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NASA NTRS1984

Prediction of the space adaptation syndrome

The univariate and multivariate relationships of provocative measures used to produce motion sickness symptoms were described. Normative subjects were used to develop and cross-validate sets of linear equations that optimally predict motion sickness in parabolic flights. The possibility of reducing the number of measurements required for prediction was assessed. After describing the variables verbally and statistically for 159 subjects, a factor analysis of 27 variables was completed to improve understanding of the relationships between variables and to reduce the number of measures for prediction purposes. The results of this analysis show that none of variables are significantly related to the responses to parabolic flights. A set of variables was selected to predict responses to KC-135 flights. A series of discriminant analyses were completed. Results indicate that low, moderate, or severe susceptibility could be correctly predicted 64 percent and 53 percent of the time on original and cross-validation samples, respectively. Both the factor analysis and the discriminant analysis provided no basis for reducing the number of tests.

Reschke, M. F.↗

NASA NTRS1992

Neural Connectivity and Immunocytochemical Studies of Anatomical Sites Related to Nauseogenic and Emetic Reflexes

The studies conducted in this research project examined several aspects of neuroanatomical structures and neurochemical processes related to motion sickness in animal models. A principle objective of these studies was to investigate neurochemical changes in the central nervous system that are related to motion sickness with the objective of defining neural mechanisms important to this malady. For purposes of exposition, the studies and research finding have been classified into five categories. These are: immunoreactivity in the brainstem, vasopressin effects, lesion studies of area postrema, role of the vagus nerve, and central nervous system structure related to adaptation to microgravity.

Fox, Robert A.↗

NASA NTRS1988

Summary of Payload Integration Plan (PIP) for Starlab-1 flight experiment, enclosure 3

The objectives of the Autogenic Feedback Training (AFT) are to: determine if preflight AFT is an effective treatment for space adaptation syndrome (SAS); determine if preflight improvements in motion sickness tolerance can be used to predict crewmembers' success in controlling symptoms in flight; and identify differences and similarities between the physiological data from preflight motion sickness tests and data collected during symptom episodes in space. The goal is to test the AFT on 8 trained and 8 control subjects. At present 2 trained and 2 contol subjects were tested. The testing will continue until the experimental goal of testing 16 individual is reached.

Cowings, Patricia S.↗

NASA NTRS2002

Maternal susceptibility to nausea and vomiting of pregnancy: is the vestibular system involved?

Nausea and vomiting of pregnancy shares many characteristics with motion sickness, a vestibular dependent phenomenon. A number of physiologic changes that occur in normal pregnancy are also known to accompany nausea and vomiting in patients with motion sickness and certain vestibular disorders. This chapter summarizes some shared features of both phenomena. The unmasking of subclinical vestibular disorders may account for some cases of hyperemesis gravidarum. Hormonal effects on neurotransmitter function may also play a role in nausea and vomiting of pregnancy and in some vestibular disorders; however, the specific neural mechanisms of nausea and vomiting have not been identified. Until the neurochemical processes underlying these phenomena are understood, prevention and management will remain in the domain of astute, but so far limited, clinical observation.

NASA Discipline Neuroscience↗

NASA NTRS2011

Cybersickness Following Repeated Exposure to DOME and HMD Virtual Environments

Virtual environments (VE) offer unique training opportunities, including training astronauts to preadapt them to the novel sensory conditions of microgravity. However, one unresolved issue with VE use is the occurrence of cybersickness during and following exposure to VE systems. Most individuals adapt and become less ill with repeated interaction with VEs. The goal of this investigation was to compare motion sickness symptoms (MSS) produced by dome and head-mounted (HMD) displays and to examine the effects of repeated exposures on MSS. Sixty-one subjects participated in the study. Three experimental sessions were performed each separated by one day. The subjects performed a navigation and pick and place task in either a dome or HMD VE. MSS were measured using a Simulator Sickness Questionnaire before, immediately after, and at 1, 2, 4 and 6 hours following exposure to the VEs. MSS data were normalized by calculating the natural log of each score and an analysis of variance was performed. We observed significant main effects for day and time and a significant day by time interaction for total sickness and for each of the subscales, nausea, oculomotor and disorientation. However, there was no significant main effect for device. In conclusion, subjects reported a large increase in MSS immediately following exposure to both the HMD and dome, followed by a rapid recovery across time. Sickness severity also decreased over days, which suggests that subjects become dual-adapted over time making VE training a viable pre-flight countermeasure for space motion sickness.

