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At least 451 records · Page 25

Comparison of treatment strategies for Space Motion Sickness

Treatment strategies for Space Motion Sickness were compared using the results of postflight oral debriefings. Standardized questionnaires were administered to all crewmembers immediately following Space Shuttle flights by NASA flight surgeons. Cases of Space Motion Sickness were graded as mild, moderate or severe based on published criteria, and medication effectiveness was judged based on subjective reports of symptom relief. Since October 1989, medication effectiveness is reported inflight through Private Medical Conferences with the crew. A symptom matrix was analyzed for 19 crewmembers treated with an oral combination of scopolamine and dextroamphetamine (scopdex) and 15 crewmembers treated with promethazine delivered by intramuscular (IM) or suppository routes. Scopdex has been given preflight as prophaxis for Space Motion Sickness but analysis showed delayed symptom presentation in 9 crewmembers or failed to prevent symptoms in 7. Only three crewmembers who took scopdex had no symptoms inflight. Fourteen out of 15 crewmembers treated with IM promethazine and 6 of 8 treated with promethazine suppositories after symptom development had immediate (within 12 h) symptom relief and required no additional medication. There were no cases of delayed symptom presentation in the crewmembers treated with promethazine. This response is in contrast to untreated crewmembers who typically have slow symptom resolution over 72-96 h. We conclude that promethazine is an effective treatment of Space Motion Sickness symptoms inflight. NASA policy currently recommends treating crewmembers with Space Motion Sickness after symptom development, and no longer recommends prophylaxis with scopdex due to delayed symptom development and apparent variable absorption of oral medications during early flight days.

STS Shuttle Project↗

Recreation Embedded State Tuning for Optimal Readiness and Effectiveness (RESTORE)

Physiological self-regulation training is a behavioral medicine intervention that has demonstrated capability to improve psychophysiological coping responses to stressful experiences and to foster optimal behavioral and cognitive performance. Once developed, these psychophysiological skills require regular practice for maintenance. A concomitant benefit of these physiologically monitored practice sessions is the opportunity to track crew psychophysiological responses to the challenges of the practice task in order to detect shifts in adaptability that may foretell performance degradation. Long-duration missions will include crew recreation periods that will afford physiological self-regulation training opportunities. However, to promote adherence to the regimen, the practice experience that occupies their recreation time must be perceived by the crew as engaging and entertaining throughout repeated reinforcement sessions on long-duration missions. NASA biocybernetic technologies and publications have developed a closed-loop concept that involves adjusting or modulating (cybernetic, for governing) a person's task environment based upon a comparison of that person's physiological responses (bio-) with a training or performance criterion. This approach affords the opportunity to deliver physiological self-regulation training in an entertaining and motivating fashion and can also be employed to create a conditioned association between effective performance state and task execution behaviors, while enabling tracking of individuals psychophysiological status over time in the context of an interactive task challenge. This paper describes the aerospace spin-off technologies in this training application area as well as the current spin-back application of the technologies to long-duration missions - the Recreation Embedded State Tuning for Optimal Readiness and Effectiveness (RESTORE) concept. The RESTORE technology is designed to provide a physiological self-regulation training countermeasure for maintaining and reinforcing cognitive readiness, resilience under psychological stress, and effective mood states in long-duration crews. The technology consists of a system for delivering physiological self-regulation training and for tracking crew central and autonomic nervous system function; the system interface is designed to be experienced as engaging and entertaining throughout repeated training sessions on long-duration missions. Consequently, this self-management technology has threefold capability for recreation, behavioral health problem prophylaxis and remediation, and psychophysiological assay. The RESTORE concept aims to reduce the risk of future manned exploration missions by enhancing the capability of individual crewmembers to self-regulate cognitive states through recreation-embedded training protocols to effectively deal with the psychological toll of long-duration space flight.

Pope, Alan T.↗

Publications of the Space Physiology and Countermeasures Program, Neuroscience Discipline: 1980-1990

A 10-year cumulative bibliography of publications resulting from research supported by the neuroscience discipline of the space physiology and countermeasures program of NASA's Life Sciences Division is provided. Primary subjects included in this bibliography are space motion sickness; vestibular performance, posture, and motor coordination; vestibular physiology; central and peripheral nervous system physiology; and general performance and methodologies. General physiology references are also included.

