Effects of Spaceflight Stressors on Brain Volume, Microstructure, and Intracranial Fluid Distribution

Cognitive performance in ISS astronauts on 6-month low earth orbit missions

Introduction

Current and future astronauts will endure prolonged exposure to spaceflight hazards and environmental stressors that could compromise cognitive functioning, yet cognitive performance in current missions to the International Space Station remains critically under-characterized. We systematically assessed cognitive performance across 10 cognitive domains in astronauts on 6-month missions to the ISS.

Methods

Twenty-five professional astronauts were administered the Cognition Battery as part of National Aeronautics and Space Administration (NASA) Human Research Program Standard Measures Cross-Cutting Project. Cognitive performance data were collected at five mission phases: pre-flight, early flight, late flight, early post-flight, and late post-flight. We calculated speed and accuracy scores, corrected for practice effects, and derived z-scores to represent deviations in cognitive performance across mission phases from the sample's mean baseline (i.e., pre-flight) performance. Linear mixed models with random subject intercepts and pairwise comparisons examined the relationships between mission phase and cognitive performance.

Results

Cognitive performance was generally stable over time with some differences observed across mission phases for specific subtests. There was slowed performance observed in early flight on tasks of processing speed, visual working memory, and sustained attention. We observed a decrease in risk-taking propensity during late flight and post-flight mission phases. Beyond examining group differences, we inspected scores that represented a significant shift from the sample's mean baseline score, revealing that 11.8% of all flight and post-flight scores were at or below 1.5 standard deviations below the sample's baseline mean. Finally, exploratory analyses yielded no clear pattern of associations between cognitive performance and either sleep or ratings of alertness.

Conclusion

There was no evidence for a systematic decline in cognitive performance for astronauts on a 6-month missions to the ISS. Some differences were observed for specific subtests at specific mission phases, suggesting that processing speed, visual working memory, sustained attention, and risk-taking propensity may be the cognitive domains most susceptible to change in Low Earth Orbit for high performing, professional astronauts. We provide descriptive statistics of pre-flight cognitive performance from 25 astronauts, the largest published preliminary normative database of its kind to date, to help identify significant performance decrements in future samples.

Effect of spaceflight experience on human brain structure, microstructure, and function: systematic review of neuroimaging studies

Spaceflight-induced brain changes have been commonly reported in astronauts. The role of microgravity in the alteration of the brain structure, microstructure, and function can be tested with magnetic resonance imaging (MRI) techniques. Here, we aim to provide a comprehensive overview of Spaceflight studies exploring the potential role of brain alterations identified by MRI in astronauts. We conducted a search on PubMed, Web of Science, and Scopus to find neuroimaging correlates of spaceflight experience using MRI. A total of 20 studies (structural MRI n = 8, diffusion-based MRI n = 2, functional MRI n = 1, structural MRI and diffusion-weighted MRI n = 6, structural MRI and functional MRI n = 3) met our inclusion criteria. Overall, the studies showed that regardless of the MRI techniques, mission duration significantly impacts the human brain, prompting the inclusion of various brain regions as features in the analyses. After spaceflight, notable alterations were also observed in the superior occipital gyrus and the precentral gyrus which show alterations in connectivity and activation during spaceflight. The results provided highlight the alterations in brain structure after spaceflight, the unique patterns of brain remodeling, the challenges in drawing unified conclusions, and the impact of microgravity on intracranial cerebrospinal fluid volume.