Taylor, Laura C.↗

NASA NTRS2011

Pharmacokinetics of Intranasal Scopolamine Gel Formulation During Antiorthostatic Bed Rest, a Microgravity Analog

Statement of Purpose, Innovation or Hypothesis: Space Motion sickness (SMS) is a long-standing problem for astronauts on both short and long duration space flights. Scopolamine (SCOP) is frequently used for the treatment of motion sickness (MS), and is available as transdermal patch and tablet dosage forms. These formulations of SCOP are ineffective for the treatment of SMS. Intranasal dosage forms are noninvasive with rapid absorption and enhanced bioavailability, thus allowing precise and reduced dosing in addition to offering rescue and treatment options. An intranasal gel dosage formulation of scopolamine (INSCOP) was developed and pharmacokinetics (PK) and bioavailability were determined in clinical trials with human subjects under IND guidelines.Description of Methods and Materials: The present clinical trial compares PK and bioavailability of INSCOP in 12 normal, healthy subjects (6 male/ 6 female) during ambulation (AMB) and antiorthostaticbed rest (ABR) used as a ground-based microgravity analog. Subjects received 0.2 mg and 0.4 mg doses of INSCOP during AMB and ABR in a 4-way crossover design.Data and Results: Results indicated no difference between AMB and ABR in PK parameters after 0.2 mg dose, Clearance (Cls) decreased with a concomitant increase in maximum concentration and area under concentration-versus-time curve (AUC) during ABR after the 0.4 mg dose.Interpretation, Conclusion or Significance: The difference in AUC and Cls at the higher (0.4 mg) but not the lower dose (0.2 mg) during ABR suggests that ABR may affect metabolism and/or clearance of INSCOP at higher doses . These results indicate that dosing adjustment may be required for treatment of SMS with INSCOP in space.

Singh, Rajendra P.↗

NASA NTRS1987

Physiologic adaptation of man in space; Proceedings of the Seventh International Man in Space Symposium, Houston, TX, Feb. 10-13, 1986

Topics discussed in this volume include space motion sickness, cardiovascular adaptation, fluid shifts, extravehicular activity, general physiology, perception, vestibular response modifications, vestibular physiology, and pharmacology. Papers are presented on the clinical characterization and etiology of space motion sickness, ultrasound techniques in space medicine, fluid shifts in weightlessness, Space Shuttle inflight and postflight fluid shifts measured by leg volume changes, and the probability of oxygen toxicity in an 8-psi space suit. Consideration is also given to the metabolic and hormonal status of crewmembers in short-term space flights, adaptive changes in perception of body orientation and mental image rotation in microgravity, the effects of a visual-vestibular stimulus on the vestibulo-ocular reflex, rotation tests in the weightless phase of parabolic flight, and the mechanisms of antimotion sickness drugs.

Holland, Albert W.↗

NASA NTRS1997

Studies of the Interactions Between Vestibular Function and Tactual Orientation Display Systems

