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Strangman, Gary

Publications and source records attributed to Strangman, Gary.

Surgical Capabilities for Exploration and Colonization Space Flight - An Exploration Symposium

Surgical capabilities in human space flight, whether on a space-based platform in low Earth orbit or on a long duration planetary exploration mission, will be challenging to conduct for a variety of reasons, some of which will be ameliorated by training, technology, and pre-flight planning. Nevertheless, inherent risks and challenges remain. Early space missions did not have any surgical capability. It was not until NASA's Skylab mission that serious consideration was given to this fundamental medical care capability. Over the past 30 years, subject matter experts have been brought together for discussion on the myriad of challenges and opportunities in this endeavor. The last such meeting was held in 2005 at the NASA Johnson Space Center. As we continue to move forward with human space flight activities for the International Space Station and beyond, the capabilities of information technology, robotics, sensors and imaging have rapidly changed since the last gathering of expertise. In December 2015, through sponsorship of the National Space Biomedical Research Institute (NSBRI), a diverse group of individuals from government, academia, and industry representing three countries gathered at the NSBRI Space 4 Biomedicine facility in Houston, TX. This two day symposia included comprehensive sessions that addressed the challenges that we all face in developing, deploying, and utilizing surgical care capabilities in all human space missions, regardless of mission duration or profile. The symposium benefited from the knowledge and experience of three seasoned NASA physician astronauts, Drs. Jay Buckey, Thomas Marshburn, and Lee Morin. At the end of the first day, the assembled group heard from the crew members about their experiences and their ideas. It is clear that the discussion of surgical capabilities is part of the larger discussion of consideration of advanced healthcare, including critical care, on exploration space missions. This report represents the culmination of the symposium, capturing knowledge, experience, conceptual dialogue, and a narrative that can be used in supporting the development of future programs and potential policy. Each of the presentations that were provided by the guest speakers is included in the appendices. Those presentations that are not included were due to sensitivity of the material or at the request of the speaker. In addition, each speaker was offered an opportunity to provide comments in a 'lightning round' format. All of these comments and speaker abstracts also appear in the appendices. At the conclusion of the second day, a discussion was held that reviewed the priorities that perhaps add value to decision makers. These are also summarized. This report will serve as the final product of this symposium. Additional material may be produced for the peer-reviewed literature.

Doarn, Charles R.↗

Review of Human Cognitive Performance in Spaceflight

Human space exploration is inherently hazardous, particularly for lon g duration (LD) missions (22 days or longer). Maintenance of cognitive functioning is essential, but flight environments pose numerous pote ntial risks to the brain and cognitive performance (eg, radiation, to xins, chronic stress, sleep deprivation, hypercarbia, fluid shifts, h ormone imbalances, and injury). There have been persistent anecdotal reports of cognitive deficits during missions, but an up?-to-date rev iew of the evidence for such changes has remained unavailable. Method s: We identified and reviewed English language publications found via electronic searches in PubMed, PsycInfo, Inspec, the NASA Technical Report Server, and the Defense Technical Information Center, plus rec ursive searches of publication bibliographies. Search terms included the word cognition, cognitive, or performance along with spaceflight, flight, mission, or closely related terms. Results: Inter?-study variability precluded meta?-analysis. Some 32 published studies involving cognitive assessment during spaceflight were identified, involving a total of 110 participants (mean: 3.4 participants per study). The lo ngest?-duration study spanned 438 days, with six additional studies i nvolving flight durations of 90 days, and 11 more studies involved fl ight durations exceeding 21 days. The available evidence failed to st rongly support or refute the existence of cognitive deficits in LD sp aceflight, in part due to inadequate power or control conditions. Evi dence of increased variability in cognitive performance during spacef light, both within and between individuals, was common. Discussion: T hese results represent a negative finding based on small numbers of s ubjects for any given cognitive function. The increased variability within and (particularly) between individuals highlights the potential danger of generalizing from case studies. A mismatch therefore remain s between anecdotal reports describing generalized cognitive slowing, attention and memory problems during missions and the experimental e vidence supporting such deficits. Since a major justification for man ned spaceflight rests with the cognitive flexibility of humans, addit ional studies and further analysis of existing operational data appea rs warranted.

