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All sourcesNASA NTRSDOE OSTI
NASA NTRS2017

Autogenic-Feedback Training Exercise (AFTE) Mitigates the Effects of Spatial Disorientation to Simulated Orion Spacecraft Re-Entry: Individual Differences

NASA has identified a potential risk of spatial disorientation to future astronauts during re-entry of the proposed Orion spacecraft. The purpose of this study was to determine if a 6-hour physiological training procedure, Autogenic-Feedback Training Exercise (AFTE), can mitigate these effects. Twenty subjects were assigned to two groups (AFTE and Control) matched for motion sickness susceptibility and gender. All subjects received a standard rotating chair test to determine motion sickness susceptibility; three training sessions on a manual performance task; and four exposures to a simulated Orion re-entry test in the rotating chair. Treatment subjects were given two hours of AFTE training before each Orion test. A diagnostic scale was used to evaluate motion sickness symptom severity. Results showed that 2 hours of AFTE significantly reduced motion sickness symptoms during the second Orion test. AFTE subjects were able to maintain lower heart rates and skin conductance levels and other responses than the control group subjects during subsequent tests. Trends show that performance was less degraded for AFTE subjects. The results of this study indicate that astronauts could benefit from receiving at least 2 hours of preflight AFTE. In addition, flight crews could benefit further by practicing physiologic self-regulation using mobile devices.

human performance↗
NASA NTRS2004

Cerebral Hypoperfusion Precedes Nausea During Centrifugation

Nausea and motion sickness are important operational concerns for aviators and astronauts. Understanding underlying mechanisms associated with motion sickness may lead to new treatments. The goal of this work was to determine if cerebral blood flow changes precede the development of nausea in motion sick susceptible subjects. Cerebral flow velocity in the middle cerebral artery (transcranial Doppler), blood pressure (Finapres) and end-tidal CO2 were measured while subjects were rotated on a centrifuge (250 degrees/sec). Following 5 min of rotation, subjects were translated 0.504 m off-center, creating a +lGx centripetal acceleration in the nasal-occipital plane. Ten subjects completed the protocol without symptoms while 5 developed nausea (4 while 6ff-center and 1 while rotating on-center). Prior to nausea, subjects had significant increases in blood pressure (+13plus or minus 3 mmHg, P less than 0.05) and cerebrovascular resistance (+46 plus or minus 17%, P less than 0.05) and decreases in cerebral flow velocity both in the second (-13 plus or minus 4%) and last minute (-22 plus or minus 5%) before symptoms (P less than 0.05). In comparison, controls demonstrated no change in blood pressure or cerebrovascular resistance in the last minute of off-center rotation and only a 7 plus or minus 2% decrease in cerebral flow velocity. All subjects had significant hypocapnia (-3.8 plus or minus 0.4 mmHg, P less than 0.05), however this hypocapnia could not fully explain the cerebral hypoperfusion associated with the development of nausea. These data indicate that reductions in cerebral blood flow precede the development of nausea. Further work is necessary to determine what role cerebral hypoperfusion plays in motion sickness and whether cerebral hypoperfusion can be used to predict the development of nausea in susceptible individuals.

Serrador, Jorge M.↗
NASA NTRS1972

Theory of antimotion sickness drug mechanisms.

The results of a series of antimotion sickness drug evaluations indicates that drugs with central anticholinergic actions and drugs that increase central sympathetic activity are effective against motion sickness. The combination of these actions produces a synergistic effect against motion sickness. The effect of these medications on central acetylcholine or on norepinephrine could alter a balance between the neurons in the vestibular and reticular areas which influence motion sickness and also sympathetic and parasympathetic reactions. It is suggested that this could be their mechanism of action in preventing motion sickness.

