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NASA NTRS2024

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↗

NASA NTRSDate not supplied

Human Performance and Fatigue

This presentation summarizes some of the work completed by the Fatigue Countermeasures Lab work for the System-wide Safety Technical Challenge 1. Highlights include the development of the NASA PVT+ application, which includes a validated psychomotor vigilance task, fatigue ratings, hassle factors, fatigue countermeasures, and workload measures. The NASA PVT+ has been used in numerous studies in short and long-haul aviation operations. Two examples of how these have been used in the real world are described.

human performance↗

NASA NTRSDate not supplied

Light as a Reactive Countermeasure to Sleep Inertia: Translating Laboratory Findings to the Field

Sleep inertia describes the brief period of impaired alertness, mood, and cognitive performance experienced after waking. Under laboratory settings, light exposure upon waking during a habitual sleep period has been shown to improve sleep inertia symptoms. We investigated whether a field-deployable light-emitting device would help to mitigate sleep inertia in a real-world setting. Thirty-six participants (18 female; 26.6 years ± 6.1) completed an at-home, within-subject, randomized crossover study. Participants followed their habitual sleep-wake schedule for five nights before an adaptation and experimental night. Forty-five minutes after bedtime on the experimental night, participants received a phone call and were instructed to wear light-emitting glasses with the light either on (light condition) or off (control). A 5-minute psychomotor vigilance task (PVT), the Karolinska Sleepiness Scale (KSS), visual analog scales of mood (VASmood), and a 3-minute descending subtraction task (DST) were performed starting at +2, +12, +22, and +32 minutes after the call. Participants then went back to sleep and were called 45 minutes after lights out for the opposite condition. A series of mixed-effects models were performed with fixed effects of test bout, condition, test bout × condition, and a random effect of participant. Covariates included pre-sleep baseline scores, randomization order, sex, and sleep history. Participants rated themselves as more alert and energetic in the light condition compared to the control condition (VASalert-sleepy p = .01; VASlethargic-energetic p = .001). There was no effect of condition for DST outcomes, but there was a significant improvement in DST total responses in the light condition in a subset of participants waking from N3 (p = .03). There was a significant effect of condition for PVT outcomes, with faster responses (p < .001) and fewer lapses (p < .001) in the control condition. Our results under naturalistic at-home settings suggest that, similar to the in-laboratory study findings, the light intervention improved subjective alertness and mood, while working memory improved after waking from N3. Future studies of light interventions should include measures of visual acuity and comfort to assess the full feasibility and efficacy of interventions in real-world environments.

sleep inertia↗

NASA NTRSDate not supplied

Light as a Reactive Countermeasure to Sleep Inertia: Translating Laboratory Findings to the Field

Sleep inertia describes the brief period of impaired alertness, mood, and cognitive performance experienced after waking. Under laboratory settings, light exposure upon waking during a habitual sleep period has been shown to improve sleep inertia symptoms. We investigated whether a field-deployable light-emitting device would help to mitigate sleep inertia in a real-world setting.\ Thirty-six participants (18 female; 26.6 years ± 6.1) completed an at-home, within-subject, randomized crossover study. Participants followed their habitual sleep-wake schedule for five nights before an adaptation and experimental night. Forty-five minutes after bedtime on the experimental night, participants received a phone call and were instructed to wear light-emitting glasses with the light either on (light condition) or off (control). A 5-minute psychomotor vigilance task (PVT), the Karolinska Sleepiness Scale (KSS), visual analog scales of mood (VASmood), and a 3-minute descending subtraction task (DST) were performed starting at +2, +12, +22, and +32 minutes after the call. Participants then went back to sleep and were called 45 minutes after lights out for the opposite condition. A series of mixed-effects models were performed with fixed effects of test bout, condition, test bout × condition, and a random effect of participant. Covariates included pre-sleep baseline scores, randomization order, sex, and sleep history. Participants rated themselves as more alert and energetic in the light condition compared to the control condition (VASalert-sleepy p = .01; VASlethargic-energetic p = .001). There was no effect of condition for DST outcomes, but there was a significant improvement in DST total responses in the light condition in a subset of participants waking from N3 (p = .03). There was a significant effect of condition for PVT outcomes, with faster responses (p < .001) and fewer lapses (p < .001) in the control condition. Our results under naturalistic at-home settings suggest that, similar to the in-laboratory study findings, the light intervention improved subjective alertness and mood, while working memory improved after waking from N3. Future studies of light interventions should include measures of visual acuity and comfort to assess the full feasibility and efficacy of interventions in real-world environments.