Dickson, Katherine J.↗

Neuroprotection trek--the next generation: neuromodulation I. Techniques--deep brain stimulation, vagus nerve stimulation, and transcranial magnetic stimulation

Neuromodulation denotes controlled electrical stimulation of the central or peripheral nervous system. The three forms of neuromodulation described in this paper-deep brain stimulation, vagus nerve stimulation, and transcranial magnetic stimulation-were chosen primarily for their demonstrated or potential clinical usefulness. Deep brain stimulation is a completely implanted technique for improving movement disorders, such as Parkinson's disease, by very focal electrical stimulation of the brain-a technique that employs well-established hardware (electrode and pulse generator/battery). Vagus nerve stimulation is similar to deep brain stimulation in being well-established (for the treatment of refractory epilepsy), completely implanted, and having hardware that can be considered standard at the present time. Vagus nerve stimulation differs from deep brain stimulation, however, in that afferent stimulation of the vagus nerve results in diffuse effects on many regions throughout the brain. Although use of deep brain stimulation for applications beyond movement disorders will no doubt involve placing the stimulating electrode(s) in regions other than the thalamus, subthalamus, or globus pallidus, the use of vagus nerve stimulation for applications beyond epilepsy-for example, depression and eating disorders-is unlikely to require altering the hardware significantly (although stimulation protocols may differ). Transcranial magnetic stimulation is an example of an external or non-implanted, intermittent (at least given the current state of the hardware) stimulation technique, the clinical value of which for neuromodulation and neuroprotection remains to be determined.

Review, Tutorial↗

Mutations in the dopamine beta-hydroxylase gene are associated with human norepinephrine deficiency

Norepinephrine (NE), a key neurotransmitter of the central and peripheral nervous systems, is synthesized by dopamine beta-hydroxylase (DBH) that catalyzes oxidation of dopamine (DA) to NE. NE deficiency is a congenital disorder of unknown etiology, in which affected patients suffer profound autonomic failure. Biochemical features of the syndrome include undetectable tissue and circulating levels of NE and epinephrine, elevated levels of DA, and undetectable levels of DBH. Here, we report identification of seven novel variants including four potentially pathogenic mutations in the human DBH gene (OMIM 223360) from analysis of two unrelated patients and their families. Both patients are compound heterozygotes for variants affecting expression of DBH protein. Each carries one copy of a T-->C transversion in the splice donor site of DBH intron 1, creating a premature stop codon. In patient 1, there is a missense mutation in DBH exon 2. Patient 2 carries missense mutations in exons 1 and 6 residing in cis. We propose that NE deficiency is an autosomal recessive disorder resulting from heterogeneous molecular lesions at DBH. Copyright 2002 Wiley-Liss, Inc.

Case Reports↗

Hemichordates and the origin of chordates

Hemichordates, the phylum of bilateral animals most closely related to chordates, could reveal the evolutionary origins of chordate traits such as the nerve cord, notochord, gill slits and tail. The anteroposterior maps of gene expression domains for 38 genes of chordate neural patterning are highly similar for hemichordates and chordates, even though hemichordates have a diffuse nerve-net. About 40% of the domains are not present in protostome maps. We propose that this map, the gill slits and the tail date to the deuterostome ancestor. The map of dorsoventral expression domains, centered on a Bmp-Chordin axis, differs between the two groups; hemichordates resemble protostomes more than they do chordates. The dorsoventral axis might have undergone extensive modification in the chordate line, including centralization of the nervous system, segregation of epidermis, derivation of the notochord, and an inversion of organization.

Review, Tutorial↗

Numerical Modeling of Ocular Dysfunction in Space

Upon introduction to microgravity, the near-loss of hydrostatic pressure causes a marked cephalic (headward) shift of fluid in an astronaut's body. The fluid shift, along with other factors of spaceflight, induces a cascade of interdependent physiological responses which occur at varying time scales. Long-duration missions carry an increased risk for the development of the Visual Impairment and Intracranial Pressure (VIIP) syndrome, a spectrum of ophthalmic changes including posterior globe flattening, choroidal folds, distension of the optic nerve sheath, kinking of the optic nerve and potentially permanent degradation of visual function. In the cases of VIIP found to date, the initial onset of symptoms occurred after several weeks to several months of spaceflight, by which time the gross bodily fluid distribution is well established. We are developing a suite of numerical models to simulate the effects of fluid shift on the cardiovascular, central nervous and ocular systems. These models calculate the modified mean volumes, flow rates and pressures that are characteristic of the altered quasi-homeostatic state in microgravity, including intracranial and intraocular pressures. The results of the lumped models provide initial and boundary data to a 3D finite element biomechanics simulation of the globe, optic nerve head and retrobulbar subarachnoid space. The integrated set of models will be used to investigate the evolution of the biomechanical stress state in the ocular tissues due to long-term exposure to microgravity.

intraocular pressure↗

Microgravity-Induced Physiological Fluid Redistribution: Computational Analysis to Assess Influence of Physiological Parameters

