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N E Beltran

Publications and source records attributed to N E Beltran.

Assessing the Relationships Between Sensorimotor Biomarkers and Post-Landing Functional Task Performance

Spaceflight drives adaptive changes in healthy individuals appropriate for sensorimotor function in a microgravity environment. These changes are maladaptive for return to earth's gravity. The inter-individual variability of sensorimotor decrements is striking, although poorly understood. The goal of this study is to identify a set of behavioral, neuroimaging and genetic measures that can be used to predict early post-flight performance on a set of sensorimotor tasks. Astronauts are recruited who previously participated in sensorimotor field tests and/or posturography soon after long-duration spaceflight. Behavioral tests include assessments of sensory dependency and adaptability. Visual dependency involves treadmill walking while viewing a moving virtual visual scene. Vestibular perceptual thresholds are measured while seated during lateral translations. Proprioception dependency is measured during one-legged stance on a horizontal air-bearing surface. Ground assessment of adaptability is performed(1) during treadmill walking with a virtual linear hallway and a moving walking surface, and (2) during multiple trials of navigating an obstacle course while wearing reversing prisms(adaptive Functional Mobility Test, aFMT). The neuroimaging tests will characterize individual differences in regional brain volumes (using Structural MRI) and white matter microstructure(using Diffusion Tensor Imaging) to serve as potential predictors of adaptive capacity. The genetic tests will utilize saliva samples to examine variations in four genes chosen because of their ability to differentiate sensorimotor adaptation ability in a normative population, including Catechol-O-methyltransferase (COMT), Dopamine Receptor D2 (DRD2), Brain-derived neurotrophic factor (BDNF) and the α2-adrenergic receptor. Twenty-seven ISS crewmembers have been tested to date, including 6 from this past year. This cohort includes 10first-time fliers, 6F, and mission durations lasting 178.6 ± 30.5 days, mean ± std. We are utilizing a combination of three post-flight functional task outcomes: tandem walk, recovery from fall and dynamic posturography. There is considerable variability among the post-flight performance outcomes for the 27participants to date. Based on a partial sample using an ordinal scale survey, 70% indicated their ability to perform functional tasks were more impacted postflight relative to inflight with 50% indicating they needed to restrict movements for a longer period postflight relative to inflight. While there is a strong association within tests obtained at different R+0 timepoints, by R+24 hr performance on one post-flight test does not necessarily correlate with performance on other post-flight tests. There are apparent relationships between individual measures and specific post-flight outcome measures, e.g., the cumulative time to complete the aFMT is significantly correlated to pre-to-post-flight changes in tandem walk (rho= 0.64, p = 0.001). Preliminary statistical analysis indicates combining biomarkers will increase predictive power and this will be explored with future analyses. Our preliminary findings underscore the importance of a comprehensive post-flight test battery including different types of tasks with varying sensory feedback. We expect that understanding the relationships between these sensorimotor biomarkers and post-flight functional task performance will improve both our understanding of the individual variability and our strategy to optimize sensorimotor countermeasures

S J Wood↗

Evaluation of Intranasal Scopolamine for the Prevention of Wave Motion Induced Motion Sickness While Maintaining Performance on Operationally Relevant Tasks

