ALBERT

Description: Upon return from spaceflight, a majority of crewmembers experience motion sickness (MS) symptoms. The interactions between crewmembers' adaptation to a gravitational transition, the performance decrements resulting from MS and/or use of promethazine (PMZ), and the constraints imposed by mission task demands could significantly challenge and limit an astronaut's ability to perform functional tasks during gravitational transitions. No operational countermeasure currently exists to mitigate the risks associated with these sensorimotor disturbances. Stochastic resonance (SR) can be thought of simply as "noise benefit" or an increase in information transfer by a system when in the presence of a non-zero level of noise. We have shown that low levels of stochastic vestibular stimulation (SVS) improve balance and locomotor performance due to SR (Goel et al. 2015, Mulavara et al. 2011, 2015). Additionally, a study in a 6-hydroxydopamine (6-OHDA) hemi-lesioned rat model of Parkinson's disease demonstrated improvements in locomotor activity after low-level SVS delivery possibly due to an increase in nigral gamma-aminobutyric acid (GABA) release in a dopamine independent way (Samoudi et al. 2012). SVS specifically increased GABA release on the lesioned, but not the intact side. These results suggest that SVS can cause targeted alterations of GABA release to affect performance of functional tasks. Activation of the GABA pathway is important in modulating MS and promoting adaptability (Cohen 2008). Magnusson et al. (2000) supported this finding by showing that the administration of a GABAB agonist caused a reversal of the symptoms that is normally seen after unilateral labyrinthectomy. Thus, GABA could play a significant role in reducing MS and promoting adaptability. We have taken advantage of the SR mechanism as a modulator of neurotransmitters to develop a unique SVS countermeasure system to mitigate MS symptoms and improve functional performance after landing. Healthy subjects (n=20) participated in two test sessions, one in which they received +/-400 microA of SVS and one where they received no stimulation (0 microA); the study design was counterbalanced. Subjects began by performing a series of four functional tasks 3-5 times as baseline measurements of task performance. Then, to induce MS, subjects walked an obstacle course with up-down reversing prisms. If they completed the course before achieving our pre-determined level of MS, they were asked to read a poster while making large up-down head movements to a metronome while still wearing the reversing prism goggles. Subjects were stopped every two minutes and asked to report their MS symptoms. Using the Pensacola Scale for motion sickness, test operators evaluated the level of MS of each subject. Once a subject reached an 8 on this scale, which is equivalent to mild malaise, or 30 minutes had passed since the start of the MS induction, this protocol was stopped. Finally, immediately after MS induction, subjects were asked to complete the four functional tasks again. Although, 100% of our subjects experienced at least one MS symptom, only 55% of our subjects experienced stomach awareness to any degree. Without SVS, only 40% of subjects lasted the full 30-minute MS induction protocol, while 65% of subjects lasted the full 30 minutes with SVS, which is nearly a significant increase (p=0.056). In addition, subjects showed significant improvement from baseline when performing a tandem walk and a prone-to-stand test immediately after the MS induction protocol was stopped but the stimulation level was continued. The results are promising and future work includes comparing MS progression between PMZ and SVS directly in subjects that are provoked to a minimum of nausea. Low levels of SVS stimulation may serve as a non-pharmacological countermeasure to replace or reduce the PMZ dosage requirements and concurrently improve functional performance during transitions to new gravitational environments after spaceflight.

Description: Gravity transitions cause changes in the vestibulo-occular reflex (VOR), which manifests as poor gaze control, a decrement in dynamic visual acuity (the ability to maintain gaze while in motion), both of which are caused by retinal slip. Retinal slip, the inability to keep an image focused on the retina, can drive or worsen sensory conflict, resulting in motion sickness (MS). Currently 100% of returning crewmembers report MS symptoms, which might affect their ability to perform mission critical tasks immediately after landing. Reschke et al. (2007) demonstrate that stroboscopic vision goggles improve motion sickness onset and symptom severity in motion sickness driven by retinal slip.

Description: Upon return from long-duration spaceflight, 100% of crewmembers experience motion sickness (MS) symptoms. The interactions between crewmembers' adaptation to a gravitational transition, the performance decrements resulting from MS and/or use of promethazine (PMZ), and the constraints imposed by mission task demands could significantly challenge and limit an astronaut's ability to perform functional tasks during gravitational transitions. Stochastic resonance (SR) is "noise benefit": adding noise to a system might increase the information (examples to the left and above). Stochastic vestibular stimulation (SVS), or low levels of noise applied to the vestibular system, improves balance and locomotor performance (Goel et al. 2015, Mulavara et al. 2011, 2015). In hemi-lesioned rat models, Samoudi et al. 2012 found that SVS increased GABA release on the lesioned, but not the intact side. Activation of the GABA pathway is important in modulating MS and promoting adaptability (Cohen 2008) and was seen to reverse MS symptoms in rats after unilateral labyrinthectomy (Magnusson et al. 2000). Thus, SVS could be used to promote GABA pathways to reduce MS and promote adaptability, eliminate the need for PMZ or other performance-inhibiting drugs.

