Auricular Vagus Nerve Stimulation and Vibro-motor Reprocessing Therapy for Motion Sickness Reduction

晕动病是一种常见而复杂的综合症，是对真实或感知运动的生理反应。尽管经过了几十年的研究，人们对晕动病发生的原因和方式还没有足够的了解。被广泛接受的理论是感觉冲突。该理论认为，晕动病是由眼睛和内耳前庭系统接收和传递的运动信号的感觉不匹配引起的。当中枢神经系统从多个感觉系统（内耳、眼睛、皮肤压力感受器以及肌肉和关节感觉感受器）接收到相互矛盾的信息时，就会出现一系列晕车症状。晕动病的主要症状是恶心和呕吐。晕动病对那些容易晕车的人来说是一个严重的问题。不幸的是，在所有现代运输方式中，这种情况仍然存在。作者认为，随着自动驾驶汽车技术的迅速普及，这个问题将在未来加剧。据报道，在自动驾驶汽车中，乘客坐在前排而不开车时，会感到更恶心。此外，随着数字设备和显示器的普及，晕动病也成为一种新出现的危害[2-3]。晕车的对策可分为药理学和行为学两大类。药理学措施包括非处方药物，如含有抗组胺药、抗胆碱能药、安非他明和血清素的药物。研究表明，这些药物的有效性与相关的神经递质有关：组胺、乙酰胆碱、去甲肾上腺素和血清素。一些药物，如东莨菪碱，只能通过处方获得。尽管目前大多数措施对预防晕动病有效，但它们所做的不过是引起困倦。尤其是非处方药，其副作用可能损害认知功能，因此在职业使用中存在安全风险。行为措施可以包括习惯化、再处理或脱敏治疗方案[10]。我建议的博士研究领域的目的是通过使用耳迷走神经刺激（aVNS）来减少晕动病/恶心。除了avns之外，还有另一种技术，它使用基于双掌交替振动刺激的再加工疗法，通常被称为眼动脱敏和再加工（EMDR），由于其新颖性，将被探索。EMDR疗法最初用于心理咨询研究，是基于眼球运动的。使用这两种非侵入性技术，我们假设分别暴露于avns和EMDR的参与者与未暴露于avns和EMDR的参与者之间的差异是明显的。迷走神经是第10条颅神经，起源于中枢神经系统的脑干，穿过周围神经，作用于胸腔和腹部的每一个主要器官。以电刺激耳迷走神经的形式进行神经调节在电疗法中具有潜在的前景。aVNS是一种非侵入性的耳迷走神经刺激和振动运动再加工疗法，用于减少运动病。Emmanuel博士建议采用纤维脑刺激技术，该技术已被证明在减轻压力方面有效[7-8]。b[9]的研究表明，aVNS是一种安全的临床程序，可以有效治疗由Covid-19和类似病毒引起的急性呼吸窘迫综合征（ARDS）。

Motion sickness is a common and complex syndrome that occurs as a physiological responseto real or perceived motion. Despite decades of research, why or how motion sicknessoccurs has not yet been understood well enough. The widely accepted theory is that ofsensory conflict. The theory posits that motion sickness is caused by sensory mismatch ofmotion signals received and transmitted by the eyes and the vestibular system in the innerear [1].An array of symptoms for motion sickness appears when the central nervous systemreceives conflicting information from the multiple sensory systems: the inner ear, eyes, skinpressure receptors and the muscle and joint sensory receptors. The primary symptoms ofmotion sickness are nausea and vomiting.Motion sickness is a serious problem for the people who are prone to the ailment.Unfortunately, this continues to be encountered in all modes of modern transportation. Theauthor believes that this problem is set to be exacerbated in future with the rapidlyincreasing adoption of autonomous vehicle technology in which passengers reportedly feelincreased sickness when sitting in front but not driving. Moreover, motion sickness is anemerging hazard with the proliferation of digital devices and displays [2-3].Countermeasures for motion sickness can be classified as either pharmacologic orbehavioural. Pharmacologic measures include over-the-counter medications such as thosecontaining antihistamines, anticholinergics, amphetamines and serotonin. Research hasshown that the effectiveness of these medications suggest involvement with relatedneurotransmitters: histamine, acetylcholine, noradrenalin and serotonin [4]. Somemedications such as scopolamine, are available only via prescription. Although most currentmeasures are effective at preventing motion sickness, they do little more than inducedrowsiness. Over-the-counter medications, particularly, have adverse effects that canimpair cognitive function and thus represent a safety risk for occupational use [5].Behavioural measures could comprise habituation, reprocessing or desensitisationtreatment protocols [5].The aim of my proposed area of PhD research is to reduce motion sickness/nausea by usingauricular Vagus Nerve Stimulation (aVNS). There exists another technique other than aVNSthat uses reprocessing therapy based on alternating vibrating stimulations in both palmsgenerally known as Eye Movement Desensitisation and Reprocessing (EMDR) that will beexplored due to its novelty. EMDR therapy was originally used in psychological counsellingstudies and is based on eye movement [6]. Using both of these non-invasive techniques, wehypothesize that differences would be evident between participants who were exposed toaVNS and EMDR and those who were not, respectively.The Vagus nerve is the 10th cranial nerve that originates in the brainstem of the centralnervous system and travels throughout the periphery, targeting every major organ in thethorax and abdomen. Neuromodulation in the form of electrical stimulation of the auricularVagus nerve has a potential promise for electroceutical therapy. aVNS is a non-invasive Auricular Vagus Nerve Stimulation and Vibro-motor Reprocessing Therapy for MotionSickness ReductionPhD Proposal by Emmanuel Molefibrain stimulation technique that has been shown to be efficacious in the reduction of stress[7-8]. Study in [9] has shown aVNS as a safe clinical procedure and could be an effectivetreatment for Acute Respiratory Distress Syndrome (ARDS) originated by Covid-19 andsimilar viruses.