sleep inertia↗

NASA NTRSDate not supplied

Light as a Reactive Countermeasure to Sleep Inertia: Translating Laboratory Findings to the Field

sleep inertia↗

NASA NTRS1991

Impaired performance from brief social isolation of rhesus monkeys (Macaca mulatta) - A multiple video-task assessment

Social isolation has been demonstrated to produce profound and lasting psychological effects in young primates. In the present investigation, two adult rhesus monkeys (Macaca mulatta) were isolated from one another for up to 6 days and tested on 7 video tasks designed to assess psychomotor and cognitive functioning. Both the number and quality (i.e., speed and accuracy) of responses were significantly compromised in the social isolation condition relative to levels in which the animals were tested together. It is argued that adult rhesus are susceptible to performance disruption by even relatively brief social isolation, and that these effects can best be assessed by a battery of complex and sensitive measures.

Washburn, David A.↗

NASA NTRS2009

Psychomotor Vigilance Self Test on ISS (Reaction Self Test on Expeditions 21 and 22)

The experiment addresses the following high-priority NASA Risk Gaps in the Behavioral Health and Performance (BHP) area: 1) Identify brief, valid objective measures of changes in cognitive functions during spaceflight that astronauts can use with minimal burden. 2) Find a practical objective aid for astronauts to quickly identify and manage the effects of fatigue (from sleep loss, circadian disruptions, workload and other factors) on their performance during space flight.

Dinges, David F.↗

NASA NTRS2019

The Relationship between Workload, Performance and Fatigue in a Short-Haul Airline

Short-haul flights are associated with irregular work schedules and increased workload, due to frequent takeoffs and landings. We examined the relationship between pilot workload, performance and subjective fatigue during normal short-haul operations. Ninety airline pilots (8 female), mean age 33 (Â±8 years) completed a NASA-Task Load Index (NASA-TLX), a Psychomotor Vigilance Task (PVT; a reaction time test sensitive to sleep loss) and a Samn-Perelli (SP) fatigue scale, over a period of 20 duty days at top-of-descent on 2762 short-haul flights. The duty days included either 2 or 4 flights per day starting at different times as scheduled during normal operations. Workload was measured using the six NASA-TLX scales: mental demand, physical demand, temporal demand, effort, performance and frustration. Lapses (reaction times [RT] > 500ms) were calculated for the PVT. Spearman correlations were calculated to identify relationships between the NASA-TLX, PVT lapses, and SP. The six scales of NASA-TLX were positively correlated with the PVT lapses (p < 0.01) showing an increase in workload when lapses increased. There was a positive correlation between subjective fatigue as measured by the SP fatigue scale and each of the six scales of NASA-TLX (p < 0.001) suggesting that pilots reported higher workload when perceived levels of fatigue were higher. Of the six workload scales, mental demand and performance were rated the highest (mental: M = 40.99, SD = 20.32; performance: M = 41.61, SD = 20.71) and effort was rated the lowest (M = 15.59, SD = 8.98). Preliminary analyses suggest that high workload is associated with poorer PVT performance and increased self-reported fatigue in this population of short-haul pilots. Future studies should explore how other workload factors (i.e. flight hours, time of day) influence self-reported and objective fatigue measures.