Wood, D. C.↗
NASA NTRS2018

Pre-Flight Training of Autonomic Responses for Mitigating the Effects of Spatial Disorientation During Spaceflight

The National Aeronautics and Space Administration (NASA) has identified a potential risk of spatial disorientation, motion sickness, and degraded performance to astronauts during re-entry and landing of the proposed Orion crew vehicle. The purpose of this study was to determine if a physiological training procedure, Autogenic-Feedback Training Exercise (AFTE), can mitigate these adverse effects. Fourteen men and six women were assigned to two groups (AFTE, no-treatment Control) matched for motion sickness susceptibility and gender. All subjects received a standard rotating chair test to determine motion sickness susceptibility; three training sessions on a manual performance task; and four exposures in the rotating chair (Orion tests) simulating angular accelerations of the crew vehicle during re-entry. AFTE subjects received 2 hours of training before Orion tests 2, 3, and 4. Motion sickness symptoms, task performance, and physiological measures were recorded on all subjects. Results showed that the AFTE group had significantly lower symptom scores when compared to Controls on test 2 (p=.05), test 3 (p=.03), and test 4 (p=.02). Although there were no significant group differences on task performance, trends showed that AFTE subjects were less impaired than Controls. Heart rate change scores (20 revolutions per minute minus baseline) of AFTE subjects indicated significantly less reactivity on Test 4 compared to Test 1 (10.09 versus 16.59, p=.02), while Controls did not change significantly across tests. Results of this study indicate that AFTE may be an effective countermeasure for mitigating spatial dis-orientation and motion sickness in astronauts.

Orion↗
NASA NTRS1986

The effect of antimotion sickness drugs on habituation to motion

The mechanism which allows for increased exposure to motion and accelerates habituation is investigated. The responses of 12 male and female subjects between 18-30 years rotated once a day for 5 days on the Contraves Goerz rotating chair after receiving placebo, 10 mg d-amphetamine, 0.6 mg scopolamine with 5 mg d-amphetamine, and 1.0 mg scopolamine are studied. It is observed that with placebo the subjects performed 48 more head movements than untreated subjects, 118 more movements with d-amphetamine, 176 more with 0.6 mg scopolamine with d-amphetamine, and 186 more with 1.0 scopolamine. The data reveal that exposure to rotation increases tolerance from 88 head movements on day 2 to 159 on day 4 at 17.4 rpm and with placebo; 96 to 186 at 19.9 rpm with 10 mg d-amphetamine; 111 to 273 at 20.2 rpm with scopolamine with d-amphetamine, and 141 to 279 at 22.4 rpm with 1.0 mg scopolamine. It is noted that a combination of cholinergic blocking and norepinephrine activation action is most effective in preventing the development of motion sickness and habituation is due to the greater exposure to vestibular simulation permitted by the drugs.

Wood, C. D.↗
NASA NTRS1992

Beta-endorphin and arginine vasopressin following stressful sensory stimuli in man

This experimentation partially defines, for the first time, the response of beta-endorphin (ENDO) in man during tests designed to elicit nausea and motion sickness. These responses are similar to those associated with arginine vasopressin (AVP) and adreno-corticotropin (ACTH) to the extent that all hormones rise in response to motion sickness (p less than 0.003). Repeated exposure diminished motion-induced release of ENDO (p less than 0.005) and AVP (p less than 0.004) despite a three-fold increase in resistance to motion stimuli. Higher post-stress levels of AVP (p less than 0.04) and ACTH (p less than 0.02) were correlated with greater resistance to motion sickness. These data support the hypothesis that release of AVP is a significant link between stressful motion and motion-induced nausea and other autonomic system changes. Further, resistant individual apparently can tolerate higher peripheral levels of AVP before nausea results. Peripheral release of ENDO and ACTH may follow release of AVP; however, given the extensive and complex functional interactions that exist between AVP and the opiate systems, it is not yet possible to define a clear role for ENDO in the etiology of motion sickness.