When humans experience conditions in which internal vestibular cues to movement or spatial location are challenged or contradicted by external visual information, the result can be spatial disorientation, often leading to motion sickness. Spatial disorientation can occur in any situation in which the individual is passively moved in the environment, but is most common in automotive, aircraft, or undersea travel. Significantly, the incidence of motion sickness in space travel is great: The majority of individuals in Shuttle operations suffer from the syndrome. Even after the space-sickness-producing influences of spatial disorientation dissipate, usually within several days, there are other situations in which, because of the absence of reliable or familiar vestibular cues, individuals in space still experience disorientation, resulting in a reliance on the already preoccupied sense of vision. One possible technique to minimize the deleterious effects of spatial disorientation might be to present attitude information (including orientation, direction, and motion) through another less-used sensory modality - the sense of touch. Data from experiences with deaf and blind persons indicate that this channel can provide useful communication and mobility information on a real-time basis. More recently, technologies have developed to present effective attitude information to pilots in situations in which dangerously ambiguous and conflicting visual and vestibular sensations occur. This summers project at NASA-Johnson Space Center will evaluate the influence of motion-based spatial disorientation on the perception of tactual stimuli representing veridical position and orientation information, presented by new dynamic vibrotactile array display technologies. In addition, the possibility will be explored that tactile presentations of motion and direction from this alternative modality might be useful in mitigating or alleviating spatial disorientation produced by multi-axis rotatory systems, monitored by physiological recording techniques developed at JSC.

Cholewiak, Roger W.↗

NASA NTRS2011

Pharmacokinetics of Intranasal Scopolamine Gel Formation During Antiorthostatic Bedrest - A Microgravity Analog

Space Motion sickness (SMS) is an age old problem for astronauts on both short and long duration space flights. Scopolamine (SCOP) is the most frequently used drug for the treatment of motion sickness (MS) which is currently available in transdermal patch and tablet dosage forms. These formulations of SCOP are ineffective for the treatment of SMS. Intranasal dosage forms are noninvasive with rapid absorption and enhanced bioavailability thus allowing precise and reduced dosing options in addition to offering rescue and treatment options. As such, an intranasal gel dosage formulation of scopolamine (INSCOP) was developed and Pharmacokinetics (PK) and bioavailability were determined under IND guidelines. The present clinical trial compares PK and bioavailability of INSCOP in 12 normal, healthy subjects (6 male/ 6 female) during ambulation (AMB) and antiorthostatic bedrest (ABR) used as a ground-based microgravity analog. Subjects received 0.2 and 0.4 mg doses of INSCOP during AMB and ABR in a four-way crossover design. Results indicated no difference between AMB and ABR in PK parameters after 0.2 mg dose. Clearance (Cls) decreased with a concomitant increase in maximum concentration and area under concentration versus time curve (AUC) during ABR after the 0.4 mg dose. This difference in AUC and Cls at the higher but not the lower dose during ABR may suggest that ABR may affect metabolism and/or clearance at higher doses of INSCOP. These results indicate that dosing adjustment may be required for treatment of SMS with INSCOP in space.

Lakshmi, Putcha↗

NASA NTRS1991

Cerebral blood flow - Comparison of ground-based and spaceflight data and correlation with space adaptation syndrome

The relationship between the cerebral blood flow velocity and the space adaptation syndrome (SAS), which includes symptoms of motion sickness, stuffy head, and/or headaches, was investigated by measuring (using a transcranial Doppler device) differences between the preflight and the inflight cerebral blood flow velocity in crew members who were motion sick and in those who were not sick during a flight aboard KC-135. It was found that the cerebral artery bloodflow inflight did not differ significantly from that recorded preflight, nor did the severity of SAS symptoms correlate directly with the cerebral blood flow.

Bagian, James P.↗

NASA NTRS1977

Some physiological effects of alternation between zero gravity and one gravity

The anatomy and physiology of the healthy vestibular system and the history of its study, maintenance of muskuloskeletal fitness under low-gravity conditions, tests of motion sickness, and data and techniques on testing subjects in a slow rotation room, are covered. Components of the inner ear labyrinth and their behavior in relation to equilibrium, gravity and inertial forces, motion sickness, and dizziness are discussed. Preventive medicine, the biologically effective force environment, weightlessness per se, activity in a weightless spacecraft, exercizing required to maintain musculoskeletal function, and ataxia problems are dealt with.