TLX↗

NASA NTRSDate not supplied

A Preliminary Assessment of Cognition and Fatigue During Simulated Lunar Surface Extravehicular Activities

Introduction: Artemis astronauts will be required to complete more rigorous Extravehicular Activity (EVA) schedules than during ever before. While new spacesuits are designed to sustain high physical workloads during exploration EVAs (xEVA), crewmembers must also sustain cognitive performance throughout xEVA timelines. It is therefore necessary to characterize the effects of surface xEVA tasks and timelines on cognition and fatigue. Methods: This study utilized NASA Johnson Space Center’s Active Response Gravity Offload System (ARGOS) to simulate lunar gravity and assess xEVA tasks and cognitive performance. Two subjects completed two ~5-hour EVAs in a pressurized Mark III spacesuit, completing simulated lander operations, cable routing, crew rescue, geology, payload relocation, and traverses. Subjects completed two cognitive assessments (Digit-Symbol Substitution Task (DSST) and Psychomotor Vigilance Task (PVT)) before the first and after the second simulated EVA to assess effects of xEVA tasks on processing speed and vigilant attention. Additionally, sleep (e.g., quality, duration, and efficiency) was monitored (Oura Ring) for ≥7 days prior to the simulated EVAs, as well as between each EVA, to account for possible effects of sleep decrements on cognitive metrics. Results: Cognitive performance changed minimally from pre to post EVA for both DSST (response time (RT): S1 Δ129.1ms, S2 Δ40.7ms; Accuracy: S1 preEVA = 1.0, S1 postEVA = 0.98, S2 preEVA = 1.0, S2 postEVA = 1.0) and PVT (S1 PVT RT Δ17.7 ms, S2 PVT RT Δ-2.7 ms). Subjects’ sleep duration immediately prior to EVA showed minimal deviation from baseline (Δhrs; S1 preEVA1= + 0.67, S1 preEVA2 = -.03, S2 preEVA1 = - 1.1, S2 preEVA2 = -1.39) and efficiency (Δ%; S1 preEVA1 = 0.09, S1 preEVA2 = 9.54, S2 preEVA1 = 0, S2 preEVA2= 12). Notably, sleep waketime shifted earlier for one subject by ~1 hr which may have impacted performance. Conclusion: Understanding the impacts of xEVA workloads on cognitive performance will be instrumental to future exploration mission planning and success. Future work will expand the subject pool and test new spacesuit designs to better characterize cognitive performance and impacts of sleep during simulated xEVA and inform modeling and prediction capabilities for future Artemis xEVA planning.

Taylor E. Schlotman↗

NASA NTRS2015

Daytime Cognitive Performance in Response to Sunlight or Fluorescent Light Controlling for Sleep Duration

Light is the primary synchronizer of the human circadian rhythm and also has acute alerting effects. Our study involves and comparing the alertness, performance and sleep of participants in the NASA Ames Sustainability Base, which uses sunlight as its primary light source, to in a traditional office building which uses overhead florescent lighting and varying exposure to natural light. The purpose of this study is to determine whether the use of natural lighting as a primary light source improves daytime cognitive function and promotes nighttime sleep. Participants from the Sustainability Base will be matched by gender and age to individuals working in other NASA buildings. In a prior study we found no differences in performance between those working in the Sustainability Base and those working in other buildings. Unexpectedly, we found that the average sleep duration among participants in both buildings was short, which likely obscured our ability to detect a difference the effect of light exposure on alertness. Given that such sleep deprivation has negative effects on cognitive performance, in this iteration of the study we are asking the participants to maintain a regular schedule with eight hours in bed each night in order to control for the effect of self-selected sleep restriction. Over the course of one week, we will ask the participants to wear actiwatches continuously, complete a psychomotor vigilance task (PVT) and digit symbol substitution task (DSST) three times per day, and keep daily sleepwork diaries. We hope that this study will provide data to support the idea that natural lighting and green architectural design are optimal to enhance healthy nighttime sleep patterns and daytime cognitive performance.

cognitive performance↗

NASA NTRS1987

Part-task vs. whole-task training on a supervisory control task

The efficacy of a part-task training for the psychomotor portion of a supervisory control simulation was compared to that of the whole-task training, using six subjects in each group, who were asked to perform a task as quickly as possible. Part-task training was provided with the cursor-control device prior to transition to the whole-task. The analysis of both the training and experimental trials demonstrated a significant performance advantage for the part-task group: the tasks were performed better and at higher speed. Although the subjects finally achieved the same level of performance in terms of score, the part-task method was preferable for economic reasons, since simple pretraining systems are significantly less expensive than the whole-task training systems.

