1
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Ritzmann R, Centner C, Hughes L, Waldvogel J, Marusic U. Neuromotor changes in postural control following bed rest. J Physiol 2025. [PMID: 40237347 DOI: 10.1113/jp285668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Accepted: 03/05/2025] [Indexed: 04/18/2025] Open
Abstract
Chronic bed rest (BR) serves as a model for studying the effects of prolonged immobility on physiological and neuromotor functions, particularly postural control. Prolonged BR leads to significant deconditioning of postural balance control, characterized by increased sway path lengths, sway velocity and fall risk, independent of muscle strength. These changes are linked to neural adaptations at spinal and supraspinal levels, including structural and functional brain changes, such as alterations in grey and white matter, increased cerebellar activation, reduced spinal excitability and increased latencies within reflex circuitries. Additionally, BR disrupts sensory integration from proprioceptive, visual and vestibular systems, impairing postural stability. Visual reliance remains stable during BR, though decreased visual acuity and contrast sensitivity are noted. Moreover, BR-induced shifts in cerebrospinal fluid contribute to altered brain activity, impacting sensorimotor function. Vestibular system adaptations, including changes in vestibulospinal reflexes, further exacerbate balance impairments. Understanding these mechanisms is crucial for developing interventions to mitigate the adverse effects of BR on postural control and prevent prolonged recovery times or increased risk of injury. This review highlights the need for further research into the neural underpinnings of BR-induced postural instability, with a focus on sensory integration and neuroplasticity.
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Affiliation(s)
- Ramona Ritzmann
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
- Innovation Translation Center, AO Foundation, Davos, Switzerland
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Luke Hughes
- Faculty of Health & Life Sciences, Northumbria University, Newcastle, UK
| | - Janice Waldvogel
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea University, Maribor, Slovenia
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2
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Li Z, Wu J, Zhao T, Wei Y, Xu Y, Liu Z, Li X, Chen X. Microglial activation in spaceflight and microgravity: potential risk of cognitive dysfunction and poor neural health. Front Cell Neurosci 2024; 18:1296205. [PMID: 38425432 PMCID: PMC10902453 DOI: 10.3389/fncel.2024.1296205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Due to the increased crewed spaceflights in recent years, it is vital to understand how the space environment affects human health. A lack of gravitational force is known to risk multiple physiological functions of astronauts, particularly damage to the central nervous system (CNS). As innate immune cells of the CNS, microglia can transition from a quiescent state to a pathological state, releasing pro-inflammatory cytokines that contribute to neuroinflammation. There are reports indicating that microglia can be activated by simulating microgravity or exposure to galactic cosmic rays (GCR). Consequently, microglia may play a role in the development of neuroinflammation during spaceflight. Prolonged spaceflight sessions raise concerns about the chronic activation of microglia, which could give rise to various neurological disorders, posing concealed risks to the neural health of astronauts. This review summarizes the risks associated with neural health owing to microglial activation and explores the stressors that trigger microglial activation in the space environment. These stressors include GCR, microgravity, and exposure to isolation and stress. Of particular focus is the activation of microglia under microgravity conditions, along with the proposal of a potential mechanism.
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Affiliation(s)
- Zihan Li
- Beijing International Science and Technology Cooperation Base for Antiviral Drugs, College of Chemistry and Life Science, Beijing University of Technology, Beijing, China
| | - Jiarui Wu
- Beijing International Science and Technology Cooperation Base for Antiviral Drugs, College of Chemistry and Life Science, Beijing University of Technology, Beijing, China
| | - Tianyuan Zhao
- Beijing International Science and Technology Cooperation Base for Antiviral Drugs, College of Chemistry and Life Science, Beijing University of Technology, Beijing, China
| | - Yiyun Wei
- Beijing International Science and Technology Cooperation Base for Antiviral Drugs, College of Chemistry and Life Science, Beijing University of Technology, Beijing, China
| | - Yajing Xu
- Beijing International Science and Technology Cooperation Base for Antiviral Drugs, College of Chemistry and Life Science, Beijing University of Technology, Beijing, China
| | - Zongjian Liu
- Department of Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Xiaoqiong Li
- School of Life Sciences, Beijing Institute of Technology, Beijing, China
| | - Xuechai Chen
- Beijing International Science and Technology Cooperation Base for Antiviral Drugs, College of Chemistry and Life Science, Beijing University of Technology, Beijing, China
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3
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McGregor HR, Lee JK, Mulder ER, De Dios YE, Beltran NE, Wood SJ, Bloomberg JJ, Mulavara AP, Seidler RD. Artificial gravity during a spaceflight analog alters brain sensory connectivity. Neuroimage 2023; 278:120261. [PMID: 37422277 DOI: 10.1016/j.neuroimage.2023.120261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/06/2023] [Accepted: 06/29/2023] [Indexed: 07/10/2023] Open
Abstract
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.
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Affiliation(s)
- Heather R McGregor
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Jessica K Lee
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States; Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Edwin R Mulder
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | | | | | - Scott J Wood
- NASA Johnson Space Center, Houston, TX, United States
| | | | | | - Rachael D Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States; Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States.
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4
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Marfia G, Guarnaccia L, Navone SE, Ampollini A, Balsamo M, Benelli F, Gaudino C, Garzia E, Fratocchi C, Di Murro C, Ligarotti GK, Campanella C, Landolfi A, Perelli P, Locatelli M, Ciniglio Appiani G. Microgravity and the intervertebral disc: The impact of space conditions on the biomechanics of the spine. Front Physiol 2023; 14:1124991. [PMID: 36998982 PMCID: PMC10043412 DOI: 10.3389/fphys.2023.1124991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/22/2023] [Indexed: 03/16/2023] Open
Abstract
The environmental conditions to which astronauts and other military pilots are subjected represent a unique example for understanding and studying the biomechanical events that regulate the functioning of the human body. In particular, microgravity has shown a significant impact on various biological systems, such as the cardiovascular system, immune system, endocrine system, and, last but not least, musculoskeletal system. Among the potential risks of flying, low back pain (LBP) has a high incidence among astronauts and military pilots, and it is often associated with intervertebral disc degeneration events. The mechanisms of degeneration determine the loss of structural and functional integrity and are accompanied by the aberrant production of pro-inflammatory mediators that exacerbate the degenerative environment, contributing to the onset of pain. In the present work, the mechanisms of disc degeneration, the conditions of microgravity, and their association have been discussed in order to identify possible molecular mechanisms underlying disc degeneration and the related clinical manifestations in order to develop a model of prevention to maintain health and performance of air- and space-travelers. The focus on microgravity also allows the development of new proofs of concept with potential therapeutic implications.