Graybiel, A.↗

NASA NTRS1991

Control of nausea and autonomic dysfunction with terfenadine, a peripherally acting antihistamine

Terfenadine (Seldane) was admisistered to 14 male subjects in a randomized, double-blinded, and cross-over design to assess the efficacy of this peripherally active antihistamine as an antimotion sickness drug. Terfenadine possesses practically no central side effects. A staircase profile test was administered 4 h following placebo or a single oral dose of terfenadine (300 mg). The study revealed a statistically significant therapeutic effect from terfenadine (p less than 0.05). This led to a conclusion that, because the drug does not or only poorly crosses the blood-brain barrier, a selective peripheral antihistamine action may be sufficient in the control of motion sickness induced through cross-coupled accelerative semicircular canal stimulation using a rotating chair. This finding implies that other peripherally acting agents might be found that possess even greater antimotion sickness efficacy. The present research raises additional questions regarding current theories on the etiology of motion sickness, its associated autonomic system dysfunction, and the validity of assumptions that effective pharmacological agents must act centrally.

Kohl, Randall L.↗

NASA NTRS1984

Area postrema ablations in cats: Evidence for separate neural routes for motion- and xylazine-induced CTA and emesis

The effects of off-vertical rotation upon the Intake of tap water Immediately after rotation, and upon conditioned taste aversion, were assessed In mice with the tilt of the rotation axis varying from 5 to 20° from the earth-vertical. Conditioned taste aversion occurred In all mice that were rotated, but the Intake of tap water was suppressed only In mice that were rotated at 15 or 20° of tilt. The greater suppression of tap water Intake and the stronger conditioned aversion In the mouse as the angle of tilt was Increased In this experiment are consistent with predictions from similar experiments with human subjects where motion sickness develops more rapidly as the angle of tilt la Increased. It was suggested that off-vertical rotation may be a useful procedure for Insuring experimental control over vestibular stimulation In animal studies of motion sickness.

Robert A Fox↗

NASA NTRS1994

Autonomic Responses to Microgravity

The purpose of this report is to describe how changes in autonomic nervous system responses may be used as an index of individual differences in adaptational capacity to space flight. During two separate Spacelab missions, six crewmembers wore an ambulatory monitoring system which enabled continuous recording of their physiological responses for up to twelve hours a day for 3 to 5 mission days. The responses recorded were electrocardiography, respiration wave form, skin conductance level, hand temperature, blood flow to the hands and triaxial accelerations of the head and upper body. Three of these subjects had been given training, before the mission, in voluntary control of these autonomic responses as a means of facilitating adaptation to space. Three of these subjects served as Controls, i.e., did not receive this training but took anti-motion sickness medication. Nearly 300 hours of flight data are summarized. These data were examined using time-series analyses, spectral analyses of heart rate variability, and analyses of variance. Information was obtained on responses to space motion sickness, inflight medications, circadian rhythm, workload and fatigue. Preliminary assessment was made on the effectiveness of self-regulation training as a means of facilitating adaptation, with recommendations for future flights.

Toscano, W. B.↗

NASA NTRSDate not supplied

Development of Head-Trunk Coordination Measures for Monitoring Postflight Sensorimotor Readaptation Strategies

During exploration missions, individual health assessments will be required to account for variability in neurosensory adaptation and task readiness for the initial extravehicular activities (EVAs). Previous research has identified postflight vestibular alterations and disruptions in head-trunk coordination after both short and long duration spaceflight missions. Astronauts were found to minimize head angular displacement and utilize a consistent forward head tilt theorized as a compensatory approach to stabilize the cephalic system and reduce motion sickness during readaptation to Earth’s gravity. Further, anecdotal self-reports from Shuttle crewmembers stated that pitch and side-to-side head movements immediately post-landing typically resulted in perceived angular self-motion. Notable disruptions also occur upon arrival in orbit, with astronauts choosing waist rotation rather than head movements during dynamic tasks. It is thought that the underlying sensorimotor disruptions may contribute to motion sickness in space and upon landing, postflight gait dysfunction, and inaccurate spatial orientation when performing daily tasks. To better characterize microgravity-induced sensorimotor adaptations, it is important to develop measures and monitoring tools that have high sensitivity in detecting changes in head-trunk coordination.

