The effect of nicotine on perceptual, ocular motor, postural, and vegetative functions at rest and in motion

• Published in: Journal of neurology Vol. 254; no. 12; pp. 1689 - 1697
• Main Authors: CARINA ZINGLER, Vera, DENECKE, Kirstin, JAHN, Klaus, VON MEYER, Ludwig, KRAFCZYK, Siegbert, KRAMS, Michael, ELFONT, Robert, BRANDT, Thomas, STRUPP, Michael, GLASAUER, Stefan
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.12.2007; Springer Nature B.V
• Subjects: Administration, Intranasal; Adult; Analysis of Variance; Biological and medical sciences; Dizziness - chemically induced; Dizziness - physiopathology; Dose-Response Relationship, Drug; Female; Humans; Male; Medical sciences; Middle Aged; Motion; Nausea - chemically induced; Nausea - physiopathology; Neurology; Neuropharmacology; Neuroprotective agent; Nicotine - administration & dosage; Nicotine - blood; Nicotinic Agonists - administration & dosage; Nicotinic Agonists - blood; Nystagmus, Optokinetic - drug effects; Oculomotor disorders; Ophthalmology; Perceptual Disorders - chemically induced; Perceptual Disorders - physiopathology; Pharmacology. Drug treatments; Posture - physiology; Random Allocation; Rest; Sensation Disorders - chemically induced; Sensation Disorders - physiopathology; Vestibular Diseases - chemically induced; Vestibular Diseases - physiopathology; Motion; Nervous system diseases; dizziness; Nausea; Vertigo; Equilibrium disorder; Eye; Visual system; Eye disease; Rest; postural imbalance; Nystagmus; ENT disease; Oculomotor syndrome; nicotine-induced nystagmus; Nicotine
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-007-0621-9

Nicotine has wellknown, unpleasant side effects, e.g., transient dizziness, nausea, and nicotine-induced nystagmus (NIN). To investigate factors influencing these effects, we addressed three questions: (1) Is the intensity of dizziness, nausea, NIN, and unsteadiness dependent on nicotine dosage? (2) Does the intensity of perceptual, ocular motor, vegetative effects, and postural imbalance correlate? (3) Do visual or vestibular motion stimuli produce and/or aggravate distressing dizziness and nausea? Sixty healthy non-smokers or occasional smokers participated; 40 were tested once before and six times after application of a nicotine nasal spray in doses of 1 mg or 2 mg with or without motion stimulation; 20 received a placebo nasal spray. Plasma nicotine concentrations were significantly related to nicotine dosage. Dizziness, nausea, NIN, and unsteadiness also depended on the nicotine dosage (p < 0.01).Nicotine blood concentration was a better predictor for the temporal dependence of nystagmus than nicotine dosage. Dizziness correlated highly with nausea (R = 0.63, p < 0.001). The degree of nicotine-induced nausea significantly correlated with postural imbalance. The time course of postural sway differed according to nicotine dosage and gender: for women, there was no clear relationship between sway magnitude and nicotine dosage, while men showed increased sway with higher dosage. Motion stimulation increased nicotine-induced dizziness and nausea, but did not significantly influence NIN or postural imbalance. Our data support the view that all measured adverse effects reflect dose-dependent nicotine-induced vestibular dysfunction. Additional motion stimulation aggravates dizziness and nausea, i.e., nicotine increases sensitivity to motion sickness.