Battiste, Vernol↗

NASA NTRS1989

Microcomputer-based tests for repeated-measures: Metric properties and predictive validities

A menu of psychomotor and mental acuity tests were refined. Field applications of such a battery are, for example, a study of the effects of toxic agents or exotic environments on performance readiness, or the determination of fitness for duty. The key requirement of these tasks is that they be suitable for repeated-measures applications, and so questions of stability and reliability are a continuing, central focus of this work. After the initial (practice) session, seven replications of 14 microcomputer-based performance tests (32 measures) were completed by 37 subjects. Each test in the battery had previously been shown to stabilize in less than five 90-second administrations and to possess retest reliabilities greater than r = 0.707 for three minutes of testing. However, all the tests had never been administered together as a battery and they had never been self-administered. In order to provide predictive validity for intelligence measurement, the Wechsler Adult Intelligence Scale-Revised and the Wonderlic Personnel Test were obtained on the same subjects.

Kennedy, Robert S.↗

NASA NTRSDate not supplied

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↗

NASA NTRSDate not supplied

Perturbations in Brain Functional Connectivity Patterns After Waking From Slow Wave Sleep Under Different Cognitive States

Sleep inertia refers to the state of transition between sleep and wake characterized by impaired alertness, confusion, and reduced cognitive and behavioral performance. While the behavioral symptoms of sleep inertia are well described, the neurological changes that lead to this state remain elusive. Here, to understand the state of sleep inertia and the reorganization that the brain undergoes, we took a graph theoretical approach and compared the EEG derived brain connectivity patterns before sleep and after waking up while participants (n = 10) performed multiple tasks that differed in cognitive complexities. We focused on how the degree and the clustering coefficient of brain regions (EEG sensors) change immediately after participants wake up from slow wave sleep. During a psychomotor vigilance task (PVT), designed to assess vigilant attention, we find that the brain regions with strong network connectivity (degree) before sleep show a reduction in connectivity after waking. In contrast, those with low connectivity before sleep have greater connectivity after waking. The regions that undergo these changes are specific to each participant and these findings are unique to the beta frequency range, which plays a key role in sensorimotor functioning and preserving the current state of the brain. Moreover, in tasks that required inhibitory control and arithmetic reasoning, we found that only regions with weak connectivity before sleep exhibited more connections after waking, but regions with high connectivity prior to sleeping remained unchanged, highlighting task specific effects. Furthermore, we find that during the PVT, the clustering coefficient within low frequency oscillations of the brain is reduced upon waking while it remains unchanged during other tasks. These results suggest that the connections between regions that are lost after abrupt awakening can be reallocated to other regions in order to renormalize the brain. However, this response may only be evident during specific cognitive states and may be more nuanced during complex task performance.

sleep inertia↗

NASA NTRS2002

Workload-Matched Adaptive Automation Support of Air Traffic Controller Information Processing Stages

Adaptive automation (AA) has been explored as a solution to the problems associated with human-automation interaction in supervisory control environments. However, research has focused on the performance effects of dynamic control allocations of early stage sensory and information acquisition functions. The present research compares the effects of AA to the entire range of information processing stages of human operators, such as air traffic controllers. The results provide evidence that the effectiveness of AA is dependent on the stage of task performance (human-machine system information processing) that is flexibly automated. The results suggest that humans are better able to adapt to AA when applied to lower-level sensory and psychomotor functions, such as information acquisition and action implementation, as compared to AA applied to cognitive (analysis and decision-making) tasks. The results also provide support for the use of AA, as compared to completely manual control. These results are discussed in terms of implications for AA design for aviation.