Space flight impacts human physiology in many ways, the most immediate being the marked cephalad (headward) shift of fluid upon introduction into the microgravity environment. This physiological response to microgravity points to the redistribution of blood and interstitial fluid as a major factor in the loss of venous tone and reduction in heart muscle efficiency which impact astronaut performance. In addition, researchers have hypothesized that a reduction in astronaut visual acuity, part of the Visual Impairment and Intracranial Pressure (VIIP) syndrome, is associated with this redistribution of fluid. VIIP arises within several months of beginning space flight and includes a variety of ophthalmic changes including posterior globe flattening, distension of the optic nerve sheath, and kinking of the optic nerve. We utilize a suite of lumped parameter models to simulate microgravity-induced fluid redistribution in the cardiovascular, central nervous and ocular systems to provide initial and boundary data to a 3D finite element simulation of ocular biomechanics in VIIP. Specifically, the lumped parameter cardiovascular model acts as the primary means of establishing how microgravity, and the associated lack of hydrostatic gradient, impacts fluid redistribution. The cardiovascular model consists of 16 compartments, including three cerebrospinal fluid (CSF) compartments, three cranial blood compartments, and 10 thoracic and lower limb blood compartments. To assess the models capability to address variations in physiological parameters, we completed a formal uncertainty and sensitivity analysis that evaluated the relative importance of 42 input parameters required in the model on relative compartment flows and compartment pressures. Utilizing the model in a pulsatile flow configuration, the sensitivity analysis identified the ten parameters that most influenced each compartment pressure. Generally, each compartment responded appropriately to parameter variations associated with itself and adjacent compartments. However, several unexpected interactions between components, such as between the choroid plexus and the lower capillaries, were found, and are due to simplifications in the formulation of the model. The analysis illustrates that highly influential parameters and those that have unique influences within the model formulation must be tightly controlled for successful model application.

gravitational physiology↗

Stroboscopic Goggles for Reduction of Motion Sickness

A device built around a pair of electronic shutters has been demonstrated to be effective as a prototype of stroboscopic goggles or eyeglasses for preventing or reducing motion sickness. The momentary opening of the shutters helps to suppress a phenomenon that is known in the art as retinal slip and is described more fully below. While a number of different environmental factors can induce motion sickness, a common factor associated with every known motion environment is sensory confusion or sensory mismatch. Motion sickness is a product of misinformation arriving at a central point in the nervous system from the senses from which one determines one s spatial orientation. When information from the eyes, ears, joints, and pressure receptors are all in agreement as to one s orientation, there is no motion sickness. When one or more sensory input(s) to the brain is not expected, or conflicts with what is anticipated, the end product is motion sickness. Normally, an observer s eye moves, compensating for the anticipated effect of motion, in such a manner that the image of an object moving relatively to an observer is held stationary on the retina. In almost every known environment that induces motion sickness, a change in the gain (in the signal-processing sense of gain ) of the vestibular system causes the motion of the eye to fail to hold images stationary on the retina, and the resulting motion of the images is termed retinal slip. The present concept of stroboscopic goggles or eyeglasses (see figure) is based on the proposition that prevention of retinal slip, and hence, the prevention of sensory mismatch, can be expected to reduce the tendency toward motion sickness. A device according to this concept helps to prevent retinal slip by providing snapshots of the visual environment through electronic shutters that are brief enough that each snapshot freezes the image on each retina. The exposure time for each snapshot is less than 5 ms. In the event that a higher rate of strobing is necessary for adequate viewing of the changing scene during rapid head movements, the rate of strobing (but not the exposure time) can be controlled in response to the readings of rate-of-rotation sensors attached to the device.

Reschke, M. F.↗

NASA's Current Evidence and Hypothesis for the Visual Impairment and Intracranial Pressure Risk

While 40 years of human spaceflight exploration has reported visual decrement to a certain extent in a subgroup of astronauts, recent data suggests that there is indeed a subset of crewmembers that experience refraction changes (hyperoptic shift), cotton wool spot formation, choroidal fold development, papilledema, optic nerve sheath distention and/or posterior globe flattening with varying degrees of severity and permanence. Pre and postflight ocular measures have identified a potential risk of permanent visual changes as a result of microgravity exposure, which has been defined as the Visual Impairment and Intracranial Pressure risk (VIIP). The combination of symptoms are referred to as the VIIP syndrome. It is thought that the ocular structural and optic nerve changes are caused by events precipitated by the cephalad fluid shift crewmembers experience during long-duration spaceflight. Three important systems, ocular, cardiovascular, and central nervous, seem to be involved in the development of symptoms, but the etiology is still under speculation. It is believed that some crewmembers are more susceptible to these changes due to genetic/anatomical predisposition or lifestyle (fitness) related factors. Future research will focus on determining the etiology of the VIIP syndrome and development of mechanisms to mitigate the spaceflight risk.

