Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Motion sickness is associated with an increase in vestibular modulation of skin but not muscle sympathetic nerve activity


We have previously shown that sinusoidal galvanic vestibular stimulation (sGVS), delivered bilaterally at frequencies of 0.08–2.00 Hz, causes a pronounced modulation of muscle sympathetic nerve activity (MSNA) and skin sympathetic nerve activity (SSNA), together with robust frequency-dependent illusions of side-to-side motion. At low frequencies of sGVS (≤0.2 Hz), some subjects report nausea, so we tested the hypothesis that vestibular modulation of MSNA and SSNA is augmented in individuals reporting nausea. MSNA was recorded via tungsten microelectrodes inserted into the left common peroneal nerve in 22 awake, seated subjects; SSNA was recorded in 14 subjects. Bipolar binaural sGVS (±2 mA, 100 cycles) was applied to the mastoid processes at 0.08, 0.13, and 0.18 Hz. Nausea was reported by 21 out of 36 subjects (58 %), but across frequencies of sGVS there was no difference in the magnitude of the vestibular modulation of MSNA in subjects who reported nausea (27.1 ± 1.8 %) and those who did not (30.4 ± 2.9 %). This contrasts with the significantly greater vestibular modulation of SSNA with nausea (41.1 ± 2.0 vs. 28.7 ± 3.1 %) and indicates an organ-specific modulation of sympathetic outflow via the vestibular system during motion sickness.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5


  1. Bent LR, Bolton PS, Macefield VG (2006) Modulation of muscle sympathetic bursts by sinusoidal galvanic vestibular stimulation in human subjects. Exp Brain Res 174:701–711

  2. Blessing WW, Nalivaiko E (2001) Raphe magnus/pallidus neurons regulate tail but not mesenteric arterial blood flow in rats. Neuroscience 105:923–929

  3. Bolton PS, Wardman DL, Macefield VG (2004) Absence of short-term vestibular modulation of muscle sympathetic outflow, assessed by brief galvanic vestibular stimulation. Exp Brain Res 154:39–43

  4. Britton TC, Day BL, Brown P, Rothwell JC, Thompson PD, Marsden CD (1993) Postural electromyographic responses in the arm and leg following galvanic vestibular stimulation in man. Exp Brain Res 94:143–151

  5. Carter JR, Ray CA (2008) Sympathetic responses to vestibular activation in humans. Am J Physiol Regul Integr Comp Physiol 294:681–688

  6. Cohen B, Yakushin SB, Holstein GR (2012) What does galvanic vestibular stimulation actually activate? Front Neurol 2:90

  7. Costa F, Lavin P, Robertson D, Biaggioni I (1995) Effect of neurovestibular stimulation on autonomic regulation. Clin Auton Res 5:289–293

  8. Crampton G (1990) Motion and space sickness. CRC Press, Boca Raton

  9. Cui J, Mukai C, Iwase S, Sawasaki N, Kitazawa H, Mano T, Sugiyama Y, Wada Y (1997) Response to vestibular stimulation of sympathetic outflow to muscle in humans. J Auton Nerv Syst 66:154–162

  10. Curthoys IS, Macdougall HG (2012) What galvanic vestibular stimulation actually activates. Front Neurol 3:117

  11. Dampney RA, Horiuchi J, Tagawa T, Fontes MA, Potts PD, Polson JW (2003a) Medullary and supramedullary mechanisms regulating sympathetic vasomotor tone. Acta Physiol Scand 177:209–218

  12. Dampney RA, Polson JW, Potts PD, Hirooka Y, Horiuchi J (2003b) Functional organization of brain pathways subserving the baroreceptor reflex: studies in conscious animals using immediate early gene expression. Cell Mol Neurobiol 23:597–616

  13. Day BL, Severac-Cauquil A, Bartolomei L, Pastor MA, Lyon IN (1997) Human body-segment tilts induced by galvanic stimulation: a vestibularly driven balance protection mechanism. J Physiol 500:661–672

  14. Delius W, Hagbarth KE, Hongell A, Wallin BG (1972) Manoeuvres affecting sympathetic outflow in human skin nerves. Acta Physiol Scand 84:177–186

  15. Forbes PA, Siegmund GP, Schouten AC, Blouin JS (2015) Task, muscle and frequency dependent vestibular control of posture. Front Integr Neurosci 8:94