Strangman, Gary↗

Functional brain imaging of a complex navigation task following one night of total sleep deprivation

Study Objectives: To assess the cerebral effects associated with sleep deprivation in a simulation of a complex, real-world, high-risk task. Design and Interventions: A two-week, repeated measures, cross-over experimental protocol, with counterbalanced orders of normal sleep (NS) and total sleep deprivation (TSD). Setting: Each subject underwent functional magnetic resonance imaging (fMRI) while performing a dual-joystick, 3D sensorimotor navigation task (simulated orbital docking). Scanning was performed twice per subject, once following a night of normal sleep (NS), and once following a single night of total sleep deprivation (TSD). Five runs (eight 24s docking trials each) were performed during each scanning session. Participants: Six healthy, young, right-handed volunteers (2 women; mean age 20) participated. Measurements and Results: Behavioral performance on multiple measures was comparable in the two sleep conditions. Neuroimaging results within sleep conditions revealed similar locations of peak activity for NS and TSD, including left sensorimotor cortex, left precuneus (BA 7), and right visual areas (BA 18/19). However, cerebral activation following TSD was substantially larger and exhibited higher amplitude modulations from baseline. When directly comparing NS and TSD, most regions exhibited TSD>NS activity, including multiple prefrontal cortical areas (BA 8/9,44/45,47), lateral parieto-occipital areas (BA 19/39, 40), superior temporal cortex (BA 22), and bilateral thalamus and amygdala. Only left parietal cortex (BA 7) demonstrated NS>TSD activity. Conclusions: The large network of cerebral differences between the two conditions, even with comparable behavioral performance, suggests the possibility of detecting TSD-induced stress via functional brain imaging techniques on complex tasks before stress-induced failures.

Strangman, Gary↗

Factors affecting the accuracy of near-infrared spectroscopy concentration calculations for focal changes in oxygenation parameters

Near-infrared spectroscopy (NIRS) can be used to noninvasively measure changes in the concentrations of oxy- and deoxyhemoglobin in tissue. We have previously shown that while global changes can be reliably measured, focal changes can produce erroneous estimates of concentration changes (NeuroImage 13 (2001), 76). Here, we describe four separate sources for systematic error in the calculation of focal hemoglobin changes from NIRS data and use experimental methods and Monte Carlo simulations to examine the importance and mitigation methods of each. The sources of error are: (1). the absolute magnitudes and relative differences in pathlength factors as a function of wavelength, (2). the location and spatial extent of the absorption change with respect to the optical probe, (3). possible differences in the spatial distribution of hemoglobin species, and (4). the potential for simultaneous monitoring of multiple regions of activation. We found wavelength selection and optode placement to be important variables in minimizing such errors, and our findings indicate that appropriate experimental procedures could reduce each of these errors to a small fraction (<10%) of the observed concentration changes.

Non-NASA Center↗

A quantitative comparison of simultaneous BOLD fMRI and NIRS recordings during functional brain activation

Near-infrared spectroscopy (NIRS) has been used to noninvasively monitor adult human brain function in a wide variety of tasks. While rough spatial correspondences with maps generated from functional magnetic resonance imaging (fMRI) have been found in such experiments, the amplitude correspondences between the two recording modalities have not been fully characterized. To do so, we simultaneously acquired NIRS and blood-oxygenation level-dependent (BOLD) fMRI data and compared Delta(1/BOLD) (approximately R(2)(*)) to changes in oxyhemoglobin, deoxyhemoglobin, and total hemoglobin concentrations derived from the NIRS data from subjects performing a simple motor task. We expected the correlation with deoxyhemoglobin to be strongest, due to the causal relation between changes in deoxyhemoglobin concentrations and BOLD signal. Instead we found highly variable correlations, suggesting the need to account for individual subject differences in our NIRS calculations. We argue that the variability resulted from systematic errors associated with each of the signals, including: (1) partial volume errors due to focal concentration changes, (2) wavelength dependence of this partial volume effect, (3) tissue model errors, and (4) possible spatial incongruence between oxy- and deoxyhemoglobin concentration changes. After such effects were accounted for, strong correlations were found between fMRI changes and all optical measures, with oxyhemoglobin providing the strongest correlation. Importantly, this finding held even when including scalp, skull, and inactive brain tissue in the average BOLD signal. This may reflect, at least in part, the superior contrast-to-noise ratio for oxyhemoglobin relative to deoxyhemoglobin (from optical measurements), rather than physiology related to BOLD signal interpretation.

Non-NASA Center↗

Non-invasive neuroimaging using near-infrared light

This article reviews diffuse optical brain imaging, a technique that employs near-infrared light to non-invasively probe the brain for changes in parameters relating to brain function. We describe the general methodology, including types of measurements and instrumentation (including the tradeoffs inherent in the various instrument components), and the basic theory required to interpret the recorded data. A brief review of diffuse optical applications is included, with an emphasis on research that has been done with psychiatric populations. Finally, we discuss some practical issues and limitations that are relevant when conducting diffuse optical experiments. We find that, while diffuse optics can provide substantial advantages to the psychiatric researcher relative to the alternative brain imaging methods, the method remains substantially underutilized in this field.

Non-NASA Center↗