Otto, Christian A.↗

Functional stability of cerebral circulatory system

The functional stability of the cerebral circulation system seems to be based on the active mechanisms and on those stemming from specific of the biophysical structure of the system under study. This latter parameter has some relevant criteria for its quantitative estimation. The data obtained suggest that the essential part of the mechanism for active responses of cerebral vessels which maintains the functional stability of this portion of the vascular system, consists of a neurogenic component involving central nervous structures localized, for instance, in the medulla oblongata.

Moskalenko, Y. Y.↗

Understanding How Astronauts Adapt to Space and to Earth: Anatomical Studies of Central Vestibular Adaptation

Significant changes take place in the nervous systems of astronauts during and following exposure to microgravity. These changes, particularly in the part of the brain that controls balance, the vestibular system, can cause sensations of rotation, dizziness, and vertigo, as well as space adaptation syndrome. Adaptation to the microgravity environment usually occurs within one week, and a subsequent re-adaptation period of several days is often required upon return to Earth. In order to realize long-term spaceflight, effective countermeasures for these symptoms must be developed. The structural changes that take place in one of the vestibular regions of the brain (the cerebellar cortex) during the process of adaptation to Earth's gravity remain unclear and are the subject of an experiment being conducted on STS-107 by Dr. Gay Holstein of the Mount Sinai School of Medicine in New York. Using the rat as a model, Dr. Holstein and her team will seek to identify the cellular changes underlying the vestibular changes experienced by astronauts.

Holstein, Gay↗

The Central Nervous Connections Involved in the Vomiting Reflex

The vomiting reflex may be elicited by a number of different types or classes of stimuli involving many varieties of receptor structures and considerable diversity in afferent pathways and central connections. Central relay or mediating structures thus may vary widely according to the type of initial emetic stimulus. The emetic circuits which have been most completely delineated to date are probably those in which the Chemoreceptor Trigger Zone (CTZ) in the Area Postrema (AP) functions as a key mediating structure. Even in this system, however, there are large gaps in our knowledge of the nerve tracts and central nervous connections involved. Knowledge of most other emetic circuits subserving the emetic reflex resulting from many diverse types of stimuli such, for example, as emotional stress (e.g. psychogenic vomiting, Wruble et al. 1982), pain (e.g. testicular trauma), and chemical or mechanical irritation of the gastrointestinal tract or urinary tract is quite incomplete at this time, thus precluding any very adequate description of their central connections at present. One physiological system, however, which has received considerable attention recently in relation to the vomiting reflex elicited by motion stimuli is the vestibular system. Due to the paucity of data on central nervous connections of several or the non-vestibular types of emetic stimuli cited above, we will devote most of our attention in this brief review to the central connections of the vestibular system which seem likely to be involved in the vomiting response to motion stimuli. However, the latter part of the review will be concerned with the concept of the reticular vomiting centre in relation to the ParviCellular Reticular Formation (PCRF), and will thus probably pertain to all of the many classes of emetic stimuli since it will address the question of the final common emetic pathway.

Brizzee, K. R.↗

Neuroscience discipline science plan

Over the past two decades, NASA's efforts in the neurosciences have developed into a program of research directed at understanding the acute changes that occur in the neurovestibular and sensorimotor systems during short-duration space missions. However, the proposed extended-duration flights of up to 28 days on the Shuttle orbiter and 6 months on Space Station Freedom, a lunar outpost, and Mars missions of perhaps 1-3 years in space, make it imperative that NASA's Life Sciences Division begin to concentrate research in the neurosciences on the chronic effects of exposure to microgravity on the nervous system. Major areas of research will be directed at understanding (1) central processing, (2) motor systems, (3) cognitive/spatial orientation, and (4) sensory receptors. The purpose of the Discipline Science Plan is to provide a conceptual strategy for NASA's Life Sciences Division research and development activities in the comprehensive area of neurosciences. It covers the significant research areas critical to NASA's programmatic requirements for the Extended-Duration Orbiter, Space Station Freedom, and exploration mission science activities. These science activities include ground-based and flight; basic, applied, and operational; and animal and human research and development. This document summarizes the current status of the program, outlines available knowledge, establishes goals and objectives, identifies science priorities, and defines critical questions in the subdiscipline areas of nervous system function. It contains a general plan that will be used by NASA Headquarters Program Offices and the field centers to review and plan basic, applied, and operational intramural and extramural research and development activities in this area.

Source record↗