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Affiliation(s)
- Giovanni Marfia
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Clinical Pathology Unit, Istituto di Medicina Aerospaziale “A. Mosso”, Aeronautica Militare, Milan, Italy
| | - Laura Guarnaccia
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Elena Navone
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonella Ampollini
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Melissa Balsamo
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Benelli
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Gaudino
- Department of Neuroradiology, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy
| | - Emanuele Garzia
- Istituto di Medicina Aerospaziale “A. Mosso”, Aeronautica Militare, Milan, Italy
| | - Claudia Fratocchi
- Clinical Pathology Unit, Istituto di Medicina Aerospaziale “A. Mosso”, Aeronautica Militare, Milan, Italy
| | - Claudia Di Murro
- Clinical Pathology Unit, Istituto di Medicina Aerospaziale “A. Mosso”, Aeronautica Militare, Milan, Italy
| | | | - Carmelo Campanella
- Istituto di Medicina Aerospaziale “Aldo Di Loreto”, Aeronautica Militare, Rome, Italy
| | | | | | - Marco Locatelli
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Medical-Surgical Physiopathology and Transplantation, University of Milan, Milan, Italy
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5
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Saveko A, Bekreneva M, Ponomarev I, Zelenskaya I, Riabova A, Shigueva T, Kitov V, Abu Sheli N, Nosikova I, Rukavishnikov I, Sayenko D, Tomilovskaya E. Impact of different ground-based microgravity models on human sensorimotor system. Front Physiol 2023; 14:1085545. [PMID: 36875039 PMCID: PMC9974674 DOI: 10.3389/fphys.2023.1085545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
This review includes current and updated information about various ground-based microgravity models and their impact on the human sensorimotor system. All known models of microgravity are imperfect in a simulation of the physiological effects of microgravity but have their advantages and disadvantages. This review points out that understanding the role of gravity in motion control requires consideration of data from different environments and in various contexts. The compiled information can be helpful to researchers to effectively plan experiments using ground-based models of the effects of space flight, depending on the problem posed.
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Affiliation(s)
- Alina Saveko
- Russian Federation State Scientific Center—Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
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6
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Jillings S, Pechenkova E, Tomilovskaya E, Rukavishnikov I, Jeurissen B, Van Ombergen A, Nosikova I, Rumshiskaya A, Litvinova L, Annen J, De Laet C, Schoenmaekers C, Sijbers J, Petrovichev V, Sunaert S, Parizel PM, Sinitsyn V, Eulenburg PZ, Laureys S, Demertzi A, Wuyts FL. Prolonged microgravity induces reversible and persistent changes on human cerebral connectivity. Commun Biol 2023; 6:46. [PMID: 36639420 PMCID: PMC9839680 DOI: 10.1038/s42003-022-04382-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 12/15/2022] [Indexed: 01/15/2023] Open
Abstract
The prospect of continued manned space missions warrants an in-depth understanding of how prolonged microgravity affects the human brain. Functional magnetic resonance imaging (fMRI) can pinpoint changes reflecting adaptive neuroplasticity across time. We acquired resting-state fMRI data of cosmonauts before, shortly after, and eight months after spaceflight as a follow-up to assess global connectivity changes over time. Our results show persisting connectivity decreases in posterior cingulate cortex and thalamus and persisting increases in the right angular gyrus. Connectivity in the bilateral insular cortex decreased after spaceflight, which reversed at follow-up. No significant connectivity changes across eight months were found in a matched control group. Overall, we show that altered gravitational environments influence functional connectivity longitudinally in multimodal brain hubs, reflecting adaptations to unfamiliar and conflicting sensory input in microgravity. These results provide insights into brain functional modifications occurring during spaceflight, and their further development when back on Earth.
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Affiliation(s)
- Steven Jillings
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| | - Ekaterina Pechenkova
- grid.410682.90000 0004 0578 2005Laboratory for Cognitive Research, HSE University, Moscow, Russia
| | - Elena Tomilovskaya
- grid.4886.20000 0001 2192 9124SSC RF—Institute for Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Ilya Rukavishnikov
- grid.4886.20000 0001 2192 9124SSC RF—Institute for Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Ben Jeurissen
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium ,grid.5284.b0000 0001 0790 3681imec-Vision Lab, University of Antwerp, Antwerp, Belgium
| | - Angelique Van Ombergen
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium ,grid.5284.b0000 0001 0790 3681Department of Translational Neuroscience—ENT, University of Antwerp, Antwerp, Belgium
| | - Inna Nosikova
- grid.4886.20000 0001 2192 9124SSC RF—Institute for Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Alena Rumshiskaya
- grid.415738.c0000 0000 9216 2496Radiology Department, National Medical Research Treatment and Rehabilitation Center of the Ministry of Health of Russia, Moscow, Russia
| | - Liudmila Litvinova
- grid.415738.c0000 0000 9216 2496Radiology Department, National Medical Research Treatment and Rehabilitation Center of the Ministry of Health of Russia, Moscow, Russia
| | - Jitka Annen
- grid.411374.40000 0000 8607 6858Coma Science Group, GIGA Consciousness, GIGA Institute, University and University Hospital of Liège, Liège, Belgium
| | - Chloë De Laet
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| | - Catho Schoenmaekers
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| | - Jan Sijbers
- grid.5284.b0000 0001 0790 3681imec-Vision Lab, University of Antwerp, Antwerp, Belgium
| | - Victor Petrovichev
- grid.415738.c0000 0000 9216 2496Radiology Department, National Medical Research Treatment and Rehabilitation Center of the Ministry of Health of Russia, Moscow, Russia
| | - Stefan Sunaert
- grid.5596.f0000 0001 0668 7884Department of Imaging & Pathology, Translational MRI, KU Leuven—University of Leuven, Leuven, Belgium
| | - Paul M. Parizel
- grid.416195.e0000 0004 0453 3875Department of Radiology, Royal Perth Hospital and University of Western Australia Medical School, Perth, WA Australia
| | - Valentin Sinitsyn
- grid.14476.300000 0001 2342 9668Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - Peter zu Eulenburg
- grid.5252.00000 0004 1936 973XInstitute for Neuroradiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Steven Laureys
- grid.411374.40000 0000 8607 6858Coma Science Group, GIGA Consciousness, GIGA Institute, University and University Hospital of Liège, Liège, Belgium ,grid.23856.3a0000 0004 1936 8390Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Laval University, Quebec, QC Canada ,grid.410595.c0000 0001 2230 9154International Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Athena Demertzi
- grid.4861.b0000 0001 0805 7253Physiology of Cognition, GIGA-CRC In Vivo Imaging, University of Liège, Liège, Belgium ,grid.4861.b0000 0001 0805 7253Department of Psychology, Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Floris L. Wuyts
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
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7
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Marfia G, Navone SE, Guarnaccia L, Campanella R, Locatelli M, Miozzo M, Perelli P, Della Morte G, Catamo L, Tondo P, Campanella C, Lucertini M, Ciniglio Appiani G, Landolfi A, Garzia E. Space flight and central nervous system: Friends or enemies? Challenges and opportunities for neuroscience and neuro-oncology. J Neurosci Res 2022; 100:1649-1663. [PMID: 35678198 PMCID: PMC9544848 DOI: 10.1002/jnr.25066] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/16/2022] [Accepted: 05/02/2022] [Indexed: 11/10/2022]
Abstract
Space environment provides many challenges to pilots, astronauts, and space scientists, which are constantly subjected to unique conditions, including microgravity, radiations, hypoxic condition, absence of the day and night cycle, etc. These stressful stimuli have the potential to affect many human physiological systems, triggering physical and biological adaptive changes to re‐establish the homeostatic state. A particular concern regards the risks for the effects of spaceflight on the central nervous system (CNS), as several lines of evidence reported a great impact on neuroplasticity, cognitive functions, neurovestibular system, short‐term memory, cephalic fluid shift, reduction in motor function, and psychological disturbances, especially during long‐term missions. Aside these potential detrimental effects, the other side of the coin reflects the potential benefit of applicating space‐related conditions on Earth‐based life sciences, as cancer research. Here, we focused on examining the effect of real and simulated microgravity on CNS functions, both in humans and in cellular models, browsing the different techniques to experience or mime microgravity on‐ground. Increasing evidence demonstrate that cancer cells, and brain cancer cells in particular, are negatively affected by microgravity, in terms of alteration in cell morphology, proliferation, invasion, migration, and apoptosis, representing an advancing novel side of space‐based investigations. Overall, deeper understandings about the mechanisms by which space environment influences CNS and tumor biology may be promisingly translated into many clinical fields, ranging from aerospace medicine to neuroscience and oncology, representing an enormous pool of knowledge for the implementation of countermeasures and therapeutic applications.