Amorphous calcium carbonate enhances osteogenic differentiation and myotube formation of human bone marrow derived mesenchymal stem cells and primary skeletal muscle cells under microgravity conditions

Astronauts are exposed to severely stressful physiological conditions due to microgravity and increased space radiation. Space environment affects every organ and cell in the body and the significant adverse effects of long-term weightlessness include muscle atrophy and deterioration of the skeleton (spaceflight osteopenia). Amorphous Calcium Carbonate (ACC) emerges as a promising candidate for prevention of these effects, owing to its unique physicochemical properties and its potential to address the intricately linked nature of bone-muscle crosstalk. Reported here are two studies carried out on the International Space Station (ISS). The first, performed in 2018 as a part of the Ramon-Spacelab project, was a preliminary experiment, in which stromal murine cells were differentiated into osteoblasts when ACC was added to the culture medium. A parallel experiment was done on Earth as a control. The second study was part of Axiom-1's Rakia project mission launched to the ISS on 2022 utilizing organ-on-a-chip methodology with a specially designed autonomous module. In this experiment, human bone-marrow derived mesenchymal stem cells (hBM-MSCs) and human primary muscle cells were cultured in the presence or absence of ACC, in duplicates. The results showed that ACC enhanced differentiation of human primary skeletal muscle cells into myotubes. Similarly, hBM-MSCs were differentiated significantly better into osteocytes in the presence of ACC leading to increased calcium deposits. The results, combined with previous data, support the use of ACC as an advantageous supplement for preventing muscle and bone deterioration in outer space conditions, facilitating extended extraterrestrial voyages and colonization.

Long-term space missions' effects on the human organism: what we do know and what requires further research

Space has always fascinated people. Many years have passed since the first spaceflight, and in addition to the enormous technological progress, the level of understanding of human physiology in space is also increasing. The presented paper aims to summarize the recent research findings on the influence of the space environment (microgravity, pressure differences, cosmic radiation, etc.) on the human body systems during short-term and long-term space missions. The review also presents the biggest challenges and problems that must be solved in order to extend safely the time of human stay in space. In the era of increasing engineering capabilities, plans to colonize other planets, and the growing interest in commercial space flights, the most topical issues of modern medicine seems to be understanding the effects of long-term stay in space, and finding solutions to minimize the harmful effects of the space environment on the human body.

Corticospinal excitability after 5-day Dry Immersion in women

In light of the development of manned astronautics and the increasing participation of women in space flights, the question of female body adaptation to microgravity conditions becomes relevant. Currently, one of the important directions in this issue is to study the effects of support withdrawal as a factor of weightlessness on the human sensorimotor system. Dry Immersion is one of the well-known ground-based models, which adequately reproduces the main physiological effects of space flight. The aim of this study was to evaluate the changes in motor evoked potentials of the lower leg gravity-dependent muscles in women after a 5-day Dry Immersion. We analyzed evoked responses to transcranial and trans-spinal magnetic stimulation. In this method, areas of interest (the motor cortex and lumbosacral thickening of the spinal cord) are stimulated with an electromagnetic stimulus. The experiment was conducted with the participation of 16 healthy female volunteers with a natural menstrual cycle. The thresholds, amplitudes, and latencies of motor potentials evoked by magnetic stimulation were assessed. We showed that 5-day exposure to support withdrawal leads to a decrease in motor-evoked potential thresholds and central motor conduction time, although changes in motor response amplitudes were ambiguous. The data obtained correspond to the results of previous research on Dry Immersion effects on the sensorimotor system in men.

Artificial gravity during a spaceflight analog alters brain sensory connectivity

Spaceflight has numerous untoward effects on human physiology. Various countermeasures are under investigation including artificial gravity (AG). Here, we investigated whether AG alters resting-state brain functional connectivity changes during head-down tilt bed rest (HDBR), a spaceflight analog. Participants underwent 60 days of HDBR. Two groups received daily AG administered either continuously (cAG) or intermittently (iAG). A control group received no AG. We assessed resting-state functional connectivity before, during, and after HDBR. We also measured balance and mobility changes from pre- to post-HDBR. We examined how functional connectivity changes throughout HDBR and whether AG is associated with differential effects. We found differential connectivity changes by group between posterior parietal cortex and multiple somatosensory regions. The control group exhibited increased functional connectivity between these regions throughout HDBR whereas the cAG group showed decreased functional connectivity. This finding suggests that AG alters somatosensory reweighting during HDBR. We also observed brain-behavioral correlations that differed significantly by group. Control group participants who showed increased connectivity between the putamen and somatosensory cortex exhibited greater mobility declines post-HDBR. For the cAG group, increased connectivity between these regions was associated with little to no mobility declines post-HDBR. This suggests that when somatosensory stimulation is provided via AG, functional connectivity increases between the putamen and somatosensory cortex are compensatory in nature, resulting in reduced mobility declines. Given these findings, AG may be an effective countermeasure for the reduced somatosensory stimulation that occurs in both microgravity and HDBR.

