Cited by 216Vestibular and auditory disordersNausea and vomiting managementVirtual Reality Applications and Impacts

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The Brain Circuitry Underlying the Temporal Evolution of Nausea in Humans

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Napadow, V., Sheehan, J. D., Kim, J., LaCount, L. T., Park, K., Kaptchuk, T. J., Rosen, B. R., Kuo, B.·2013·Cerebral Cortex

DOI 10.1093/cercor/bhs073PMC PMC3593575

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Abstract

Nausea is a universal human experience. It evolves slowly over time, and brain mechanisms underlying this evolution are not well understood. Our functional magnetic resonance imaging (fMRI) approach evaluated brain activity contributing to and arising from increasing motion sickness. Subjects rated transitions to increasing nausea, produced by visually induced vection within the fMRI environment. We evaluated parametrically increasing brain activity 1) precipitating increasing nausea and 2) following transition to stronger nausea. All subjects demonstrated visual stimulus-associated activation (P < 0.01) in primary and extrastriate visual cortices. In subjects experiencing motion sickness, increasing phasic activity preceding nausea was found in amygdala, putamen, and dorsal pons/locus ceruleus. Increasing sustained response following increased nausea was found in a broader network including insular, anterior cingulate, orbitofrontal, somatosensory and prefrontal cortices. Moreover, sustained anterior insula activation to strong nausea was correlated with midcingulate activation (r = 0.87), suggesting a closer linkage between these specific regions within the brain circuitry subserving nausea perception. Thus, while phasic activation in fear conditioning and noradrenergic brainstem regions precipitates transition to strong nausea, sustained activation following this transition occurs in a broader interoceptive, limbic, somatosensory, and cognitive network, reflecting the multiple dimensions of this aversive commonly occurring symptom.

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Nausea and vomiting
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SEASICKNESS - CURRENT STATE OF PREVENTION AND TREATMENT ISSUE
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Gastrointestinal Symptoms: Nausea and Vomiting
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Additional file 1 of Successful implementation of an enhanced recovery after surgery (ERAS) protocol reduces nausea and vomiting after infratentorial craniotomy for tumour resection: a randomized controlled trial
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“Previous research has shown phasic activation of the amygdala prior to the onset of nausea (Napadow et al., 2013), while the subjective sensation of nausea is accompanied by activation of the anterior cingulate cortex, a region associated with sympathetic but not parasympathetic regulation…”

Authors: Napadow, V., Sheehan, J. D., Kim, J., LaCount, L. T., Park, K., Kaptchuk, T. J., Rosen, B. R., & Kuo, B.
Affiliations: Harvard University (US)
Massachusetts General Hospital (US)
Kyung Hee University (KR)
Beth Israel Deaconess Medical Center (US)
ORCID: Napadow, V.
Kim, J.
Park, K.
Kaptchuk, T. J.
Rosen, B. R.
Kuo, B.
Venue: Cerebral Cortex
Publisher: Oxford University Press (OUP)
Published: 2012-04-02
Volume: 23
Issue: 4
Pages: 806-813
ISSN: 1047-3211 (ISSN-L)
1460-2199
DOI: 10.1093/cercor/bhs073
PMC: PMC3593575
OpenAlex: W2147691780
Semantic Scholar: 0a06a06e294f3469f9768684508df0ae84ee9339
Cited by: 215
References: 55
Citations by year: 2026: 20 · 2025: 7 · 2024: 12 · 2023: 14 · 2022: 14 · 2021: 11 · 2020: 18 · 2019: 19 · 2018: 14 · 2017: 15 · 2016: 27 · 2015: 14 · 2014: 14 · 2013: 13 · 2012: 2
FWCI: 6.91
Type: journal article
Language: en
Open access: green
europepmc.org
Locations: Cerebral Cortex (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (K23DK069614)
National Center for Research Resources (P41-RR-14075, UL1RR025758, P41RR014075)
National Center for Complementary and Integrative Health (R01AT004714, F05AT003770, K24AT004095, K01AT002166, P01AT002048)
Topics: Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
Health Sciences › Medicine › Surgery › Nausea and vomiting management
Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
Keywords: nausea, motion sickness, brain circuits, amygdala, anterior insula, anterior cingulate cortex, locus coeruleus, interoception, noradrenergic system, fear conditioning, somatosensory cortex, orbitofrontal cortex
MeSH terms: Adult, Brain, Brain Mapping, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Middle Aged, Motion Perception, Nausea, Nerve Net, Neural Pathways, Oxygen, Photic Stimulation, Reaction Time, Young Adult

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The Brain Circuitry Underlying the Temporal Evolution of Nausea in Humans

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