Description: Astronauts experience Postflight disturbances in postural and locomotor control due to sensorimotor adaptation to the unique environment of spaceflight. These alterations might have adverse consequences if a rapid egress were required following a Mars landing or on return to Earth after a water landing. Currently, no operational countermeasure is targeted to mitigate Postflight balance and locomotor dysfunction.

Description: Long-term exposure to microgravity causes sensorimotor adaptations that result in functional deficits upon returning to a gravitational environment. At landing, the vestibular system and the central nervous system, responsible for coordinating head and eye movements via the vestibulo-occular reflex (VOR), are adapted to microgravity and must re-adapt to the Earth's gravitational environment. This re-adaptation causes decrements in gaze control and dynamic visual acuity, with astronauts reporting oscillopsia and blurred vision. These effects are caused by retinal slip, or the inability to keep an image focused on their retina, which is thought to drive motion sickness symptoms experienced upon landing. Retinal slip can be estimated by dynamic visual acuity (DVA); visual acuity while in motion. Peters et al. (2011) find that DVA is worsened in astronauts by an average of 0.75 eye-chart lines one day after landing. Previously, the use of stroboscopic goggles has shown to be effective in minimizing motion sickness symptoms due to retinal slip (Reschke et al. 2007). In this study, we simulated the decrement in DVA caused by sensorimotor re-adaptation by using minifying lenses and then testing the efficacy of stroboscopic goggles in preventing retinal slip and improving DVA. Dynamic visual acuity is assessed using an oscillating chair developed in the Neuroscience Laboratory at JSC. This chair is motor-driven and oscillates vertically at 2 Hz with a vertical displacement of +/- 2 cm to simulate the vertical translations that occur while walking. As the subject is being oscillated, they are asked to discern the direction of Landolt-C optotypes of varying sizes and record their direction using a gamepad. The visual acuity thresholds are determined using an algorithm that alters the size of the optotype based on the previous responses of the subject using a forced-choice best parameter estimation that is able to rapidly converge on the threshold value. Visual acuity thresholds were determined both for static (seated) and dynamic (oscillating) conditions. Dynamic visual acuity is defined as the difference between the dynamic and static conditions. We found that healthy subjects (n=20) have a significantly impaired DVA while wearing the minifying lenses, demonstrating that the VOR is in an adaptive state and retinal slip is occurring. When subjects' acuity was tested wearing the stroboscopic goggles with the minifying lenses, there was no significant difference in their DVA compared to their baseline DVA. This suggests that stroboscopic goggles are preventing retinal slip and would function as an efficient countermeasure for VOR adaptations and thus help mitigate landing sickness symptoms experienced by long-duration crewmembers. These goggles might also be used to counter blurred vision (caused by retinal slip) experienced by crewmembers during launch where the vehicle vibrations are greatest. The stroboscopic effect could be built into a section of their head mounted displays on the visor of their helmets to be used in these high vibration situation if a mission critical task is necessary.

Description: Exposure to the microgravity environment during spaceflight missions impacts crewmembers' sensorimotor function. Bock et al. [1] studied the cognitive demands of human sensorimotor performance and dual tasking during long duration missions and concluded that both stress and scarcity of cognitive resources required for sensorimotor adaptation may be responsible for these deficits during spaceflight. Therefore, in consideration of the health and performance of crewmembers in- and post-flight, we are conducting this study to investigate the effects of spaceflight on the extent, longevity and neural bases of sensorimotor, cognitive, and neural changes. The data presented will focus on the behavioral measures that were collected pre-, in- and post-flight including spatial cognition, processing speed, bimanual coordination, functional mobility, computerized dynamic posturography (CDP), and vibrotactile induced vestibular evoked myogenic potential (VEMP). To date, data were collected over the course of two pre-flight sessions and four post-flight sessions on five crewmembers (n=13) using the protocol described in Koppelmans et al. [2]. Balance control was assessed using CDP, with eyes closed and a sway-referenced base of support (Sensory Organization Test 5), with and without head movements in the pitch plane. Spatial working memory was assessed using Thurston's Card Rotation Test and a Mental Rotation Test. The Rod and Frame Test was performed to test visual dependence. The Digit Symbol Substitution Test was performed to evaluate processing speed, and the Purdue Pegboard Task was performed to test bimanual coordination. Vestibular function was assessed by eliciting ocular VEMP via a hand held striker on the side of the head as subjects lay supine on a gurney. Subjects also performed the Functional Mobility Test of walking through an obstacle course to assess rate of early motor learning. Data were also collected on the same crewmembers during three in-flight sessions on the International Space Station (ISS). In-flight, spatial working memory was assessed using the Mental Rotation Test, adaptation to visuo-motor transformation in manual control was assessed using the Sensorimotor Adaptation Test, and multi-tasking ability was assessed using the Dual Task Test. These three tests were performed in a strapped-in configuration mimicking a seated position - waist bungees pulled the crewmember toward the "floor" with feet secured in foot loops. The Mental Rotation Test was also performed in a free-floating configuration while the crewmember floated while holding on to the gamepad controller used to provide input that was secured to the equipment rack on the ISS. Preliminary findings from data collected to date, will be included in the presentation. Eventual comparison to results from supporting bed rest and longitudinal studies will enable the parsing out of the multiple mechanisms contributing to any observed spaceflight-induced sensorimotor and cognitive behavioral changes.