Kaber, David B.↗

NASA NTRS1973

Cognitions and 'placebos' in behavioral research on ambient noise

Investigation of the effects of noise on visual and psychomotor tasks, with special attention to influences of certain cognitive variables. The results include the finding that 100-dB ambient noise has no effects per se, though cognitive variables in the testing situation affect both performance and ratings of disturbance.

Harcum, E. R.↗

NASA NTRS1973

Cognitions and 'placebos' in behavioral research on ambient noise.

The study investigated effects of noise on visual and psychomotor tasks, with particular concern for influences of certain cognitive variables. A first experiment, using visual and card-sorting tasks, found no effects of 100 dB ambient noise per se, although cognitive variables in the testing situation affected both performance and ratings of disturbance. In two subsequent experiments some of the subjects were told that a noise was extraneous to their task of reproducing tachistoscopic patterns, and others were told that effects of the noise were being studied. It appears that in the absence of an adequate 'placebo' to control for cognitive factors, deceptive instructions may always be necessary in studies of ambient noise.

Harcum, E. R.↗

NASA NTRSDate not supplied

Changes in Oculomotor Behavior and PVT Reaction Time During One Night of Sleep Deprivation

INTRODUCTION: The Psychomotor Vigilance Test (PVT) is a widely used objective measure of sustained attention, alertness, and fatigue. Previous studies consistently show that prolonged wakefulness and disrupted sleep patterns lead to increased lapses of attention and slower reaction times. These findings have critical implications for various professions, including healthcare, aviation, transportation safety, and spaceflight. In this study, we employed linear mixed models (LMM) to investigate hourly-measured 5-minute PVT reaction times during one night of total sleep deprivation. Our goal was to characterize the contribution of homeostatic sleep pressure (time awake) and circadian phase (salivary melatonin levels) on the dynamics of PVT reaction time. MATERIALS & METHODS: Data from twelve human participants were used in the analysis. Participants were healthy non-smokers, aged 18 and 40, with normal sleep habits defined as Pittsburg Sleep Quality Index scores < 5, and Morningness – Eveningness Questionnaire scores > 42 and < 58, respectively. Participants followed a constant-routine protocol and arrived at the NASA sleep laboratory approximately 1 to 2 hours after their habitual waking time. Tympanic temperature was measured every 30 min to provide a real-time estimate of circadian phase. Participants were required to stay awake throughout the laboratory experiment, which continued until their tympanic temperature had returned to baseline levels. This approach ensured that we could capture each participant's circadian trough and recovery, typically occurring between 24 and 26 hours after waking. The PVT and saliva melatonin were measured every hour, starting approximately from 3 hours after awakening. More information about the measurement protocol can be found in the publication by Stone et al. We used PVT reaction times between 100 and 10000 ms to calculate Reciprocal Reaction Times (RRTs). LMM models were employed to assess the contribution of time awake and saliva melatonin levels on changes in RRTs. Two models were created: the first model treated time awake as a fixed effect and the second model considered both the salivary melatonin level and time awake as fixed effects. Participants were included as a random effect in both models. We compared the models using an Analysis of Variance (ANOVA). The models were computed using the 'lmer' function from the 'lme4' package in R, and LMM p-values were determined using Satterthwaite's method. RESULTS: We found that time awake had a statistically significant effect on PVT RRTs during one night of sleep deprivation [χ2 = 2132.4, df = 1, p < 0.001]. In addition, the model including both saliva melatonin levels and time awake was statistically significantly better than one that uses just time awake [χ2 = 17.4, df = 1, p < 0.001]. DISCUSSION & CONCLUSION: As expected, these preliminary results suggest that the time awake and circadian phase each contribute to performance reductions as measured by the PVT. Future analyses will explore the contributions of other factors to the model.

sleep deprivation↗