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Affiliation(s)
- Giovanni Marfia
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Aldo Ravelli' Research Center, Milan, Italy.,Clinical Pathology Unit, Istituto di Medicina Aerospaziale "A. Mosso", Aeronautica Militare, Milan, Italy
| | - Stefania Elena Navone
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Aldo Ravelli' Research Center, Milan, Italy
| | - Laura Guarnaccia
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Rolando Campanella
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Locatelli
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Aldo Ravelli' Research Center, Milan, Italy.,Department of Medical-Surgical Physiopathology and Transplantation, University of Milan, Milan, Italy
| | - Monica Miozzo
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Unit of Medical Genetics, ASST Santi Paolo e Carlo, Milan, Italy
| | - Pietro Perelli
- Istituto di Medicina Aerospaziale "Aldo Di Loreto", Aeronautica Militare, Rome, Italy
| | - Giulio Della Morte
- Clinical Pathology Unit, Istituto di Medicina Aerospaziale "A. Mosso", Aeronautica Militare, Milan, Italy
| | - Leonardo Catamo
- Clinical Pathology Unit, Istituto di Medicina Aerospaziale "A. Mosso", Aeronautica Militare, Milan, Italy
| | - Pietro Tondo
- Clinical Pathology Unit, Istituto di Medicina Aerospaziale "A. Mosso", Aeronautica Militare, Milan, Italy
| | - Carmelo Campanella
- Istituto di Medicina Aerospaziale "Aldo Di Loreto", Aeronautica Militare, Roma, Italy
| | | | | | | | - Emanuele Garzia
- Istituto di Medicina Aerospaziale "A. Mosso", Aeronautica Militare, Milan, Italy
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8
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Arshad I, Ferrè ER. Express: Cognition in Zero Gravity: Effects of Non-Terrestrial Gravity on Human Behaviour. Q J Exp Psychol (Hove) 2022; 76:979-994. [PMID: 35786100 PMCID: PMC10119906 DOI: 10.1177/17470218221113935] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Iqra Arshad
- Department of Psychology, Royal Holloway University of London, Egham, UK 3162
| | - Elisa Raffaella Ferrè
- Department of Psychological Sciences, Birkbeck University of London, London, UK 3162
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9
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Desai RI, Limoli CL, Stark CEL, Stark SM. Impact of spaceflight stressors on behavior and cognition: A molecular, neurochemical, and neurobiological perspective. Neurosci Biobehav Rev 2022; 138:104676. [PMID: 35461987 DOI: 10.1016/j.neubiorev.2022.104676] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/15/2022] [Accepted: 04/18/2022] [Indexed: 11/19/2022]
Abstract
The response of the human body to multiple spaceflight stressors is complex, but mounting evidence implicate risks to CNS functionality as significant, able to threaten metrics of mission success and longer-term behavioral and neurocognitive health. Prolonged exposure to microgravity, sleep disruption, social isolation, fluid shifts, and ionizing radiation have been shown to disrupt mechanisms of homeostasis and neurobiological well-being. The overarching goal of this review is to document the existing evidence of how the major spaceflight stressors, including radiation, microgravity, isolation/confinement, and sleep deprivation, alone or in combination alter molecular, neurochemical, neurobiological, and plasma metabolite/lipid signatures that may be linked to operationally-relevant behavioral and cognitive performance. While certain brain region-specific and/or systemic alterations titrated in part with neurobiological outcome, variations across model systems, study design, and the conspicuous absence of targeted studies implementing combinations of spaceflight stressors, confounded the identification of specific signatures having direct relevance to human activities in space. Summaries are provided for formulating new research directives and more predictive readouts of portending change in neurobiological function.
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Affiliation(s)
- Rajeev I Desai
- Harvard Medical School, McLean Hospital, Behavioral Biology Program, Belmont, MA 02478, USA.
| | - Charles L Limoli
- Department of Radiation Oncology, University of California Irvine, Medical Sciences I, B146B, Irvine, CA 92697, USA
| | - Craig E L Stark
- Department of Neurobiology of Behavior, University of California Irvine, 1400 Biological Sciences III, Irvine, CA 92697, USA
| | - Shauna M Stark
- Department of Neurobiology of Behavior, University of California Irvine, 1400 Biological Sciences III, Irvine, CA 92697, USA
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10
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McGregor HR, Lee JK, Mulder ER, De Dios YE, Beltran NE, Kofman IS, Bloomberg JJ, Mulavara AP, Smith SM, Zwart SR, Seidler RD. Ophthalmic changes in a spaceflight analog are associated with brain functional reorganization. Hum Brain Mapp 2021; 42:4281-4297. [PMID: 34105833 PMCID: PMC8357001 DOI: 10.1002/hbm.25546] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/31/2021] [Accepted: 04/29/2021] [Indexed: 12/27/2022] Open
Abstract
Following long-duration spaceflight, some astronauts exhibit ophthalmic structural changes referred to as Spaceflight Associated Neuro-ocular Syndrome (SANS). Optic disc edema is a common sign of SANS. The origin and effects of SANS are not understood as signs of SANS have not manifested in previous spaceflight analog studies. In the current spaceflight analog study, 11 subjects underwent 30 days of strict head down-tilt bed rest in elevated ambient carbon dioxide (HDBR+CO2 ). Using functional magnetic resonance imaging (fMRI), we acquired resting-state fMRI data at 6 time points: before (2), during (2), and after (2) the HDBR+CO2 intervention. Five participants developed optic disc edema during the intervention (SANS subgroup) and 6 did not (NoSANS group). This occurrence allowed us to explore whether development of signs of SANS during the spaceflight analog impacted resting-state functional connectivity during HDBR+CO2 . In light of previous work identifying genetic and biochemical predictors of SANS, we further assessed whether the SANS and NoSANS subgroups exhibited differential patterns of resting-state functional connectivity prior to the HDBR+CO2 intervention. We found that the SANS and NoSANS subgroups exhibited distinct patterns of resting-state functional connectivity changes during HDBR+CO2 within visual and vestibular-related brain networks. The SANS and NoSANS subgroups also exhibited different resting-state functional connectivity prior to HDBR+CO2 within a visual cortical network and within a large-scale network of brain areas involved in multisensory integration. We further present associations between functional connectivity within the identified networks and previously identified genetic and biochemical predictors of SANS. Subgroup differences in resting-state functional connectivity changes may reflect differential patterns of visual and vestibular reweighting as optic disc edema develops during the spaceflight analog. This finding suggests that SANS impacts not only neuro-ocular structures, but also functional brain organization. Future prospective investigations incorporating sensory assessments are required to determine the functional significance of the observed connectivity differences.
