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Metter, E. Jeffrey

Publications and source records attributed to Metter, E. Jeffrey.

Postflight balance control recovery in an elderly astronaut: a case report

OBJECTIVE: To examine the sensorimotor adaptive response of a 77-year-old man exposed to the gravito-inertial challenges of orbital space flight. STUDY DESIGN: Prospective case study with retrospective comparisons. SETTING: NASA Neurosciences Laboratory (Johnson Space Center) and Baseline Data Collection Facility (Kennedy Space Center). PRIMARY PARTICIPANT: One 77-year-old male shuttle astronaut. INTERVENTION: Insertion into low Earth orbit was used to remove gravitational stimuli and thereby trigger sensorimotor adaptation to the microgravity environment. Graviceptor stimulation was reintroduced at landing, and sensorimotor readaptation to the terrestrial environment was tracked to completion. MAIN OUTCOME MEASURES: Computerized dynamic posturography tests were administered before and after orbital flight to determine the magnitude and time course of recovery. RESULTS: The elderly astronaut exhibited balance control performance decrements on landing day; however, there were no significant differences between his performance and that of younger astronauts tested on the same shuttle mission or on previous shuttle missions of similar duration. CONCLUSIONS: These results demonstrate that the physiological changes attributed to aging do not necessarily impair adaptive sensorimotor control processes.

Case Reports

A statistical model for interpreting computerized dynamic posturography data

Computerized dynamic posturography (CDP) is widely used for assessment of altered balance control. CDP trials are quantified using the equilibrium score (ES), which ranges from zero to 100, as a decreasing function of peak sway angle. The problem of how best to model and analyze ESs from a controlled study is considered. The ES often exhibits a skewed distribution in repeated trials, which can lead to incorrect inference when applying standard regression or analysis of variance models. Furthermore, CDP trials are terminated when a patient loses balance. In these situations, the ES is not observable, but is assigned the lowest possible score--zero. As a result, the response variable has a mixed discrete-continuous distribution, further compromising inference obtained by standard statistical methods. Here, we develop alternative methodology for analyzing ESs under a stochastic model extending the ES to a continuous latent random variable that always exists, but is unobserved in the event of a fall. Loss of balance occurs conditionally, with probability depending on the realized latent ES. After fitting the model by a form of quasi-maximum-likelihood, one may perform statistical inference to assess the effects of explanatory variables. An example is provided, using data from the NIH/NIA Baltimore Longitudinal Study on Aging.

NASA Discipline Neuroscience

Unimpaired Neuro-Adaptive Plasticity in an Elderly Astronaut

Quantitative analyses of a 77 year old astronaut's balance control performances on a standardized test battery revealed few differences between his neuro-adaptive responses to space flight and those of a group of younger astronauts tested following missions of similar duration. This finding suggests that the physiological changes associated with age do not necessarily impair adaptive plasticity in the human following removal and subsequent reintroduction of gravity.

Paloski, William H.