Motion sickness represents one of the greatest clinical challenges impacting crew activities during and following g-transitions. Our overall goal is to characterize the effectiveness of motion sickness countermeasures during controlled laboratory experiments using capsule wave motion simulation and during field testing in operational environments. This laboratory study focused on prevention of motion sickness using intranasal scopolamine using a double-blinded repeated measures design in 30 subjects (19M, 11F). Intranasal scopolamine was provided by Defender Pharmaceuticals, Inc. (DPI-386 Nasal Gel, referred to as Inscop) self-administered by a nasal pump (Aptar Pharma) that delivers 0.4 mg dose (0.2 mg / nostril). During each session, subjects were exposed to complex wave motion on a six degree-of-freedom platform that included pitch, roll and heave at provocative stimulus frequencies (0.1-0.25 Hz) while seated in an illuminated cabin deprived of external visual cues. Motion sickness symptoms were compared across treatment and placebo control sessions counterbalanced across subjects and separated by at least one week. The time-to-motion sickness endpoint was based on severe malaise, defined as symptom score of ≥8 points using the Pensacola Diagnostic Index [1]. The bioavailability of scopolamine for each session was estimated from plasma concentrations obtained every 15 min[2]. Side effects during the treatment session were minimal, and performance was not impaired on a test battery including motion perception tracking, tablet-based eye-hand coordination and psychomotor vigilance testing. The plasma concentration remained near-peak levels throughout the 45 min motion sickness testing for most subjects. The percentile ranking on the Motion Sickness Susceptibility Questionnaire [MSSQ, 3]was moderately correlated with the motion sickness time-to-endpoint during the placebo control session (rho = –0.3, p=0.056). Seventeen subjects did not reach an endpoint during their placebo session and were eliminated from subsequent analysis. Another subject was excluded due to insufficient plasma concentration during the treatment session. For the remaining 12 subjects, the change in time-to-motion sickness endpoint between placebo and treatment sessions was moderately correlated with plasma concentration (rho =0.48, p = 0.056), improving on average 4.4 ± 18.4 min, mean ± std with Inscop versus placebo. Our results are consistent with previous findings that intranasal delivery of scopolamine can be effective at reducing motion sickness symptoms with minimal cognitive or sedative side effects. Future work is needed to optimize the delivery of Inscop for rescue (treatment) of symptoms following g-transitions as one of the key advantages of this formulation is self-administration in a suited environment. We will also explore how the combination of Inscop with non-pharmaceutical sensory aids, e.g., vibrotactile feedback of Earth vertical, may further mitigate motion sickness and improve task performance.

S J Wood↗

Assessing the Relationships Between Sensorimotor Biomarkers and Post-Landing Functional Task Performance

Spaceflight drives adaptive changes in healthy individuals appropriate for sensorimotor function in a microgravity environment. These changes are maladaptive for return to earth's gravity. The inter-individual variability of sensorimotor decrements is striking, although poorly understood. The goal of this study is to identify a set of behavioral, neuroimaging and genetic measures that can be used to predict early post-flight performance on a set of sensorimotor tasks. Astronauts are recruited who previously participated in sensorimotor field tests and/or posturography soon after long-duration spaceflight. Behavioral tests include assessments of sensory dependency and adaptability. Visual dependency involves treadmill walking while viewing a moving virtual visual scene. Vestibular thresholds are measured while seated during lateral translations. Proprioception dependency is measured during one-legged stance on a horizontal air-bearing surface. Ground assessment of adaptability is performed (1) during treadmill walking with a virtual linear hallway and a moving walking surface, and (2) during multiple trials of navigating an obstacle course while wearing reversing prisms. The neuroimaging tests will characterize individual differences in regional brain volumes (using Structural MRI) and white matter microstructure (using Diffusion Tensor Imaging) to serve as potential predictors of adaptive capacity. The genetic tests will utilize saliva samples to examine variations in four genes chosen because of their ability to differentiate sensorimotor adaptation ability in a normative population, including Catechol-O-methyltransferase (COMT), Dopamine Receptor D2 (DRD2), Brain-derived neurotrophic factor (BDNF) and the α2-adrenergic receptor. Twenty-one ISS crewmembers have been tested to date, including 6 from this past year after testing resumed post-COVID. This cohort includes 9 first-time fliers, 4F, and mission durations lasting 182 ± 32 days, mean ± std. We are utilizing a combination of three post-flight functional task outcomes: tandem walk, recovery from fall and dynamic posturography. There is considerable variability among the post-flight performance outcomes for the 21 participants to date. Based on a partial sample using an ordinal scale survey, 80% indicated their ability to perform functional tasks were more impacted postflight relative to inflight with 50% indicating they needed to restrict movements for a longer period postflight relative to inflight. While there is a strong association within tests obtained at different R+0 timepoints, by R+24 hr performance on one post-flight test does not necessarily correlate with performance on other post-flight tests. There are apparent relationships between individual measures and specific post-flight outcome measures; however, additional data is needed to draw conclusions. Preliminary statistical analysis indicates combining biomarkers will increase predictive power and this will be explored with future analyses. Our preliminary findings underscore the importance of a comprehensive post-flight test battery including different types of tasks with varying sensory feedback. We expect that understanding the relationships between these sensorimotor biomarkers and post-flight functional task performance will improve both our understanding of the individual variability and our strategy to optimize sensorimotor countermeasures.