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Affiliation(s)
- Heather R. McGregor
- Department of Applied Physiology and KinesiologyUniversity of FloridaGainesvilleFloridaUSA
| | - Jessica K. Lee
- Department of Applied Physiology and KinesiologyUniversity of FloridaGainesvilleFloridaUSA
- Institute of Aerospace Medicine, German Aerospace CenterCologneGermany
| | - Edwin R. Mulder
- Institute of Aerospace Medicine, German Aerospace CenterCologneGermany
| | | | | | | | | | | | | | | | - Rachael D. Seidler
- Department of Applied Physiology and KinesiologyUniversity of FloridaGainesvilleFloridaUSA
- Norman Fixel Institute for Neurological Diseases, University of FloridaGainesvilleFloridaUSA
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11
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Buoite Stella A, Ajčević M, Furlanis G, Manganotti P. Neurophysiological adaptations to spaceflight and simulated microgravity. Clin Neurophysiol 2020; 132:498-504. [PMID: 33450569 DOI: 10.1016/j.clinph.2020.11.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 11/12/2020] [Accepted: 11/29/2020] [Indexed: 01/03/2023]
Abstract
Changes in physiological functions after spaceflight and simulated spaceflight involve several mechanisms. Microgravity is one of them and it can be partially reproduced with models, such as head down bed rest (HDBR). Yet, only a few studies have investigated in detail the complexity of neurophysiological systems and their integration to maintain homeostasis. Central nervous system changes have been studied both in their structural and functional component with advanced techniques, such as functional magnetic resonance (fMRI), showing the main involvement of the cerebellum, cortical sensorimotor, and somatosensory areas, as well as vestibular-related pathways. Analysis of electroencephalography (EEG) led to contrasting results, mainly due to the different factors affecting brain activity. The study of corticospinal excitability may enable a deeper understanding of countermeasures' effect, since greater excitability has been shown being correlated with better preservation of functions. Less is known about somatosensory evoked potentials and peripheral nerve function, yet they may be involved in a homeostatic mechanism fundamental to thermoregulation. Extending the knowledge of such alterations during simulated microgravity may be useful not only for space exploration, but for its application in clinical conditions and for life on Earth, as well.
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Affiliation(s)
- Alex Buoite Stella
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Miloš Ajčević
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy; Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio, 6/1, 34127 Trieste, Italy
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy.
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12
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Romanella SM, Sprugnoli G, Ruffini G, Seyedmadani K, Rossi S, Santarnecchi E. Noninvasive Brain Stimulation & Space Exploration: Opportunities and Challenges. Neurosci Biobehav Rev 2020; 119:294-319. [PMID: 32937115 PMCID: PMC8361862 DOI: 10.1016/j.neubiorev.2020.09.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/22/2020] [Accepted: 09/03/2020] [Indexed: 01/11/2023]
Abstract
As NASA prepares for longer space missions aiming for the Moon and Mars, astronauts' health and performance are becoming a central concern due to the threats associated with galactic cosmic radiation, unnatural gravity fields, and life in extreme environments. In space, the human brain undergoes functional and structural changes related to fluid shift and changes in intracranial pressure. Behavioral abnormalities, such as cognitive deficits, sleep disruption, and visuomotor difficulties, as well as psychological effects, are also an issue. We discuss opportunities and challenges of noninvasive brain stimulation (NiBS) methods - including transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tES) - to support space exploration in several ways. NiBS includes safe and portable techniques already applied in a wide range of cognitive and motor domains, as well as therapeutically. NiBS could be used to enhance in-flight performance, supporting astronauts during pre-flight Earth-based training, as well as to identify biomarkers of post-flight brain changes for optimization of rehabilitation/compensatory strategies. We review these NiBS techniques and their effects on brain physiology, psychology, and cognition.
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Affiliation(s)
- S M Romanella
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy
| | - G Sprugnoli
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Radiology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Ruffini
- Neuroelectrics Corporation, Cambridge, MA, USA
| | - K Seyedmadani
- University Space Research Association NASA Johnson Space Center, Houston, TX, USA; Ann and H.J. Smead Aerospace Engineering Sciences, University of Colorado, Boulder, CO, USA
| | - S Rossi
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy; Human Physiology Section, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - E Santarnecchi
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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13
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Pechenkova E, Nosikova I, Rumshiskaya A, Litvinova L, Rukavishnikov I, Mershina E, Sinitsyn V, Van Ombergen A, Jeurissen B, Jillings S, Laureys S, Sijbers J, Grishin A, Chernikova L, Naumov I, Kornilova L, Wuyts FL, Tomilovskaya E, Kozlovskaya I. Alterations of Functional Brain Connectivity After Long-Duration Spaceflight as Revealed by fMRI. Front Physiol 2019; 10:761. [PMID: 31333476 PMCID: PMC6621543 DOI: 10.3389/fphys.2019.00761] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 05/31/2019] [Indexed: 12/22/2022] Open
Abstract
The present study reports alterations of task-based functional brain connectivity in a group of 11 cosmonauts after a long-duration spaceflight, compared to a healthy control group not involved in the space program. To elicit the postural and locomotor sensorimotor mechanisms that are usually most significantly impaired when space travelers return to Earth, a plantar stimulation paradigm was used in a block design fMRI study. The motor control system activated by the plantar stimulation involved the pre-central and post-central gyri, SMA, SII/operculum, and, to a lesser degree, the insular cortex and cerebellum. While no post-flight alterations were observed in terms of activation, the network-based statistics approach revealed task-specific functional connectivity modifications within a broader set of regions involving the activation sites along with other parts of the sensorimotor neural network and the visual, proprioceptive, and vestibular systems. The most notable findings included a post-flight increase in the stimulation-specific connectivity of the right posterior supramarginal gyrus with the rest of the brain; a strengthening of connections between the left and right insulae; decreased connectivity of the vestibular nuclei, right inferior parietal cortex (BA40) and cerebellum with areas associated with motor, visual, vestibular, and proprioception functions; and decreased coupling of the cerebellum with the visual cortex and the right inferior parietal cortex. The severity of space motion sickness symptoms was found to correlate with a post- to pre-flight difference in connectivity between the right supramarginal gyrus and the left anterior insula. Due to the complex nature and rapid dynamics of adaptation to gravity alterations, the post-flight findings might be attributed to both the long-term microgravity exposure and to the readaptation to Earth's gravity that took place between the landing and post-flight MRI session. Nevertheless, the results have implications for the multisensory reweighting and gravitational motor system theories, generating hypotheses to be tested in future research.