Description: Due to the deconditioned state of crewmembers in the initial hours after landing, it is safer and more practical to perform a vision test while seated in a chair versus walking on a treadmill. The purpose of this study was to validate the ability of a manually operated oscillating chair to produce the oscillatory frequency and displacement equivalent of walking on a treadmill at a 4 mph pace. A fast Fourier transform (FFT)was performed on the vertical trunk acceleration to compare the peak and spread of the distribution of oscillation frequencies for each oscillating condition. Peak oscillation frequencies achieved with the manual chair were lower and more variable than those of treadmill walking and the automatic chair. This can mostly be attributed to operator fatigue. However, DVA scores across conditions were not significantly different, indicating that the manual chair can provide adequate vertical oscillation frequency and displacement with the added advantage of being portable enough for testing outside a laboratory. Furthermore the automatic chair very closely matches the oscillation frequency of treadmill walking, making it an ideal method for testing DVA in a laboratory setting.

Description: Long-duration spaceflight results in sensorimotor adaptations, which cause functional deficits during gravitational transitions, such as landing on a planetary surface after long-duration microgravity exposure. Both the vestibular system and the central nervous system are affected by gravitational transitions. These systems are responsible for coordinating head and eye movements via the vestibulo-ocular reflex (VOR) and go through an adaptation period upon exposure to microgravity. Consequently, they must also re-adapt to Earth's gravitational environment upon landing. This re-adaptation causes decrements in gaze control and dynamic visual acuity, with crewmembers reporting oscillopsia and blurred vision caused by retinal slip, or the inability to keep an image focused on their retina. This is thought to drive motion sickness symptoms experienced by most crewmembers following landing. Retinal slip can be estimated by dynamic visual acuity (DVA); visual acuity while in motion. Previously, DVA has been assessed in the laboratory where subjects walked at 6.4 km/hr on a motorized treadmill. Using this method, Peters et al. (2011) found that DVA is worsened in astronauts by an average of 0.75 eye-chart lines one day after landing. However, it is believed that re-adaptation occurs quickly and that DVA might be worse immediately upon re-exposure to a gravitational environment. Since many crewmembers are unable to walk safely upon landing, it was necessary to develop a method for replicating the vertical head movements associated with walking. In addition, the use of a chair to imitate the head displacement caused by walking isolates eye-head interactions without allowing for trunk and lower-body compensation, as seen with treadmill walking (Mulavara & Bloomberg 2003). Therefore, a modality for assessing DVA in the field within a few hours of landing was developed. In this study, we validated the ability of a manually operated oscillating chair to reproduce the oscillatory frequency of walking on a treadmill. Healthy non-astronaut subjects (n=14) participated in one test session and completed three static (seated) and three dynamic (walking/oscillated) visual acuity tests. DVA was assessed using a motorized treadmill, an automated oscillating chair, and a manually operated chair, both developed in the Neuroscience Laboratory at JSC. The automated chair was motor-driven and set to oscillate vertically at 2 Hz with a vertical displacement of +/- 5 cm to simulate vertical translation while walking. The manually operated chair was oscillated vertically by a test operator to the beat of a metronome at 120 beats/min (2 Hz) and a vertical displacement of approximately +/- 5 cm. As the subject was oscillated, they were asked to discern the direction gap of Landolt-C optotypes of varying sizes and verbally reported the direction while an operator recorded their response using a gamepad. Subjects were outfitted with accelerometers (sampling rate = 128 Hz) on their head, trunk and lumbar spine. A fast Fourier transform was performed on the vertical trunk acceleration to compare the peak and spread of the distribution of oscillation frequencies for each oscillating condition. The spread of the frequency distribution for the manual chair was not significantly different from either the treadmill or the automated chair. However, all three conditions had similar non-zero standard error values, suggesting a variance in head movement frequency which may affect DVA. The average oscillation frequency of the manual chair (1.85 Hz) was significantly different (=0.05) from that of treadmill walking (2.24 Hz), but not significantly different from that of the automated chair (1.85 Hz) and all three conditions had small standard errors (SEM = 0.04, 0.06, and 0.08 Hz for manual, treadmill, and automated respectively). This implies that both chairs oscillate at a frequency below that of treadmill walking, but are comparable to each other and reproducible across sessions. Additionally, DVA scores did not vary significantly across conditions. The smaller spread values of the oscillating chairs' frequencies indicated mitigation of variation induced by locomotor strategies, which enables better examination of the issue of VOR adaptation. Furthermore, due to the deconditioned state of crewmembers in the initial hours after landing, it is easier to transport a manual bouncing chair into the field and safer to perform a vision test while seated in a chair versus walking on a treadmill. Therefore, the manually oscillating chair has been deemed to meet and exceed the DVA testing capabilities previously obtained by treadmill walking.