S J Wood↗

Evaluating Sensory Augmentation as A Non-Pharmaceutical Tool to Mitigate Motion Sickness and Enhance Sensorimotor Task Performance: A Pilot Study Using Simulated Capsule Wave Motion

Wave motion during capsule recovery operations can result in motion sickness and performance decrements exacerbating reentry sickness following long duration spaceflight. The purpose of this pilot study was (1) to validate a capsule wave motion simulation as a platform to evaluate motion sickness countermeasures and (2) to evaluate a sensory augmentation belt providing vibrotactile feedback of gravitational upright. Ten healthy subjects ages 38.0 ± 10.1 (6M|4F) were exposed to complex wave motions on a six degree-of-freedom platform that included pitch, roll, and heave at provocative stimulus frequencies (0.1-0.25 Hz) while seated in an illuminated cabin deprived of external visual cues. Subjects reported acute symptoms for up to three consecutive 15 min trials or until they reached a motion sickness endpoint of 8 pts on the Pensacola Diagnostic Index (PDI). Five subjects were randomly assigned to the Sensory Augmentation (SA) group while the other five served as controls (CN group). Based on a Motion Sickness Susceptibility Questionnaire, the two groups had similar motion sickness histories (susceptibility percentile ranking of CN group = 27.5 ± 63.6 in the CN group versus 27.5 ± 37.0 in the SA group, median ± IQR). The vibrotactile feedback consisted of a single array of 8 electromechanical tactors positioned around the torso on an adjustable belt (Engineering Acoustics, Inc) that utilized an integrated inertial measurement unit (IMU) to indicate the direction of upright (e.g., subject’s back tactor on during forward tilt). During each wave motion trial subjects performed a battery of four different tasks: tracking Earth vertical using a joystick with and without a secondary task (Paced Auditory Serial Addition Test), an eye-hand target acquisition task on a cabin-fixed tablet, and the psychomotor vigilance test (PVT). All ten subjects reported varying levels of motion sickness with 6 of 10 reaching a symptom endpoint. Interestingly, subjects anecdotally reported that engagement in the joystick tracking task was less provocative than tasks involving the cabin-fixed tablet or periods of no activity. Sensory augmentation appeared to delay symptom onset, with 2 of 5 subjects reaching an endpoint within the first 15 min trial in the CN group versus none in the SA group (PDI after 15 min = 6.0 ± 2.5 in the CN group versus 3.4 ± 2.5 in the SA group, mean ±std). Sensory augmentation also improved performance on the joystick tracking task at lower stimulus frequencies (0.1 Hz in roll and 0.2 Hz in pitch). Both CN and SA groups maintained a consistent level of performance on the eye-hand target acquisition and PVT throughout the baseline (no motion) and wave motion periods. Our results validated that the simulated capsule wave motion paradigm provides an effective motion sickness stressor. This paradigm is currently being used to investigate the efficacy of intranasal scopolamine to mitigate motion sickness. Sensory augmentation using vibrotactile feedback appears to improve spatial awareness and delay symptom onset during complex passive motion. One advantage of this portable belt design is that it incorporates all tactor drive and IMU circuitry and therefore could continue to be worn by crewmembers and serve as a balance aid during egress and ambulation with recovery operations.

A M Bollinger↗