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Affiliation(s)
| | - Inna Nosikova
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Alena Rumshiskaya
- Radiology Department, Federal Center of Treatment and Rehabilitation, Moscow, Russia
| | - Liudmila Litvinova
- Radiology Department, Federal Center of Treatment and Rehabilitation, Moscow, Russia
| | - Ilya Rukavishnikov
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Elena Mershina
- Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Valentin Sinitsyn
- Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Angelique Van Ombergen
- Lab for Equilibrium Investigations and Aerospace, Faculty of Science, University of Antwerp, Antwerp, Belgium
| | - Ben Jeurissen
- iMec/Vision Lab, Faculty of Science, University of Antwerp, Antwerp, Belgium
| | - Steven Jillings
- Lab for Equilibrium Investigations and Aerospace, Faculty of Science, University of Antwerp, Antwerp, Belgium
- Coma Science Group, GIGA Consciousness Research Centre, Neurology Department, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness Research Centre, Neurology Department, University Hospital of Liège, Liège, Belgium
| | - Jan Sijbers
- iMec/Vision Lab, Faculty of Science, University of Antwerp, Antwerp, Belgium
| | | | - Ludmila Chernikova
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Ivan Naumov
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Ludmila Kornilova
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Floris L. Wuyts
- Lab for Equilibrium Investigations and Aerospace, Faculty of Science, University of Antwerp, Antwerp, Belgium
| | - Elena Tomilovskaya
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Inessa Kozlovskaya
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
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14
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Yuan P, Koppelmans V, Reuter-Lorenz P, De Dios Y, Gadd N, Riascos R, Kofman I, Bloomberg J, Mulavara A, Seidler RD. Change of cortical foot activation following 70 days of head-down bed rest. J Neurophysiol 2018; 119:2145-2152. [PMID: 29488843 PMCID: PMC6032127 DOI: 10.1152/jn.00693.2017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 02/09/2018] [Accepted: 02/25/2018] [Indexed: 12/11/2022] Open
Abstract
Head-down tilt bed rest (HDBR) has been used as a spaceflight analog to study some of the effects of microgravity on human physiology, cognition, and sensorimotor functions. Previous studies have reported declines in balance control and functional mobility after spaceflight and HDBR. In this study we investigated how the brain activation for foot movement changed with HDBR. Eighteen healthy men participated in the current HDBR study. They were in a 6° head-down tilt position continuously for 70 days. Functional MRI scans were acquired to estimate brain activation for foot movement before, during, and after HDBR. Another 11 healthy men who did not undergo HDBR participated as control subjects and were scanned at four time points. In the HDBR subjects, the cerebellum, fusiform gyrus, hippocampus, and middle occipital gyrus exhibited HDBR-related increases in activation for foot tapping, whereas no HDBR-associated activation decreases were found. For the control subjects, activation for foot tapping decreased across sessions in a couple of cerebellar regions, whereas no activation increase with session was found. Furthermore, we observed that less HDBR-related decline in functional mobility and balance control was associated with greater pre-to-post HDBR increases in brain activation for foot movement in several cerebral and cerebellar regions. Our results suggest that more neural control is needed for foot movement as a result of HDBR. NEW & NOTEWORTHY Long-duration head-down bed rest serves as a spaceflight analog research environment. We show that brain activity in the cerebellum and visual areas during foot movement increases from pre- to post-bed rest and then shows subsequent recovery. Greater increases were seen for individuals who exhibited less decline in functional mobility and balance control, suggestive of adaptive changes in neural control with long-duration bed rest.
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Affiliation(s)
- Peng Yuan
- School of Kinesiology, University of Michigan , Ann Arbor, Michigan
| | - Vincent Koppelmans
- School of Kinesiology, University of Michigan , Ann Arbor, Michigan
- Department of Psychiatry, University of Utah , Salt Lake City, Utah
| | | | | | | | - Roy Riascos
- The University of Texas Health Science Center , Houston, Texas
| | | | | | | | - Rachael D Seidler
- School of Kinesiology, University of Michigan , Ann Arbor, Michigan
- Department of Applied Physiology & Kinesiology, University of Florida , Gainesville, Florida
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15
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Wang Y, Zhou Y, Rao LL, Zheng R, Liang ZY, Chen XP, Tan C, Tian ZQ, Wang CH, Bai YQ, Chen SG, Li S. Effect of 45-Day −6° Head-Down Bed Rest on Cooperation and Aggression. APPLIED COGNITIVE PSYCHOLOGY 2017. [DOI: 10.1002/acp.3346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Yun Wang
- Key Laboratory of Behavioral Science, Institute of Psychology; Chinese Academy of Sciences; Beijing China
- University of Chinese Academy of Sciences; Beijing China
| | - Yuan Zhou
- Key Laboratory of Behavioral Science, Institute of Psychology; Chinese Academy of Sciences; Beijing China
| | - Li-Lin Rao
- Key Laboratory of Behavioral Science, Institute of Psychology; Chinese Academy of Sciences; Beijing China
| | - Rui Zheng
- Key Laboratory of Behavioral Science, Institute of Psychology; Chinese Academy of Sciences; Beijing China
| | - Zhu-Yuan Liang
- Key Laboratory of Behavioral Science, Institute of Psychology; Chinese Academy of Sciences; Beijing China
| | - Xiao-Ping Chen
- National Key Laboratory of Human Factors Engineering; China Astronaut Research and Training Center; Beijing China
| | - Cheng Tan
- National Key Laboratory of Human Factors Engineering; China Astronaut Research and Training Center; Beijing China
| | - Zhi-Qiang Tian
- National Key Laboratory of Human Factors Engineering; China Astronaut Research and Training Center; Beijing China
| | - Chun-Hui Wang
- National Key Laboratory of Human Factors Engineering; China Astronaut Research and Training Center; Beijing China
| | - Yan-Qiang Bai
- National Key Laboratory of Human Factors Engineering; China Astronaut Research and Training Center; Beijing China
| | - Shan-Guang Chen
- National Key Laboratory of Human Factors Engineering; China Astronaut Research and Training Center; Beijing China
| | - Shu Li
- Key Laboratory of Behavioral Science, Institute of Psychology; Chinese Academy of Sciences; Beijing China
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16
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Koppelmans V, Bloomberg JJ, De Dios YE, Wood SJ, Reuter-Lorenz PA, Kofman IS, Riascos R, Mulavara AP, Seidler RD. Brain plasticity and sensorimotor deterioration as a function of 70 days head down tilt bed rest. PLoS One 2017; 12:e0182236. [PMID: 28767698 PMCID: PMC5540603 DOI: 10.1371/journal.pone.0182236] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 07/15/2017] [Indexed: 12/18/2022] Open
Abstract
Background Adverse effects of spaceflight on sensorimotor function have been linked to altered somatosensory and vestibular inputs in the microgravity environment. Whether these spaceflight sequelae have a central nervous system component is unknown. However, experimental studies have shown spaceflight-induced brain structural changes in rodents’ sensorimotor brain regions. Understanding the neural correlates of spaceflight-related motor performance changes is important to ultimately develop tailored countermeasures that ensure mission success and astronauts’ health. Method Head down-tilt bed rest (HDBR) can serve as a microgravity analog because it mimics body unloading and headward fluid shifts of microgravity. We conducted a 70-day 6° HDBR study with 18 right-handed males to investigate how microgravity affects focal gray matter (GM) brain volume. MRI data were collected at 7 time points before, during and post-HDBR. Standing balance and functional mobility were measured pre and post-HDBR. The same metrics were obtained at 4 time points over ~90 days from 12 control subjects, serving as reference data. Results HDBR resulted in widespread increases GM in posterior parietal regions and decreases in frontal areas; recovery was not yet complete by 12 days post-HDBR. Additionally, HDBR led to balance and locomotor performance declines. Increases in a cluster comprising the precuneus, precentral and postcentral gyrus GM correlated with less deterioration or even improvement in standing balance. This association did not survive Bonferroni correction and should therefore be interpreted with caution. No brain or behavior changes were observed in control subjects. Conclusions Our results parallel the sensorimotor deficits that astronauts experience post-flight. The widespread GM changes could reflect fluid redistribution. Additionally, the association between focal GM increase and balance changes suggests that HDBR also may result in neuroplastic adaptation. Future studies are warranted to determine causality and underlying mechanisms.
