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Psychophysiological Markers and the Brain Processing of Visual Motion Induced Nausea in Healthy Humans

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Psychophysiological Markers and the Brain Processing of Visual Motion Induced Nausea in Healthy Humans Psychophysiological markers and the brain processing of visual motion induced nausea in healthy humans Kee Seong Ng Thesis submitted for the Degree of Doctor of Philosophy Barts & The London School of Medicine & Dentistry, Queen Mary University of London November 2012 1 TABLE OF CONTENTS ABSTRACT ........................................................................................................................................... 19 ABBREVIATIONS ................................................................................................................................. 21 CHAPTER 1 .......................................................................................................................................... 24 1.1 DEFINITIONS ........................................................................................................................................ 26 1.2 ASSESSING NAUSEA .............................................................................................................................. 27 1.3 IMPACT OF NAUSEA .............................................................................................................................. 28 1.4 NAUSEA THE NEGLECTED SYMPTOM ........................................................................................................ 29 1.5 PATHWAYS OF NAUSEA AND VOMITING .................................................................................................... 30 1.5.1 Potential cortical pathways of nausea ..................................................................................... 31 1.6 AIMS ................................................................................................................................................. 40 CHAPTER 2 .......................................................................................................................................... 41 1 INTRODUCTION ............................................................................................................................... 42 1.1 THE CHALLENGE OF STUDYING NAUSEA IN HUMANS .................................................................................... 42 1.2 METHODS OF STUDYING NAUSEA. ........................................................................................................... 44 1.2.1 Ingested or injected agents ...................................................................................................... 44 1.3 OPTOKINETIC DRUM FOR MOTION INDUCED NAUSEA .................................................................................. 45 1.4 KNOWLEDGE GAP ................................................................................................................................. 48 1.5 RESEARCH AIMS AND HYPOTHESIS ........................................................................................................... 49 2 METHODS ........................................................................................................................................ 50 2.1 STUDY DESIGN AND SETTING .................................................................................................................. 50 2 2.2.ETHICAL APPROVAL .............................................................................................................................. 50 2.3 SUBJECTS ............................................................................................................................................ 50 2.4 MATERIALS AND PROTOCOL ................................................................................................................... 51 2.4.1 Psychometrics and motion sickness susceptibility questionnaires ........................................... 52 2.4.2 Big five inventory ...................................................................................................................... 53 2.4.3 Spielberger State and Trait Anxiety Inventory .......................................................................... 53 2.4.4 Weinberger Adjustment Inventory ........................................................................................... 53 2.4.5 Hospital Anxiety Depression Scale ............................................................................................ 54 2.4.6 Assessment of motion sickness susceptibility ........................................................................... 54 2.4.7 Assessment of visual motion induced nausea .......................................................................... 55 2.5 PREPARATION FOR EXPERIMENT .............................................................................................................. 57 2.6 BASELINE ACTIVITY ............................................................................................................................... 58 2.7 EXPOSURE TO STIMULUS ........................................................................................................................ 58 2.8 NAUSEA MARKERS ................................................................................................................................ 59 2.9 THE AUTONOMIC NERVOUS SYSTEM ........................................................................................................ 60 2.9.1 Beat-to-beat measures ............................................................................................................. 60 2.9.2 Cardiac vagal tone ................................................................................................................... 61 2.9.3 Cardiac sensitivity to the baroreflex ......................................................................................... 63 2.10 SELECTIVE SYMPATHETIC MEASURES ..................................................................................................... 64 2.10.1 Vasomotor .............................................................................................................................. 64 2.10.2 Sudomotor .............................................................................................................................. 65 2.11 STATISTICAL ANALYSIS ..................................................................................................................... 66 3 3. RESULTS .......................................................................................................................................... 67 3.1 SUBJECT CHARACTERISTICS ..................................................................................................................... 67 3.2 EFFECTS OF VIDEOS ON SUBJECTIVE SENSATIONS ........................................................................................ 69 3.3 EFFECTS OF VIDEOS ON ANS BIOMARKERS ................................................................................................ 73 3.4 DIFFERENCES BETWEEN NAUSEA SUSCEPTIBLE AND RESISTANT SUBJECTS ........................................................ 77 4 DISCUSSION ........................................................................................................................................... 82 4.1 VISUAL MOTION INDUCED NAUSEA .......................................................................................................... 82 4.2 NAUSEA ASSOCIATED PSYCHOPHYSIOLOGICAL MEASURES ............................................................................ 82 4.3 LIMITATIONS AND THE WAY FORWARD ..................................................................................................... 83 CHAPTER 3 .......................................................................................................................................... 85 1 INTRODUCTION ............................................................................................................................... 86 1.1 INDIVIDUAL VARIABILITY TO MOTION SICKNESS NAUSEA ............................................................................... 86 1.2 PSYCHOPHYSIOLOGICAL MARKERS OF NAUSEA ........................................................................................... 89 1.3 ELECTROGASTROGRAPHY ....................................................................................................................... 90 1.4 NEUROENDOCRINAL SYSTEM INFLUENCE ON NAUSEA ................................................................................. 93 1.5 IDENTIFYING SUITABLE STUDY SUBJECTS ................................................................................................... 94 1.6 KNOWLEDGE GAPS ............................................................................................................................... 95 1.7 AIMS ................................................................................................................................................. 95 1.8 HYPOTHESIS ........................................................................................................................................ 96 2 METHODS ........................................................................................................................................ 96 2.1 STUDY DESIGN AND SETTING .................................................................................................................. 96 2.2 ETHICAL APPROVAL ............................................................................................................................... 96 4 2.3 SUBJECTS ...........................................................................................................................................
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