Kohl, Randall L.↗
NASA NTRS1981

Vestibular selection criteria development

The experimental elicitation of motion sickness using a short arm centrifuge or a rotating chair surrounded by a striped cylindrical enclosure failed to reveal any systematic group or consistent individual relationship between changes in heart rate, blood pressure, and body temperature and the appearance of symptoms of motion sickness. A study of the influence of vision on susceptability to motion sickness during sudden stop simulation shows that having the eyes open during any part of the sudden stop assessment is more stressful than having them closed throughout the test. Subjects were found to be highly susceptible to motion sickness when tested in free fall and in high force phases of flight. The effect of touch and pressure cues on body orientation during rotation and in parabolic flight are considered as sensory as well as motor adaptation.

Lackner, J. R.↗
NASA NTRS1977

Experiment M131. Human vestibular function

The lower susceptibility to vestibular stimulation aloft, compared with that on ground under experimental conditions, is attributed to a precondition, namely, either there is no need to adapt, or, as exemplified by the Skylab 3 pilot, adaptation to weightlessness is achieved. Findings in some of the astronauts emphasize the distinction between two categories of vestibular side effects: immediate reflex phenomena (illusions, sensations of turning, etc.), and delayed epiphenomena that include the constellation of symptoms and syndromes comprising motion sickness. The drug combinations 1-scopolamine and d-amphetamine and promethazine hydrochloride and ephedrine sulfate are effective in prevention and treatment of motion sickness. It is concluded that prevention of motion sickness in any stressful motion environment involves selection, adaptation, and the use of drugs.

Graybiel, A.↗
NASA NTRS2009

Pharmacokinetics of Intranasal Scopolamine Gel Formulation (Inscop)

Space Motion Sickness (SMS) is commonly experienced by astronauts and often requires treatment with medications during early flight days of space missions. Orally administered scopolamine is commonly used by astronauts to prevent SMS. Bioavailability of oral (PO) SMS medications is often low and highly variable. Intranasal (IN) administration of medications achieves higher and more reliable bioavailability than from an equivalent PO dose. Methods: To test the safety and reliability of INSCOP, two clinical studies were performed, a dose escalation study and a comparison study administering INSCOP during normal ambulation and head down tilt bedrest. Efficacy was evaluated by testing INSCOP with two, different motion sickness inducing paradigms. Results: Preliminary results indicate that INSCOP demonstrates linear pharmacokinetics and a low side effect profile. In head down tilt bedrest, relative bioavailability of INSCOP was increased for females at both doses (0.2 and 0.4 mg) and for males at the higher dose (0.4 mg) but is reduced at the lower dose (0.2 mg) compared to normal ambulation. INSCOP displays gender specific differences during ABR. One of the treatment efficacy trials conducted at Dartmouth Hitchcock Medical Center demonstrated that INSCOP is efficacious at both doses (0.2 and 0.4 mg) in suppressing motion sickness symptoms as indicated by longer chair ride times with INSCOP administration than with placebo, and efficacy increases with dose. Similar results were seen using another motion sickness simulator, the motion simulator dome, at the Naval Aerospace Medical Research Laboratory, with significantly increased time in the dome in motion-susceptible subjects when using INSCOP compared to untreated controls. Conclusion: Higher bioavailability, linear pharmacokinetics, a low incidence of side effects, and a favorable efficacy profile make INSCOP a desirable formulation for prophylactic and rescue treatment of astronauts in space and military personnel on duty.

Boyd, Jason L.↗
NASA NTRS1993

Health monitoring of Japanese payload specialist: Autonomic nervous and cardiovascular responses under reduced gravity condition (L-0)

In addition to health monitoring of the Japanese Payload Specialists (PS) during the flight, this investigation also focuses on the changes of cardiovascular hemodynamics during flight which will be conducted under the science collaboration with the Lower Body Negative Pressure (LBNP) Experiment of NASA. For the Japanese, this is an opportunity to examine firsthand the effects of microgravity of human physiology. We are particularly interested in the adaption process and how it relates to space motion sickness and cardiovascular deconditioning. By comparing data from our own experiment to data collected by others, we hope to understand the processes involved and find ways to avoid these problems for future Japanese astronauts onboard Space Station Freedom and other Japanese space ventures. The primary objective of this experiment is to monitor the health condition of Japanese Payload Specialists to maintain a good health status during and after space flight. The second purpose is to investigate the autonomic nervous system's response to space motion sickness. To achieve this, the function of the autonomic nervous system will be monitored using non-invasive techniques. Data obtained will be employed to evaluate the role of autonomic nervous system in space motion sickness and to predict susceptibility to space motion sickness. The third objective is evaluation of the adaption process of the cardiovascular system to microgravity. By observation of the hemodynamics using an echocardiogram we will gain insight on cardiovascular deconditioning. The last objective is to create a data base for use in the health care of Japanese astronauts by obtaining control data in experiment L-O in the SL-J mission.