Impacts of spaceflight experience on human brain structure

Spaceflight induces widespread changes in human brain morphology. It is unclear if these brain changes differ with varying mission duration or spaceflight experience history (i.e., novice or experienced, number of prior missions, time between missions). Here we addressed this issue by quantifying regional voxelwise changes in brain gray matter volume, white matter microstructure, extracellular free water (FW) distribution, and ventricular volume from pre- to post-flight in a sample of 30 astronauts. We found that longer missions were associated with greater expansion of the right lateral and third ventricles, with the majority of expansion occurring during the first 6 months in space then appearing to taper off for longer missions. Longer inter-mission intervals were associated with greater expansion of the ventricles following flight; crew with less than 3 years of time to recover between successive flights showed little to no enlargement of the lateral and third ventricles. These findings demonstrate that ventricle expansion continues with spaceflight with increasing mission duration, and inter-mission intervals less than 3 years may not allow sufficient time for the ventricles to fully recover their compensatory capacity. These findings illustrate some potential plateaus in and boundaries of human brain changes with spaceflight.

The Unresolved Methodological Challenge of Detecting Neuroplastic Changes in Astronauts

After completing a spaceflight, astronauts display a salient upward shift in the position of the brain within the skull, accompanied by a redistribution of cerebrospinal fluid. Magnetic resonance imaging studies have also reported local changes in brain volume following a spaceflight, which have been cautiously interpreted as a neuroplastic response to spaceflight. Here, we provide evidence that the grey matter volume changes seen in astronauts following spaceflight are contaminated by preprocessing errors exacerbated by the upwards shift of the brain within the skull. While it is expected that an astronaut's brain undergoes some neuroplastic adaptations during spaceflight, our findings suggest that the brain volume changes detected using standard processing pipelines for neuroimaging analyses could be contaminated by errors in identifying different tissue types (i.e., tissue segmentation). These errors may undermine the interpretation of such analyses as direct evidence of neuroplastic adaptation, and novel or alternate preprocessing or experimental paradigms are needed in order to resolve this important issue in space health research.

Ionizing radiation, cerebrovascular disease, and consequent dementia: A review and proposed framework relevant to space radiation exposure

Space exploration requires the characterization and management or mitigation of a variety of human health risks. Exposure to space radiation is one of the main health concerns because it has the potential to increase the risk of cancer, cardiovascular disease, and both acute and late neurodegeneration. Space radiation-induced decrements to the vascular system may impact the risk for cerebrovascular disease and consequent dementia. These risks may be independent or synergistic with direct damage to central nervous system tissues. The purpose of this work is to review epidemiological and experimental data regarding the impact of low-to-moderate dose ionizing radiation on the central nervous system and the cerebrovascular system. A proposed framework outlines how space radiation-induced effects on the vasculature may increase risk for both cerebrovascular dysfunction and neural and cognitive adverse outcomes. The results of this work suggest that there are multiple processes by which ionizing radiation exposure may impact cerebrovascular function including increases in oxidative stress, neuroinflammation, endothelial cell dysfunction, arterial stiffening, atherosclerosis, and cerebral amyloid angiopathy. Cerebrovascular adverse outcomes may also promote neural and cognitive adverse outcomes. However, there are many gaps in both the human and preclinical evidence base regarding the long-term impact of ionizing radiation exposure on brain health due to heterogeneity in both exposures and outcomes. The unique composition of the space radiation environment makes the translation of the evidence base from terrestrial exposures to space exposures difficult. Additional investigation and understanding of the impact of low-to-moderate doses of ionizing radiation including high (H) atomic number (Z) and energy (E) (HZE) ions on the cerebrovascular system is needed. Furthermore, investigation of how decrements in vascular systems may contribute to development of neurodegenerative diseases in independent or synergistic pathways is important for protecting the long-term health of astronauts.