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Affiliation(s)
- Vincent Koppelmans
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | | | | | - Scott J. Wood
- NASA Johnson Space Center, Houston, TX, United States of America
| | | | | | - Roy Riascos
- The University of Texas Health Science Center, Houston, TX, United States of America
| | | | - Rachael D. Seidler
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, United States of America
- Neuroscience Program, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail:
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17
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Abstract
Microgravity, confinement, isolation, and immobilization are just some of the features astronauts have to cope with during space missions. Consequently, long-duration space travel can have detrimental effects on human physiology. Although research has focused on the cardiovascular and musculoskeletal system in particular, the exact impact of spaceflight on the human central nervous system remains to be determined. Previous studies have reported psychological problems, cephalic fluid shifts, neurovestibular problems, and cognitive alterations, but there is paucity in the knowledge of the underlying neural substrates. Previous space analogue studies and preliminary spaceflight studies have shown an involvement of the cerebellum, cortical sensorimotor, and somatosensory areas and the vestibular pathways. Extending this knowledge is crucial, especially in view of long-duration interplanetary missions (e.g., Mars missions) and space tourism. In addition, the acquired insight could be relevant for vestibular patients, patients with neurodegenerative disorders, as well as the elderly population, coping with multisensory deficit syndromes, immobilization, and inactivity.
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18
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Van Ombergen A, Laureys S, Sunaert S, Tomilovskaya E, Parizel PM, Wuyts FL. Spaceflight-induced neuroplasticity in humans as measured by MRI: what do we know so far? NPJ Microgravity 2017. [PMID: 28649624 PMCID: PMC5445591 DOI: 10.1038/s41526-016-0010-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Space travel poses an enormous challenge on the human body; microgravity, ionizing radiation, absence of circadian rhythm, confinement and isolation are just some of the features associated with it. Obviously, all of the latter can have an impact on human physiology and even induce detrimental changes. Some organ systems have been studied thoroughly under space conditions, however, not much is known on the functional and morphological effects of spaceflight on the human central nervous system. Previous studies have already shown that central nervous system changes occur during and after spaceflight in the form of neurovestibular problems, alterations in cognitive function and sensory perception, cephalic fluid shifts and psychological disturbances. However, little is known about the underlying neural substrates. In this review, we discuss the current limited knowledge on neuroplastic changes in the human central nervous system associated with spaceflight (actual or simulated) as measured by magnetic resonance imaging-based techniques. Furthermore, we discuss these findings as well as their future perspectives, since this can encourage future research into this delicate and intriguing aspect of spaceflight. Currently, the literature suffers from heterogeneous experimental set-ups and therefore, the lack of comparability of findings among studies. However, the cerebellum, cortical sensorimotor and somatosensory areas and vestibular-related pathways seem to be involved across different studies, suggesting that these brain regions are most affected by (simulated) spaceflight. Extending this knowledge is crucial, especially with the eye on long-duration interplanetary missions (e.g. Mars) and space tourism.
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Affiliation(s)
- Angelique Van Ombergen
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Groenenborgerlaan 171, Antwerp, 2020 Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk (Antwerp), 2610 Belgium.,Faculty of Sciences, Department of Biomedical Physics, University of Antwerp, Groenenborgerlaan 171, Antwerp, 2020 Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Research & Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Stefan Sunaert
- KU Leuven-University of Leuven, Department of Imaging & Pathology, Translational MRI, Leuven, Belgium
| | - Elena Tomilovskaya
- SSC RF-Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Paul M Parizel
- Department of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium
| | - Floris L Wuyts
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Groenenborgerlaan 171, Antwerp, 2020 Belgium.,Faculty of Sciences, Department of Biomedical Physics, University of Antwerp, Groenenborgerlaan 171, Antwerp, 2020 Belgium
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19
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Cassady K, Koppelmans V, Reuter-Lorenz P, De Dios Y, Gadd N, Wood S, Castenada RR, Kofman I, Bloomberg J, Mulavara A, Seidler R. Effects of a spaceflight analog environment on brain connectivity and behavior. Neuroimage 2016; 141:18-30. [DOI: 10.1016/j.neuroimage.2016.07.029] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/22/2016] [Accepted: 07/12/2016] [Indexed: 01/25/2023] Open
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20
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Zeng LL, Liao Y, Zhou Z, Shen H, Liu Y, Liu X, Hu D. Default network connectivity decodes brain states with simulated microgravity. Cogn Neurodyn 2015; 10:113-120. [PMID: 27066149 DOI: 10.1007/s11571-015-9359-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 09/25/2015] [Accepted: 10/08/2015] [Indexed: 11/24/2022] Open
Abstract
With great progress of space navigation technology, it becomes possible to travel beyond Earth's gravity. So far, it remains unclear whether the human brain can function normally within an environment of microgravity and confinement. Particularly, it is a challenge to figure out some neuroimaging-based markers for rapid screening diagnosis of disrupted brain function in microgravity environment. In this study, a 7-day -6° head down tilt bed rest experiment was used to simulate the microgravity, and twenty healthy male participants underwent resting-state functional magnetic resonance imaging scans at baseline and after the simulated microgravity experiment. We used a multivariate pattern analysis approach to distinguish the brain states with simulated microgravity from normal gravity based on the functional connectivity within the default network, resulting in an accuracy of no less than 85 % via cross-validation. Moreover, most discriminative functional connections were mainly located between the limbic system and cortical areas and were enhanced after simulated microgravity, implying a self-adaption or compensatory enhancement to fulfill the need of complex demand in spatial navigation and motor control functions in microgravity environment. Overall, the findings suggest that the brain states in microgravity are likely different from those in normal gravity and that brain connectome could act as a biomarker to indicate the brain state in microgravity.