Sekiguchi, Chiharu↗
NASA NTRS2012

Monitors Track Vital Signs for Fitness and Safety

Have you ever felt nauseous reading a book in the back seat of a car? Or woken from a deep sleep feeling disoriented, unsure which way is up? Momentary mixups like these happen when the sensory systems that track the body's orientation in space become confused. (In the case of the backseat bookworm, the conflict arises when the reader s inner ear, part of the body s vestibular system, senses the car s motion while her eyes are fixed on the stationary pages of the book.) Conditions like motion sickness are common on Earth, but they also present a significant challenge to astronauts in space. Human sensory systems use the pull of gravity to help determine orientation. In the microgravity environment onboard the International Space Station, for example, the body experiences a period of confusion before it adapts to the new circumstances. (In space, even the body s proprioceptive system, which tells the brain where the arms and legs are oriented without the need for visual confirmation, goes haywire, meaning astronauts sometimes lose track of where their limbs are when they are not moving them.) This Space Adaptation Syndrome affects a majority of astronauts, even experienced ones, causing everything from mild disorientation to nausea to severe vomiting. "It can be quite debilitating," says William Toscano, a research scientist in NASA s Ames Research Center Psychophysiology Laboratory, part of the Center s Human Systems Integration Division. "When this happens, as you can imagine, work proficiency declines considerably." Since astronauts cannot afford to be distracted or incapacitated during critical missions, NASA has explored various means for preventing and countering motion sickness in space, including a range of drug treatments. Many effective motion sickness drugs, however, cause undesirable side effects, such as drowsiness. Toscano and his NASA colleague, Patricia Cowings, have developed a different approach: Utilizing biofeedback training methods, the pair can teach astronauts, military pilots, and others susceptible to motion sickness to self-regulate their own physiological responses and suppress the unpleasant symptoms. This NASA-patented method invented by Cowings is called the Autogenic Feedback Training Exercise (ATFE), and several studies have demonstrated its promise

Source record↗
NASA NTRS2004

Pharmacotherapeutic Aspects of Space Medicine

Medications are used for a wide variety of indications during space flight. For example, astronauts have taken drugs in flight to ameliorate or prevent symptoms of space motion sickness, headache, sleeplessness, backache, nasal congestion, and constipation. Russian cosmonauts reportedly take medications to prevent metabolic disturbances of the myocardium and intestinal flora, and to optimize their work capacity. Although the discomfort associated with some acute responses to microgravity (e.g., space motion sickness) is expected to diminish with length of time in flight, other responses that have delayed onset (e.g., maintaining nutritional status, bone and muscle strength, and perhaps immune response) may affect health and quality of life during longer missions. Therefore, as the duration of space flights increases, the need for treatment with medications is expected to increase accordingly. Medications carried on Space Shuttle missions have varied somewhat from flight to flight, depending on the individual needs of the crewmembers. Medications use during Shuttle flights seems to be more prevalent than during earlier programs, perhaps because drugs are provided in easy-to-use forms. In fact, nearly all medications taken to date have been ingested orally in tablet form. However, given that the oral route may not be ideal for those suffering motion-sickness symptoms, intramuscular and intranasal preparations are being tested. For example, intramuscular administration of promethazine hydrochloride (Phenergan(Registered TradeMark)) has been reported to be more effective in alleviating motion-sickness symptoms. The difficulties involved in conducting definitive studies of drug efficacy during U.S. space flights have been compounded by the absence of a systematic approach to determining which drugs were taken by whom and under what circumstances. The use of some drugs in space has been less efficacious than expected. The onset, intensity, and duration of the response produced by any drug depend upon rates of absorption, distribution, metabolism, and elimination of the drug; space flight-induced changes in blood flow and the function of the gastrointestinal (GI) tract, liver, or kidneys may alter these processes. Another important aspect of clinical efficacy of medications in space is the stability of pharmaceuticals. As the U.S. space program is moving toward extended Space Shuttle flights and beyond, to space station missions and planetary explorations, understanding how space flight affects organ systems and clinical pharmacology is necessary to optimize pharmacotherapeutics in space and ensure adequate safety and health of crewmembers.