Monitoring the Impact of Spaceflight on the Human Brain

Extended exposure to radiation, microgravity, and isolation during space exploration has significant physiological, structural, and psychosocial effects on astronauts, and particularly their central nervous system. To date, the use of brain monitoring techniques adopted on Earth in pre/post-spaceflight experimental protocols has proven to be valuable for investigating the effects of space travel on the brain. However, future (longer) deep space travel would require some brain function monitoring equipment to be also available for evaluating and monitoring brain health during spaceflight. Here, we describe the impact of spaceflight on the brain, the basic principles behind six brain function analysis technologies, their current use associated with spaceflight, and their potential for utilization during deep space exploration. We suggest that, while the use of magnetic resonance imaging (MRI), positron emission tomography (PET), and computerized tomography (CT) is limited to analog and pre/post-spaceflight studies on Earth, electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), and ultrasound are good candidates to be adapted for utilization in the context of deep space exploration.

Express: Cognition in Zero Gravity: Effects of Non-Terrestrial Gravity on Human Behaviour

As humanity prepares for deep space exploration, understanding the impact of spaceflight on bodily physiology is critical. While the effects of non-terrestrial gravity on the body are well established, little is known about its impact on human behaviour and cognition. Astronauts often describe dramatic alterations in sensorimotor functioning, including orientation, postural control and balance. Changes in cognitive functioning as well as in socio-affective processing have also been observed. Here we have reviewed the key literature and explored the impact of non-terrestrial gravity across three key functional domains: sensorimotor, cognition, and socio-affective processing. We have proposed a neuroanatomical model to account for the effects of non-terrestrial gravity in these domains. Understanding the impact of non-terrestrial gravity on human behaviour has never been more timely and it will help mitigate against risks in both commercial and non-commercial spaceflight.

Cortical thickness of primary motor and vestibular brain regions predicts recovery from fall and balance directly after spaceflight

Motor adaptations to the microgravity environment during spaceflight allow astronauts to perform adequately in this unique environment. Upon return to Earth, this adaptation is no longer appropriate and can be disruptive for mission critical tasks. Here, we measured if metrics derived from MRI scans collected from astronauts can predict motor performance post-flight. Structural and diffusion MRI scans from 14 astronauts collected before launch, and motor measures (balance performance, speed of recovery from fall, and tandem walk step accuracy) collected pre-flight and post-flight were analyzed. Regional measures of gray matter volume (motor cortex, paracentral lobule, cerebellum), myelin density (motor cortex, paracentral lobule, corticospinal tract), and white matter microstructure (corticospinal tract) were derived as a-priori predictors. Additional whole-brain analyses of cortical thickness, cerebellar gray matter, and cortical myelin were also tested for associations with post-flight and pre-to-post-flight motor performance. The pre-selected regional measures were not significantly associated with motor behavior. However, whole-brain analyses showed that paracentral and precentral gyri thickness significantly predicted recovery from fall post-spaceflight. Thickness of vestibular and sensorimotor regions, including the posterior insula and the superior temporal gyrus, predicted balance performance post-flight and pre-to-post-flight decrements. Greater cortical thickness pre-flight predicted better performance post-flight. Regional thickness of somatosensory, motor, and vestibular brain regions has some predictive value for post-flight motor performance in astronauts, which may be used for the identification of training and countermeasure strategies targeted for maintaining operational task performance.