H M Weiss↗

NASA NTRS2017

Stroboscopic Goggles as a Countermeasure for 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 via the vestibulo-occular reflex (VOR), are adapted to microgravity and must re-adapt to the Earth's gravitational environment. This re-adaptation causes decrements in gaze control and dynamic visual acuity, with astronauts reporting oscillopsia and blurred vision. These effects are caused by retinal slip, or the inability to keep an image focused on their retina, which is thought to drive motion sickness symptoms experienced upon landing. Retinal slip can be estimated by dynamic visual acuity (DVA); visual acuity while in motion. Peters et al. (2011) find that DVA is worsened in astronauts by an average of 0.75 eye-chart lines one day after landing. Previously, the use of stroboscopic goggles has shown to be effective in minimizing motion sickness symptoms due to retinal slip (Reschke et al. 2007). In this study, we simulated the decrement in DVA caused by sensorimotor re-adaptation by using minifying lenses and then testing the efficacy of stroboscopic goggles in preventing retinal slip and improving DVA. Dynamic visual acuity is assessed using an oscillating chair developed in the Neuroscience Laboratory at JSC. This chair is motor-driven and oscillates vertically at 2 Hz with a vertical displacement of +/- 2 cm to simulate the vertical translations that occur while walking. As 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 responses 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. We found that healthy subjects (n=20) have a significantly impaired DVA while wearing the minifying lenses, demonstrating that the VOR is in an adaptive state and retinal slip is occurring. When subjects' acuity was tested wearing the stroboscopic goggles with the minifying lenses, there was no significant difference in their DVA compared to their baseline DVA. This suggests that stroboscopic goggles are preventing retinal slip and would function as an efficient countermeasure for VOR adaptations and thus help mitigate landing sickness symptoms experienced by long-duration crewmembers. These goggles might also be used to counter blurred vision (caused by retinal slip) experienced by crewmembers during launch where the vehicle vibrations are greatest. The stroboscopic effect could be built into a section of their head mounted displays on the visor of their helmets to be used in these high vibration situation if a mission critical task is necessary.

Rosenberg, M. J. F.↗

NASA NTRS1981

Habituation to novel visual vestibular environments with special reference to space flight

The etiology of space motion sickness and the underlying physiological mechanisms associated with spatial orientation in a space environment were investigated. Human psychophysical experiments were used as the basis for the research concerning the interaction of visual and vestibular cues in the development of motion sickness. Particular emphasis is placed on the conflict theory in terms of explaining these interactions. Research on the plasticity of the vestibulo-ocular reflex is discussed.

Young, L. R.↗

NASA NTRS1998

Vestibular influences on autonomic cardiovascular control in humans

There is substantial evidence that anatomical connections exist between vestibular and autonomic nuclei. Animal studies have shown functional interactions between the vestibular and autonomic systems. The nature of these interactions, however, is complex and has not been fully defined. Vestibular stimulation has been consistently found to reduce blood pressure in animals. Given the potential interaction between vestibular and autonomic pathways this finding could be explained by a reduction in sympathetic activity. However, rather than sympathetic inhibition, vestibular stimulation has consistently been shown to increase sympathetic outflow in cardiac and splanchnic vascular beds in most experimental models. Several clinical observations suggest that a link between vestibular and autonomic systems may also exist in humans. However, direct evidence for vestibular/autonomic interactions in humans is sparse. Motion sickness has been found to induce forearm vasodilation and reduce baroreflex gain, and head down neck flexion induces transient forearm and calf vasoconstriction. On the other hand, studies using optokinetic stimulation have found either very small, variable, or inconsistent changes in heart rate and blood pressure, despite substantial symptoms of motion sickness. Furthermore, caloric stimulation severe enough to produce nystagmus, dizziness, and nausea had no effect on sympathetic nerve activity measured directly with microneurography. No effect was observed on heart rate, blood pressure, or plasma norepinephrine. Several factors may explain the apparent discordance of these results, but more research is needed before we can define the potential importance of vestibular input to cardiovascular regulation and orthostatic tolerance in humans.

Review↗