Putcha, Lakshmi↗
NASA NTRS1991

8-OH-DPAT does not interfere with habituation to motion-induced emesis in cats

Experiments were performed to determine if suppression of motion-induced emesis (motion sickness) by 8-OH-DPAT altered the development or retention of habituation to the motion stimulus. Cats received 8-OH-DPAT followed by provocative motion on three consecutive treatment days. A drug-free test on the fourth day resulted in an incidence of emesis that was not different from that obtained on the fourth consecutive day of drug-free motion testing. Three consecutive days of treatment with 8-OH-DPAT without motion had no effect on the incidence of motion sickness on the fourth day. It was concluded that suppression of motion sickness by 8-OH-DPAT does not alter the acquisition or retention of habituation.

Lucot, James B.↗
NASA NTRS2009

Bioavailability of Promethazine during Spaceflight

Promethazine (PMZ) is the choice anti-motion sickness medication for treating space motion sickness (SMS) during flight. The side effects associated with PMZ include dizziness, drowsiness, sedation, and impaired psychomotor performance which could impact crew performance and mission operations. Early anecdotal reports from crewmembers indicate that these central nervous system side effects of PMZ are absent or greatly attenuated in microgravity, potentially due to changes in pharmacokinetics (PK) and pharmacodynamics in microgravity. These changes could also affect the therapeutic effectiveness of drugs in general and PMZ, in particular. In this investigation, we examined bioavailability and associated pharmacokinetics of PMZ in astronauts during and after space flight. Methods. Nine astronauts received, per their preference, PMZ (25 or 50 mg as intramuscular injection, oral tablet, or rectal suppository) on flight day one for the treatment of SMS and subsequently collected saliva samples and completed sleepiness scores for 72 h post dose. Thirty days after the astronauts returned to Earth, they repeated the protocol. Bioavailability and PK parameters were calculated and compared between flight and ground. Results. Maximum concentration (Cmax) was lower and time to reach Cmax (tmax) was longer in flight than on the ground. Area under the curve (AUC), a measure of bioavailability, was lower and biological half-life (t1/2) was longer in flight than on the ground. Conclusion. Results indicate that bioavailability of PMZ is reduced during spaceflight. Number of samples, sampling method, and sampling schedule significantly affected PK parameter estimates.

Boyd, Jason L.↗
NASA NTRS1988

Serotonergic mechanisms in emesis

The observation that the cerebrospinal fluid of cats which are susceptible to motion sickness contained lower baseline levels of 5-hydroxyindoleacetic acid, among other constituents, led to the hypothesis that serotonin inhibits emesis. The hypothesis was tested by administration of the serotonin-1A agonists buspirone and 8-OH-DPAT before motion testing in cats susceptible to motion sickness. Both drugs blocked motion sickness in a dose-dependent fashion. To determine if these drugs blocked emesis elicited by other stimuli, they were administered before subcutaneous administration of the alpha-2 noradrenergic agonist, xylazine. Both drugs also blocked xylazine-induced emesis. It was concluded that the stimulation of serotonin-1A receptors inhibits emesis elicited by the two stimuli and that this mechanism may exert a general antiemetic effect.