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Affiliation(s)
- Ling-Li Zeng
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, 410073 Hunan People's Republic of China
| | - Yang Liao
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032 Shaanxi People's Republic of China
| | - Zongtan Zhou
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, 410073 Hunan People's Republic of China
| | - Hui Shen
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, 410073 Hunan People's Republic of China
| | - Yadong Liu
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, 410073 Hunan People's Republic of China
| | - Xufeng Liu
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032 Shaanxi People's Republic of China
| | - Dewen Hu
- College of Mechatronics and Automation, National University of Defense Technology, Changsha, 410073 Hunan People's Republic of China
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21
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Koppelmans V, Mulavara AP, Yuan P, Cassady KE, Cooke KA, Wood SJ, Reuter-Lorenz PA, De Dios YE, Stepanyan V, Szecsy DL, Gadd NE, Kofman I, Scott JM, Downs ME, Bloomberg JJ, Ploutz-Snyder L, Seidler RD. Exercise as potential countermeasure for the effects of 70 days of bed rest on cognitive and sensorimotor performance. Front Syst Neurosci 2015; 9:121. [PMID: 26388746 PMCID: PMC4558429 DOI: 10.3389/fnsys.2015.00121] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 08/17/2015] [Indexed: 12/14/2022] Open
Abstract
Background: Spaceflight has been associated with changes in gait and balance; it is unclear whether it affects cognition. Head down tilt bed rest (HDBR) is a microgravity analog that mimics cephalad fluid shifts and body unloading. In consideration of astronaut’s health and mission success, we investigated the effects of HDBR on cognition and sensorimotor function. Furthermore, we investigated if exercise mitigates any cognitive and sensorimotor sequelae of spaceflight. Method: We conducted a 70-day six-degree HDBR study in 10 male subjects who were randomly assigned to a HDBR supine exercise or a HDBR control group. Cognitive measures (i.e., processing speed, manual dexterity, psychomotor speed, visual dependency, and 2D and 3D mental rotation) and sensorimotor performance (functional mobility (FMT) and balance performance) were collected at 12 and 8 days pre-HDBR, at 7, 50, and 70 days in HDBR, and at 8 and 12 days post-HDBR. Exercise comprised resistance training, and continuous and high-intensity interval aerobic exercise. We also repeatedly assessed an outside-of-bed rest control group to examine metric stability. Results: Small practice effects were observed in the control group for some tasks; these were taken into account when analyzing effects of HDBR. No significant effects of HDBR on cognition were observed, although visual dependency during HDBR remained stable in HDBR controls whereas it decreased in HDBR exercise subjects. Furthermore, HDBR was associated with loss of FMT and standing balance performance, which were almost fully recovered 12 days post-HDBR. Aerobic and resistance exercise partially mitigated the effects of HDBR on FMT and accelerated the recovery time course post-HDBR. Discussion: HDBR did not significantly affect cognitive performance but did adversely affect FMT and standing balance performance. Exercise had some protective effects on the deterioration and recovery of FMT.
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Affiliation(s)
| | - Ajitkumar P Mulavara
- NASA Johnson Space Center Houston, TX, USA ; Universities Space Research Association Houston, TX, USA
| | - Peng Yuan
- School of Kinesiology, University of Michigan Ann Arbor, MI, USA
| | - Kaitlin E Cassady
- School of Kinesiology, University of Michigan Ann Arbor, MI, USA ; Department of Psychology, University of Michigan Ann Arbor, MI, USA
| | - Katherine A Cooke
- School of Kinesiology, University of Michigan Ann Arbor, MI, USA ; Department of Psychology, University of Michigan Ann Arbor, MI, USA
| | - Scott J Wood
- NASA Johnson Space Center Houston, TX, USA ; Department of Psychology, Azusa Pacific University Azusa, CA, USA
| | - Patricia A Reuter-Lorenz
- Department of Psychology, University of Michigan Ann Arbor, MI, USA ; Neuroscience Program, University of Michigan Ann Arbor, MI, USA
| | - Yiri E De Dios
- Wyle Science, Technology and Engineering Group Houston, TX, USA
| | | | | | - Nichole E Gadd
- Wyle Science, Technology and Engineering Group Houston, TX, USA
| | - Igor Kofman
- Wyle Science, Technology and Engineering Group Houston, TX, USA
| | | | - Meghan E Downs
- Department of Health and Human Performance, University of Houston Houston, TX, USA
| | | | - Lori Ploutz-Snyder
- NASA Johnson Space Center Houston, TX, USA ; Universities Space Research Association Houston, TX, USA
| | - Rachael D Seidler
- School of Kinesiology, University of Michigan Ann Arbor, MI, USA ; Department of Psychology, University of Michigan Ann Arbor, MI, USA ; Neuroscience Program, University of Michigan Ann Arbor, MI, USA ; Institute of Gerontology, University of Michigan Ann Arbor, MI, USA
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22
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Liao Y, Lei M, Huang H, Wang C, Duan J, Li H, Liu X. The time course of altered brain activity during 7-day simulated microgravity. Front Behav Neurosci 2015; 9:124. [PMID: 26029071 PMCID: PMC4428138 DOI: 10.3389/fnbeh.2015.00124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/29/2015] [Indexed: 11/21/2022] Open
Abstract
Microgravity causes multiple changes in physical and mental levels in humans, which can induce performance deficiency among astronauts. Studying the variations in brain activity that occur during microgravity would help astronauts to deal with these changes. In the current study, resting-state functional magnetic resonance imaging (rs-fMRI) was used to observe the variations in brain activity during a 7-day head down tilt (HDT) bed rest, which is a common and reliable model for simulated microgravity. The amplitudes of low frequency fluctuation (ALFF) of twenty subjects were recorded pre-head down tilt (pre-HDT), during a bed rest period (HDT0), and then each day in the HDT period (HDT1–HDT7). One-way analysis of variance (ANOVA) of the ALFF values over these 8 days was used to test the variation across time period (p < 0.05, corrected). Compared to HDT0, subjects presented lower ALFF values in the posterior cingulate cortex (PCC) and higher ALFF values in the anterior cingulate cortex (ACC) during the HDT period, which may partially account for the lack of cognitive flexibility and alterations in autonomic nervous system seen among astronauts in microgravity. Additionally, the observed improvement in function in CPL during the HDT period may play a compensatory role to the functional decline in the paracentral lobule to sustain normal levels of fine motor control for astronauts in a microgravity environment. Above all, those floating brain activities during 7 days of simulated microgravity may indicate that the brain self-adapts to help astronauts adjust to the multiple negative stressors encountered in a microgravity environment.
