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征，是对真实或感知的运动做出的生理反应。尽管进行了几十年的研究，但为什么或如何发生运动病还没有被很好地理解。被广泛接受的理论是感觉冲突理论。该理论认为，晕动病是由眼睛和内耳前庭系统接收和传输的运动信号的感觉不匹配引起的[1]。当中枢神经系统从多个感觉系统接收到相互冲突的信息时，就会出现一系列晕动病症状：内耳、眼睛、皮肤压力感受器以及肌肉和关节感觉感受器。晕动病的主要症状是恶心和呕吐。晕动病对那些容易患晕动病的人来说是一个严重的问题。不幸的是，这种情况在现代交通工具中仍然存在。作者认为，随着自动驾驶汽车技术的迅速普及，这个问题在未来肯定会加剧。据报道，在自动驾驶汽车技术中，乘客坐在前面而不是开车时会感觉更恶心。此外，随着数字设备和显示器的激增，晕动病也是一个新出现的危险[2-3]。晕动病的对策可以归类为药理学或行为学。药理措施包括非处方药，如含有抗组胺、抗胆碱、苯丙胺和5-羟色胺的非处方药。研究表明，这些药物的有效性表明与相关的神经递质有关：组胺、乙酰胆碱、去甲肾上腺素和5-羟色胺。一些药物，如东莨菪碱，只能通过处方获得。尽管目前的大多数措施在预防晕动病方面是有效的，但它们除了诱发晕动症之外，几乎没有什么作用。尤其是非处方药，有可能损害认知功能的不良影响，因此是职业使用的安全风险[5]。行为措施可以包括习惯化、再加工或脱敏治疗方案[5]。我提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VNS之外，还有另一种技术，它在两个手掌上使用基于交替振动刺激的后处理疗法，通常被称为眼动脱敏和再处理(EMDR)，由于其新颖性，将被探索。EMDR疗法最初用于心理咨询研究，基于眼球运动[6]。使用这两种非侵入性技术，我们假设暴露于VNS和EMDR的参与者与没有暴露于VNS和EMDR的参与者之间的差异将是明显的。迷走神经是第10条脑神经，起源于中枢神经系统的脑干，遍及周围，靶向胸部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的神经调节在电针疗法中具有潜在的前景。AVNS是Emmanuel Molefif脑刺激技术提出的一种非侵入性迷走神经刺激和振动运动再处理疗法，用于减少运动疼痛[7-8]。文献[9]中的研究表明，AVNs是一种安全的临床程序，可能是治疗由新冠肺炎和类似病毒引起的急性呼吸窘迫综合征的有效方法。

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.