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Michael B. Stenger

Publications and source records attributed to Michael B. Stenger.

Noninvasive Indicators of Intracranial Pressure Before, During, and After Long-Duration Spaceflight

Weightlessness induces a cephalad shift of blood and cerebrospinal fluid that may increase intracranial pressure (ICP) during spaceflight, while lower body negative pressure (LBNP) may provide an opportunity to caudally redistribute fluids and lower ICP. To investigate the effects of spaceflight and LBNP on noninvasive indicators of ICP (nICP), we studied thirteen crewmembers before and after spaceflight in seated, supine, and 15° head-down tilt postures, and at ~45 and ~150 days of spaceflight with and without 25 mmHg LBNP. We used 4 techniques to quantify nICP: cerebral and cochlear fluid pressure (CCFP), otoacoustic emissions (OAE), ultrasound measures of optic nerve sheath diameter (ONSD), and ultrasound-based internal jugular vein pressure (IJVp). On flight day 45, two nICP measures were lower than preflight supine posture (CCFP: mean difference -98.5 -nl [CI: -190.8 to -6.1 -nl], p = 0.037]; OAE: -19.7 degrees [CI: -10.4 to -29.1 degrees], p < 0.001), but not significantly different from preflight seated measures. Conversely, ONSD was not different than any preflight posture, whereas IJVp was significantly greater than preflight seated measures (14.3 mmHg [CI: 10.1 to 18.5mmHg], p < 0.001), but not significantly different than preflight supine measures. During spaceflight, acute LBNP application did not cause a significant change in nICP indicators. These data suggest that during spaceflight nICP is not elevated above values observed in the seated posture on Earth. Invasive measures would be needed to provide absolute ICP values and more precise indications of ICP change during various phases of spaceflight.

Jessica V. Jasien↗

Changes in Optic Nerve Head and Retinal Morphology During Spaceflight and Acute Fluid Shift Reversal

Importance: Countermeasures that reverse the headward fluid shift experienced in weightlessness have the potential to mitigate spaceflight-associated neuro-ocular syndrome. This study investigated whether use of the countermeasure lower-body negative pressure during spaceflight was associated with changes in ocular structure. Objective: To determine whether changes to the optic nerve head and retina during spaceflight can be mitigated by brief in-flight application of 25-mm Hg lower-body negative pressure. Design, Setting, and Participants: In the National Aeronautics and Space Administration’s “Fluid Shifts Study,” a prospective cohort study, optical coherence tomography scans of the optic nerve head and macula were obtained from US and international crew members before flight, in-flight, and up to 180 days after return to Earth. In-flight scans were obtained both under normal weightless conditions and 10 to 20 minutes into lower-body negative pressure exposure. Preflight and postflight data were collected in the seated, supine, and head-down tilt postures. Crew members completed 6- to 12-month missions that took place on the International Space Station. Data were analyzed from 2016 to 2021. Interventions or Exposures: Spaceflight and lower-body negative pressure. Main Outcomes and Measures: Changes in minimum rim width, optic cup volume, Bruch membrane opening height, peripapillary total retinal thickness, and macular thickness. Results: Mean (SD) flight duration for the 14 crew members (mean [SD] age, 45 [6] years; 11 male crew members [79%]) was 214 (72) days. Ocular changes on flight day 150, as compared with preflight seated, included an increase in minimum rim width (33.8 μm; 95% CI, 27.9-39.7 μm; P < .001), decrease in cup volume (0.038 mm^3; 95% CI, 0.030-0.046 mm^3; P < .001), posterior displacement of Bruch membrane opening (−9.0 μm; 95% CI, −15.7 to −2.2 μm; P = .009), and decrease in macular thickness (fovea to 500 μm, 5.1 μm; 95% CI, 3.5-6.8 μm; P < .001). Brief exposure to lower-body negative pressure did not affect these parameters. Conclusions and Relevance: Results of this cohort study suggest that peripapillary tissue thickening, decreased cup volume, and mild central macular thinning were associated with long-duration spaceflight. Acute exposure to 25-mm Hg lower-body negative pressure did not alter optic nerve head or retinal morphology, suggesting that longer durations of a fluid shift reversal may be needed to mitigate spaceflight-induced changes and/or other factors are involved.

Laura P. Pardon↗

Quantitative Magnetic Resonance Image Assessment of the Optic Nerve and Surrounding Sheath after Spaceflight

A subset of long-duration spaceflight astronauts have experienced ophthalmic abnormalities, collectively termed spaceflight-associated neuro-ocular syndrome (SANS). Little is understood about the pathophysiology of SANS; however, microgravity-induced alterations in intracranial pressure (ICP) due to headward fluid shifts is the primary hypothesized contributor. In particular, potential changes in optic nerve (ON) tortuosity and ON sheath (ONS) distension may indicate altered cerebrospinal fluid dynamics during weightlessness. The present longitudinal study aims to provide a quantitative analysis of ON and ONS cross-sectional areas, and ON deviation, an indication of tortuosity, before and after spaceflight. Ten astronauts undergoing ~6-month missions on the International Space Station (ISS) underwent high-resolution magnetic resonance imaging (MRI) preflight and at five recovery timepoints extending to 1 year after return from the ISS. The mean changes in ON deviation, ON cross-sectional area, and ONS cross-sectional area immediately post flight were−0.14 mm (95% CI:−0.36 to 0.08, Bonferroni-adjusted P=1.00), 0.13 mm2(95% CI−0.66 to 0.91, Bonferroni-adjusted P=1.00), and−0.22 mm2(95% CI:−1.78 to 1.34, Bonferroni-adjusted P=1.00), respectively, and remained consistent during the recovery period. Terrestrially, ONS distension is associated with increased ICP; therefore, these results suggest that, on average, ICP was not pathologically elevated immediately after spaceflight. However, a subject diagnosed with optic disc edema (Frisen Grade 1, right eye) displayed increased ONS area post flight, although this increase is relatively small compared to clinical populations with increased ICP. Advanced quantitative MRI-based assessment of the ON and ONS could help our understanding of SANS and the role of ICP.

Jesse Rohr↗

Artemis Sustained Translational Acceleration Limits: Human Tolerance Evidence from Apollo to ISS

The designers of the next generation of lunar landers may adopt novel, crew-body orientations outside of our flight history or applied to flight durations and environments outside of our experience. Current sustained translational acceleration requirements in NASA-STD-3001 are applicable only to crewmembers in a seated posture and are thus inadequate to address human tolerance in non-seated configurations. Initial designs for the Apollo Lunar Module (LM) included seats for both commander and pilot; however, these were subsequently removed from the vehicle due to mass constraints and a willingness to accept the unknown risks for short-duration missions given the limited human physiologic data at the time. In the years since Apollo, our evidence base has grown immensely. Initial Artemis mission timelines under consideration will be longer than the longest Apollo mission, by a significant margin, with timeframes more analogous to longer Space Shuttle missions. Given the incidence of postflight orthostatic intolerance following shuttle missions, a significant risk may exist for lander design(s) pursuing a standing crew configuration similar to Apollo LM. New sustained translational acceleration limits developed to address this risk are presented herein. These limits were derived from evaluations of Apollo biomedical and flight profile data during lunar descent and ascent operations, Soyuz and Space Shuttle flight profile and post-landing biomedical data, and analogue bed rest post-exposure data on orthostatic intolerance.

James M. Pattarini↗

Reply to Greaves et al.

Explore the source record for details and available documents.

Stuart M. C. Lee↗