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Affiliation(s)
- Yang Liao
- Department of Medical Psychology, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Meiying Lei
- Mental Health Center, 303 Hospital of PLA Nanning, Guangxi, China
| | - Haibo Huang
- Department of Radiology, 303 Hospital of PLA Nanning, Guangxi, China
| | - Chuang Wang
- Mental Health Center, 303 Hospital of PLA Nanning, Guangxi, China
| | - Jiaobo Duan
- Department of Medical Psychology, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Hongzheng Li
- Mental Health Center, 303 Hospital of PLA Nanning, Guangxi, China
| | - Xufeng Liu
- Department of Medical Psychology, Fourth Military Medical University Xi'an, Shaanxi, China
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23
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Zhou Y, Wang Y, Rao LL, Liang ZY, Chen XP, Zheng D, Tan C, Tian ZQ, Wang CH, Bai YQ, Chen SG, Li S. Disrupted resting-state functional architecture of the brain after 45-day simulated microgravity. Front Behav Neurosci 2014; 8:200. [PMID: 24926242 PMCID: PMC4046318 DOI: 10.3389/fnbeh.2014.00200] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 05/18/2014] [Indexed: 01/01/2023] Open
Abstract
Long-term spaceflight induces both physiological and psychological changes in astronauts. To understand the neural mechanisms underlying these physiological and psychological changes, it is critical to investigate the effects of microgravity on the functional architecture of the brain. In this study, we used resting-state functional MRI (rs-fMRI) to study whether the functional architecture of the brain is altered after 45 days of −6° head-down tilt (HDT) bed rest, which is a reliable model for the simulation of microgravity. Sixteen healthy male volunteers underwent rs-fMRI scans before and after 45 days of −6° HDT bed rest. Specifically, we used a commonly employed graph-based measure of network organization, i.e., degree centrality (DC), to perform a full-brain exploration of the regions that were influenced by simulated microgravity. We subsequently examined the functional connectivities of these regions using a seed-based resting-state functional connectivity (RSFC) analysis. We found decreased DC in two regions, the left anterior insula (aINS) and the anterior part of the middle cingulate cortex (MCC; also called the dorsal anterior cingulate cortex in many studies), in the male volunteers after 45 days of −6° HDT bed rest. Furthermore, seed-based RSFC analyses revealed that a functional network anchored in the aINS and MCC was particularly influenced by simulated microgravity. These results provide evidence that simulated microgravity alters the resting-state functional architecture of the brains of males and suggest that the processing of salience information, which is primarily subserved by the aINS–MCC functional network, is particularly influenced by spaceflight. The current findings provide a new perspective for understanding the relationships between microgravity, cognitive function, autonomic neural function, and central neural activity.
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Affiliation(s)
- Yuan Zhou
- Key Laboratory of Behavioral Science and Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences Beijing, China
| | - Yun Wang
- Key Laboratory of Behavioral Science and Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences Beijing, China ; University of Chinese Academy of Sciences Beijing, China
| | - Li-Lin Rao
- Key Laboratory of Behavioral Science and Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences Beijing, China
| | - Zhu-Yuan Liang
- Key Laboratory of Behavioral Science and Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences Beijing, China
| | - Xiao-Ping Chen
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center Beijing, China
| | - Dang Zheng
- Key Laboratory of Behavioral Science and Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences Beijing, China ; University of Chinese Academy of Sciences Beijing, China
| | - Cheng Tan
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center Beijing, China
| | - Zhi-Qiang Tian
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center Beijing, China
| | - Chun-Hui Wang
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center Beijing, China
| | - Yan-Qiang Bai
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center Beijing, China
| | - Shan-Guang Chen
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center Beijing, China
| | - Shu Li
- Key Laboratory of Behavioral Science and Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences Beijing, China
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24
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Koppelmans V, Erdeniz B, De Dios YE, Wood SJ, Reuter-Lorenz PA, Kofman I, Bloomberg JJ, Mulavara AP, Seidler RD. Study protocol to examine the effects of spaceflight and a spaceflight analog on neurocognitive performance: extent, longevity, and neural bases. BMC Neurol 2013; 13:205. [PMID: 24350728 PMCID: PMC3878338 DOI: 10.1186/1471-2377-13-205] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 12/02/2013] [Indexed: 11/10/2022] Open
Abstract
Background Long duration spaceflight (i.e., 22 days or longer) has been associated with changes in sensorimotor systems, resulting in difficulties that astronauts experience with posture control, locomotion, and manual control. The microgravity environment is an important causal factor for spaceflight induced sensorimotor changes. Whether spaceflight also affects other central nervous system functions such as cognition is yet largely unknown, but of importance in consideration of the health and performance of crewmembers both in- and post-flight. We are therefore conducting a controlled prospective longitudinal study to investigate the effects of spaceflight on the extent, longevity and neural bases of sensorimotor and cognitive performance changes. Here we present the protocol of our study. Methods/design This study includes three groups (astronauts, bed rest subjects, ground-based control subjects) for which each the design is single group with repeated measures. The effects of spaceflight on the brain will be investigated in astronauts who will be assessed at two time points pre-, at three time points during-, and at four time points following a spaceflight mission of six months. To parse out the effect of microgravity from the overall effects of spaceflight, we investigate the effects of seventy days head-down tilted bed rest. Bed rest subjects will be assessed at two time points before-, two time points during-, and three time points post-bed rest. A third group of ground based controls will be measured at four time points to assess reliability of our measures over time. For all participants and at all time points, except in flight, measures of neurocognitive performance, fine motor control, gait, balance, structural MRI (T1, DTI), task fMRI, and functional connectivity MRI will be obtained. In flight, astronauts will complete some of the tasks that they complete pre- and post flight, including tasks measuring spatial working memory, sensorimotor adaptation, and fine motor performance. Potential changes over time and associations between cognition, motor-behavior, and brain structure and function will be analyzed. Discussion This study explores how spaceflight induced brain changes impact functional performance. This understanding could aid in the design of targeted countermeasures to mitigate the negative effects of long-duration spaceflight.
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25
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Liao Y, Miao D, Huan Y, Yin H, Xi Y, Liu X. Altered regional homogeneity with short-term simulated microgravity and its relationship with changed performance in mental transformation. PLoS One 2013; 8:e64931. [PMID: 23755162 PMCID: PMC3670926 DOI: 10.1371/journal.pone.0064931] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 04/19/2013] [Indexed: 11/18/2022] Open
Abstract
In order to further the insight into the explanation of changed performance in mental transformation under microgravity, we discuss the change of performance in mental transformation and its relationship with altered regional homogeneity (ReHo) in resting-state brain by using simulated weightlessness model. Twelve male subjects with age between 24 and 31 received resting-state fMRI scan and mental transformation test both in normal condition and immediately after 72 hours -6° head down tilt (HDT). A paired sample t-test was used to test the difference of behavior performance and brain activity between these two conditions. Compare with normal condition, subjects showed a changed performance in mental transformation with short term simulated microgravity and appeared to be falling. Meanwhile, decreased ReHo were found in right inferior frontal gyrus (IFG) and left inferior parietal lobule (IPL) after 72 hours -6° HDT, while increased ReHo were found in bilateral medial frontal gyrus (MFG) and left superior frontal gyrus (SFG) (P<0.05, corrected). Particularly, there was a significant correlation between ReHo values in left IPL and velocity index of mental transformation. Our findings indicate that gravity change may disrupt the function of right IFG and left IPL in the resting-state, among of which functional change in left IPL may contribute to changed abilities of mental transformation. In addition, the enhanced activity of the bilateral MFG and decreased activity of right IFG found in the current study maybe reflect a complementation effect on inhibitory control process.
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Affiliation(s)
- Yang Liao
- Department of Psychology, Fourth Military Medical University, Xi'an Shaanxi, China
| | - Danmin Miao
- Department of Psychology, Fourth Military Medical University, Xi'an Shaanxi, China
| | - Yi Huan
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an Shaaxi, China
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an Shaaxi, China
| | - Yibin Xi
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an Shaaxi, China
| | - Xufeng Liu
- Department of Psychology, Fourth Military Medical University, Xi'an Shaanxi, China
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