  16. Golding JF (2006) Motion sickness susceptibility. Auton Neurosci 129:67–76

  17. Grewal T, James C, Macefield VG (2009) Frequency-dependent modulation of muscle sympathetic nerve activity by sinusoidal galvanic vestibular stimulation in human subjects. Exp Brain Res 197:379–386

  18. Hammam E, James C, Dawood T, Macefield VG (2011) Low-frequency sinusoidal galvanic stimulation of the left and right vestibular nerves reveals two peaks of modulation in muscle sympathetic nerve activity. Exp Brain Res 213:507–514

  19. Hammam E, Dawood T, Macefield VG (2012) Low-frequency galvanic vestibular stimulation evokes two peaks of modulation in skin sympathetic nerve activity. Exp Brain Res 219:441–446

  20. Himi N, Koga T, Nakamura E, Kobashi M, Yamane M, Tsujioka K (2004) Differences in autonomic responses between subjects with and without nausea while watching an irregularly oscillating video. Auton Neurosci 116:46–53

  21. Hume KM, Ray CA (1999) Sympathetic responses to head-down rotations in humans. J Appl Physiol 86:1971–1976

  22. James C, Stathis A, Macefield VG (2010) Vestibular and pulse-related modulation of skin sympathetic nerve activity during sinusoidal galvanic vestibular stimulation in human subjects. Exp Brain Res 202:291–298

  23. Kaufmann H, Biaggioni I, Voustianiouk A, Diedrich A, Costa F, Clarke R, Gizzi M, Raphan T, Cohen B (2002) Vestibular control of sympathetic activity. An otolith-sympathetic reflex in humans. Exp Brain Res 143:463–469

  24. Kerman IA, Yates BJ, McAllen RM (2000) Anatomic patterning in the expression of vestibulosympathetic reflexes. Am J Physiol Regul Integr Comp Physiol 279:R109–R117

  25. Lackner JR (2014) Motion sickness: more than nausea and vomiting. Exp Brain Res 232:2493–2510

  26. Macefield VG, Wallin BG (1995) Effects of static lung inflation on sympathetic activity in human muscle nerves at rest and during asphyxia. J Auton Nerv Syst 53:148–156

  27. McAllen RM, Farrell M, Johnson JM, Trevaks D, Cole L, McKinley MJ, Jackson G, Denton DA, Egan GF (2006) Human medullary responses to cooling and rewarming the skin: a functional MRI study. Proc Natl Acad Sci U S A 103:809–813

  28. Miller JC, Sharkey TJ, Graham GA, McCauley ME (1993) Autonomic physiological data associated with simulator discomfort. Aviat Space Environ Med 64:813–819

  29. Money K (1970) Motion sickness. Physiol Rev 50:1–39

  30. Mullen TJ, Berger RD, Oman CM, Cohen RJ (1998) Human heart rate variability relation is unchanged during motion sickness. J Vestib Res 8:95–105

  31. Raphan T, Cohen B (2002) The vestibulo-ocular reflex in three dimensions. Exp Brain Res 145:1–27

  32. Ray CA, Monahan KD (2002) The vestibulosympathetic reflex in humans: neural interactions between cardiovascular reflexes. Clin Exp Pharmacol Physiol 29:98–102

  33. Tyler DB, Bard P (1949) Motion sickness. Physiol Rev 29:311–369

  34. Yates BJ, Yamagata Y, Bolton PS (1991) The ventrolateral medulla of the cat mediates vestibulosympathetic reflexes. Brain Res 552:265–272

  35. Yates BJ, Goto T, Bolton PS (1993) Responses of neurons in the rostral ventrolateral medulla of the cat to natural vestibular stimulation. Brain Res 601:255–264

  36. Yates BJ, Bolton PS, Macefield VG (2014) Vestibulo-sympathetic responses. Compr Physiol 4:851–887

  37. Yokota Y, Aoki M, Mizuta K, Ito Y, Isu N (2005) Motion sickness susceptibility associated with visually induced postural instability and cardiac autonomic responses in healthy subjects. Acta Otolaryngol 125:280–285

Download references


This work was supported by the Australian Research Council (ARC Discovery Project 1096179).

Author information

Correspondence to Vaughan G. Macefield.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Klingberg, D., Hammam, E. & Macefield, V.G. Motion sickness is associated with an increase in vestibular modulation of skin but not muscle sympathetic nerve activity. Exp Brain Res 233, 2433–2440 (2015).

Download citation


  • Muscle sympathetic nerve activity
  • Nausea
  • Skin sympathetic nerve activity
  • Vestibulosympathetic reflexes