke, Millard  Ph.D. NASA Johnson Space Center 
Stepanek, Jan  M.D. Mayo Clinic Arizona 
Cevette, Michael  Ph.D. Mayo Clinic Arizona 
Project Information: Grant/Contract No. Internal Project 
Responsible Center: NASA JSC 
Grant Monitor: Stenger, Michael  
Center Contact: 281-483-1311 
michael.b.stenger@nasa.gov 
Solicitation / Funding Source: 2019 HERO 80JSC019N0001-FLAGSHIP & OMNIBUS: Human Research Program Crew Health. Appendix A&B 
Grant/Contract No.: Internal Project 
Project Type: GROUND 
Flight Program:  
TechPort: No 
No. of Post Docs:  
No. of PhD Candidates:  
No. of Master's Candidates:  
No. of Bachelor's Candidates:  
No. of PhD Degrees:  
No. of Master's Degrees:  
No. of Bachelor's Degrees:  
Human Research Program Elements: (1) HHC:Human Health Countermeasures
Human Research Program Risks: (1) Sensorimotor:Risk of Altered Sensorimotor/Vestibular Function Impacting Critical Mission Tasks (Revised as of IRP Rev M)
Human Research Program Gaps: (1) SM-203:Develop and test SMS countermeasures (IRP Rev L/M)
Flight Assignment/Project Notes: NOTE: End date changed to 9/30/2022 per PI (Ed., 7/7/21)

Task Description: The primary objective of our proposal is to develop an alternative treatment for post-flight motion sickness treatment that can effectively manage symptoms without impacting functional performance on critical crew egress tasks. Our project will validate a non-pharmaceutical tool using galvanic vestibular reduction (GVR) for suppressing vestibular function and thereby reducing motion sickness susceptibility. Our first specific aim is to evaluate the effect of timing on the administration of our non-pharmaceutical treatment to motion sickness. To accomplish this research, we will use a repeated measures design to compare motion sickness symptom onset, severity, and recovery across three conditions: administration from the onset of testing, at a midpoint of testing, and placebo control. Our second specific aim is to evaluate the effect of GVR amplitude on functional fitness task performance. We will test this hypothesis by measuring performance on a sensorimotor and cognitive test battery in steps ranging from 0 mA (control) to the level of GVR thought to provide maximal motion sickness protection. The combined deliverable from both specific aims will be to validate the efficacy of GVR when customizing the stimulus level and introducing it following symptom onset and to understand the effects of this non-pharmaceutical approach on crew performance on functional task performance. The ability to treat motion sickness with non-pharmaceutical approaches has the benefit to not only avoid sedative side effects of the medication but also allow for flexibility to turn the treatment on and off without residual effects associated with drug metabolism. Understanding the operational impacts of each device will provide a more informed evidence base for implementing this tool into crew recovery operations.

Research Impact/Earth Benefits:

Task Progress & Bibliography Information FY2021 
Task Progress: New project for FY2021.

Bibliography Type: Description: (Last Updated: 10/25/2021)  Show Cumulative Bibliography Listing
 
 None in FY 2021