Lucot, J. B.↗
NASA NTRS1980

Free fall - A partial unique motion environment

Conditions leading to the elicitation of motion sickness have been divided into two main categories: partial motion environments, in which head movements are required to elicit motion sickness, and complete motion environments, in which independent movements of the head are not required for the production of symptoms. It is postulated that, according to this categorization, free fall constitutes a partial motion environment. In support of this hypothesis evidence is reviewed from Skylab missions, experiments in parabolic flight, and ground-based studies.

Graybiel, A.↗
NASA NTRS2016

Dynamic Visual Acuity and Landing Sickness in Crewmembers Returning from Long-Duration Spaceflight

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, are adapted to microgravity and must re-adapt to the gravitational environment. This re-adaptation causes decrements in gaze control and dynamic visual acuity, with astronauts reporting oscillopsia and blurred vision. Dynamic visual acuity (DVA) is assessed using an oscillating chair developed in the Neuroscience Laboratory at JSC. This chair is lightweight and easily portable for quick deployment in the field. The base of the chair is spring-loaded and allows for manual oscillation of the subject. Using a metronome, the chair is vertically oscillated plus or minus 2 cm at 2 Hz by an operator, to simulate walking. While 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 response 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. Dynamic visual acuity measures will be taken prior to flight (typically L-180, L-90, and L-60) and up to eight times after landing, including up to 3 times on R plus 0. Follow up measurements will be taken at R plus 1 (approximately 36 hours after landing). Long-duration International Space Station crewmembers will be tested once at the refueling stop in Europe and once again upon return to Johnson Space Center. In addition to DVA, subjective ratings of motion sickness will be recorded throughout the testing. Using the chair as a portable and reliable way to test DVA, we aim to test returning astronauts to assess the amount of retinal slip that they experience. By comparing these measurements to their motion sickness scores (using a scale of 1 to 20 where 20 is vomiting), we will correlate the amount of retinal slip to the level of motion sickness experienced. In addition to testing this in returning astronauts, we will perform ground-based studies to determine the effectiveness of stroboscopic goggles in reducing retinal slip and improving DVA. Finally, we will employ stroboscopic goggles in the field to astronauts experiencing high levels of motion sickness to minimize retinal slip and reduce their symptoms.

Rosenberg, M.J.F↗
NASA NTRS2002

Neurovestibular Effects of Long-Duration Spaceflight: A Summary of Mir-Phase 1 Experiences

Space motion sickness and associated neurovestibular dysfunction though not completely understood - have been relatively well clinically and operationally characterized on short-duration (1-2 week) Space Shuttle missions (Oman, et al, 1984, 1986; Thornton, et al, 1987; Reschke, et al, 1994). Between March 1995 and June 1998, seven NASA astronauts flew on the Russian Mir space station, as "Phase 1" of the joint effort to build the International Space Station, and provided NASA with invaluable experience on the operational and biomedical problems associated with flights of up to six months in duration. The goal of this paper is to provide a summary of the available information on neurovestibular dysfunction, space motion sickness, and readaptation to Earth's gravity on the NASA Mir flights, based on a set of medical questionnaire data, transcripts, and interviews which are available from the NASA-Mir Phase I program. Records were incomplete and anecdotal. All references to specific crewmembers have been removed, to respect their individual privacy. Material was excerpted from multiple sources of information relating to neurologic function, sensory illusions and motion sickness of NASA-Mir Phase I Program crewmembers. Data were compiled by epoch (in-flight vs landing/postflight) and grouped by neurovestibular topic. The information was recorded either contemporaneously during or within days after landing, or retrospectively weeks to months later. Space motion sickness symptoms are more intense and longer in duration. Sense of spatial orientation takes at least a month to become "natural and instinctive" in space station structures, but mental survey knowledge is apparently not completely developed even after 3 months in some cases. Visual reorientation illusions (VRI) are more easily induced after long exposure to weightlessness. Head movements can cause illusory spinning sensations for up to 7 days postflight. Postural and balance control does not fully recover for at least a month postflight.

Richards, Jason T.↗