{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:16:58Z","timestamp":1791472618533,"version":"4.3.4"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Determine whether shipboard motion variability relates to simulator\u2011sickness symptoms, Mal de D\u00e9barquement syndrome (MdDS) features, and cognition, and whether migraine or motion\u2011sickness history modify these vestibular effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective observational cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>USNS Mercy (T\u2011AH 19) during Pacific Partnership 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>38 Active\u2011Duty personnel were tested at baseline (land), after California\u2010Hawaii (CA\u2010HI; rougher), and after Chuuk\u2010Hawaii (CHUUK\u2010HI; calmer). A centrally mounted, inertial measurement unit (IMU) yielded per\u2011minute standard deviation of linear\u2011acceleration magnitude (IMU SD). Outcomes: Simulator Sickness Questionnaire (SSQ); MdDS calculator mapped to B\u00e1r\u00e1ny criteria; Rey\u2010Osterrieth Complex Figure (ROCF); Symbol Digit Modalities Test (SDMT); Stroop Test; linear mixed\u2010effects model using voyage leg and IMU SD as predictors of symptom outcomes and adjusted for migraine and motion\u2011sickness history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>IMU SD was higher on CA\u2010HI. SSQ totals were higher on CA\u2010HI and increased with IMU SD. MdDS criteria counts, and cases were similar between legs; Migraine Disability Assessment Score (MIDAS) was positively associated with MdDS criterion burden, but not with SSQ. ROCF showed slower copy\/recall and lower recall accuracy on CA\u2010HI; SDMT and Stroop errors were largely unchanged. There were no statistical differences based on migraine or motion\u2011sickness history, but analyses were limited by small subgroup sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rougher sea states (greater IMU variability) were linked to higher acute symptom burden and specific visuospatial memory impairments. The incidence of persistent MdDS did not differ by leg. IMU\u2011informed monitoring with brief, targeted cognitive tests may support future planning and post\u2011voyage screening to identify at\u2010risk individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70162","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:13:04Z","timestamp":1773007984000},"page":"1321-1329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Motion Exposure, Cognitive Impairment, and Risk Factors for Mal de D\u00e9barquement Syndrome"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5442-7112","authenticated-orcid":false,"given":"Charlotte K.","family":"Hughes","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Naval Medical Center San Diego California USA"},{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Diego La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Diego La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hudson","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Medicine Georgetown University Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco A.","family":"Ayala","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery California Head &amp; Neck Specialists San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy E.","family":"Ashman","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Naval Medical Center San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong","family":"Bin Lee","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head &amp; Neck Surgery Konyang University Hospital Daejeon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashima","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Shri Ashwini Saxena Hospital Rewari Haryana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Eliason","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Naval Medical Center Portsmouth Portsmouth Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor","family":"de Cos","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiersten R.","family":"Russ","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Diego La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6926-4604","authenticated-orcid":false,"given":"Akihiro J.","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Balance &amp; Vestibular Program, Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Diego La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.125.6.615"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-200714"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2144\/fsoa-2022-0022"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usad449"},{"issue":"6","key":"e_1_2_11_6_1","article-title":"Mal de debarquement syndrome complicated by psychiatric comorbidities","volume":"24","author":"Amuk \u00d6C","year":"2022","journal-title":"Prim Care Companion CNS Disord"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119513469"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327108ijap0303_3"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.680474"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517690821"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e31818457fb"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00433"},{"key":"e_1_2_11_13_1","unstructured":"BloombergJJ ReschkeMF Cl\u00e9mentGR et al. Risk of impaired control of spacecraft\/associated systems and decreased mobility due to vestibular\/sensorimotor alterations associated with spaceflight. NASA Johnson Space Center Houston TX; Sep. 2015 cited from NASA Technical Reports Server Document ID: 20150018603."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0018720814522484"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2014.00124"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00175"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00814"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70162","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70162","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:46:17Z","timestamp":1777455977000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,3]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/ohn.70162"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70162","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,3]]},"assertion":[{"value":"2025-09-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}