Eye-brain axis in microgravity and its implications for Spaceflight Associated Neuro-ocular Syndrome

The effect of Hydrogen-rich water on retinal degeneration in the outer nuclear layer of simulated weightlessness rats

Long-term spaceflight can lead to changes in eye structure and decreased visual function. At present, there are almost no effective methods to prevent and treat eye damage caused by microgravity environments. Oxidative stress has been identified as one of the contributing mechanisms of spaceflight-associated neuro-ocular syndrome (SANS), and hydrogen (H2) has demonstrated significant antioxidant and anti-inflammatory effects. The aim of this study was to determine whether hydrogen-rich water (HRW) has a protective effect against eye injury induced by tail-suspension simulated weightlessness in rats, and to elucidate the underlying mechanisms. In this experiment, we utilized an 8-week tail-suspension model to simulate weightlessness, and employed histopathology, visual electrophysiology, and biochemical indices to evaluate retinal structure, function, and related molecular mechanisms leading to retinal damage. We also assessed the therapeutic efficacy of HRW treatment. Results demonstrated that tail-suspension simulated weightlessness induced thinning of the retinal outer nuclear layer, decreased visual function, and promoted retinal inflammation, oxidative stress, and mitochondrial dysfunction in rats. HRW treatment effectively alleviated the degenerative changes in the retinal outer nuclear layer, improved retinal function, and reduced retinal inflammation in treated rats. Our findings revealed that HRW reduced the retinal oxidative stress response and enhanced mitochondrial function through the PI3K/Akt/Nrf2 signaling pathway. Overall, HRW may be a promising candidate for the treatment of eye injuries in simulated microgravity environments.

Brains in space: impact of microgravity and cosmic radiation on the CNS during space exploration

Solar system exploration is a grand endeavour of humankind. Space agencies have been planning crewed missions to the Moon and Mars for several decades. However, several environmental stress factors in space, such as microgravity and cosmic radiation, confer health risks for human explorers. This Review examines the effects of microgravity and exposure to cosmic radiation on the CNS. Microgravity presents challenges for the brain, necessitating the development of adaptive movement and orientation strategies to cope with alterations in sensory information. Exposure to microgravity also affects cognitive function to a certain extent. Recent MRI results show that microgravity affects brain structure and function. Post-flight recovery from these changes is gradual, with some lasting up to a year. Regarding cosmic radiation, animal experiments suggest that the brain could be much more sensitive to this stressor than may be expected from experiences on Earth. This may be due to the presence of energetic heavy ions in space that have an impact on cognitive function, even at low doses. However, all data about space radiation risk stem from rodent experiments, and extrapolation of these data to humans carries a high degree of uncertainty. Here, after presenting an overview of current knowledge in the above areas, we provide a concise description of possible counter-measures to protect the brain against microgravity and cosmic radiation during future space missions.

Retinal blood vessel diameter changes with 60-day head-down bedrest are unaffected by antioxidant nutritional cocktail

Long-term human spaceflight can lead to cardiovascular deconditioning, but little is known about how weightlessness affects microcirculation. In this study, we examined how the retinal microvessels and cerebrovascular regulation of 19 healthy male participants responded to long-term head-down bedrest (HDBR), an earth-based analog for weightlessness. In addition, we examined whether an anti-inflammatory/antioxidant cocktail could prevent the vascular changes caused by HDBR. In all study participants, we found a decrease in retinal arteriolar diameter by HDBR day 8 and an increase in retinal venular diameter by HDBR day 16. Concurrently, blood pressure at the level of the middle cerebral artery and the cerebrovascular resistance index were higher during HDBR, while cerebral blood flow velocity was lower. None of these changes were reversed in participants receiving the anti-inflammatory/antioxidant cocktail, indicating that this cocktail was insufficient to restore the microvascular and cerebral blood flow changes induced by HDBR.

Differential Functional Changes in Visual Performance during Acute Exposure to Microgravity Analogue and Their Potential Links with Spaceflight-Associated Neuro-Ocular Syndrome

BACKGROUND

Spaceflight-Associated Neuro-Ocular Syndrome (SANS) is a complex pathology threatening the health of astronauts, with incompletely understood causes and no current specific functional diagnostic or screening test. We investigated the use of the differential performance of the visual system (central vs. perimacular visual function) as a candidate marker of SANS-related pathology in a ground-based microgravity analogue.

METHODS

We used a simple reaction time (SRT) task to visual stimuli, presented in the central and perimacular field of view, as a measure of the overall performance of the visual function, during acute settings (first 10 min) of vertical, bed rest (BR), -6°, and -15° head-down tilt (HDT) presentations in healthy participants (n = 8). We built dose-response models linking the gravitational component to SRT distribution parameters in the central vs. perimacular areas.

RESULTS

Acute exposure to microgravity induces detectable changes between SRT distributions in the perimacular vs. central retina (increased mean, standard deviation, and tau component of the ex-Gaussian function) in HDT compared with vertical presentation.

CONCLUSIONS

Functional testing of the perimacular retina might be beneficial for the earlier detection of SANS-related ailments in addition to regular testing of the central vision. Future diagnostic tests should consider the investigation of the extra-macular areas, particularly towards the optic disc.

Imaging in spaceflight associated neuro-ocular syndrome (SANS): Current technology and future directions in modalities

With plans for future long-duration crewed exploration, NASA has identified several high priority potential health risks to astronauts in space. One such risk is a collection of neurologic and ophthalmic findings termed spaceflight associated neuro-ocular syndrome (SANS). The findings of SANS include optic disc edema, globe flattening, retinal nerve fiber layer thickening, chorioretinal folds, hyperopic shifts, and cotton-wool spots. The cause of SANS was initially thought to be a cephalad fluid shift in microgravity leading to increased intracranial pressure, venous stasis and impaired CSF outflow, but the precise etiology of SANS remains ill defined. Recent studies have explored multiple possible pathogenic mechanisms for SANS including genetic and hormonal factors; a cephalad shift of fluid into the orbit and brain in microgravity; and disruption to the brain glymphatic system. Orbital, ocular, and cranial imaging, both on Earth and in space has been critical in the diagnosis and monitoring of SANS (e.g., fundus photography, optical coherence tomography (OCT), magnetic resonance imaging (MRI), and orbital/cranial ultrasound). In addition, we highlight near-infrared spectroscopy and diffusion tensor imaging, two newer modalities with potential use in future studies of SANS. In this manuscript we provide a review of these modalities, outline their current and potential use in space and on Earth, and review the reported major imaging findings in SANS.

Weighing the impact of microgravity on vestibular and visual functions

Numerous technological challenges have been overcome to realize human space exploration. As mission durations gradually lengthen, the next obstacle is a set of physical limitations. Extended exposure to microgravity poses multiple threats to various bodily systems. Two of these systems are of particular concern for the success of future space missions. The vestibular system includes the otolith organs, which are stimulated in gravity but unloaded in microgravity. This impairs perception, posture, and coordination, all of which are relevant to mission success. Similarly, vision is impaired in many space travelers due to possible intracranial pressure changes or fluid shifts in the brain. As humankind prepares for extended missions to Mars and beyond, it is imperative to compensate for these perils in prolonged weightlessness. Possible countermeasures are considered such as exercise regimens, improved nutrition, and artificial gravity achieved with a centrifuge or spacecraft rotation.