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Neuropsychological Testing of Astronauts

The Spaceflight Cognitive Assessment Tool for Windows (WinSCAT) is a computer program that administers a battery of five timed neuro-cognitive tests. WinSCAT was developed to give astronauts an objective and automated means of assessing their cognitive functioning during space flight, as compared with their own baseline performances measured during similar prior testing on the ground. WinSCAT is also intended for use by flight surgeons to assess cognitive impairment after exposure of astronauts to such cognitive assaults as head trauma, decompression sickness, and exposure to toxic gas. The tests were selected from among a group of tests, denoted the Automated Neuropsychological Assessment Metrics, that were created by the United States Navy and Army for use in evaluating the cognitive impairment of military personnel who have been subjected to medication or are suspected to have sustained brain injuries. These tests have been validated in a variety of clinical settings and are now in the public domain. The tests are presented in a Microsoft Windows shell that facilitates administration and enables immediate reporting of test scores in numerical and graphical forms.

Flynn, Christopher

NASA Tech Briefs, November 2004

Topics include: Multifunction Imaging and Spectroscopic Instrument; Position-Finding Instrument Built Around a Magnetometer; Improved Measurement of Dispersion in an Optical Fiber; Probe for Sampling of Interstitial Fluid From Bone; Neuropsychological Testing of Astronauts; Method of Calibration for a Large Cathetometer System; Four-Channel PC/104 MIL-STD-1553 Circuit Board; Improved Method of Locating Defects in Wiring Insulation; Strobe Traffic Lights Warn of Approaching Emergency Vehicles; Improved Timing Scheme for Spaceborne Precipitation Radar; Concept for Multiple-Access Free-Space Laser Communications; Variable Shadow Screens for Imaging Optical Devices; Verifying Diagnostic Software; Initial Processing of Infrared Spectral Data; Activity-Centric Approach to Distributed Programming; Controlling Distributed Planning; New Material for Surface-Enhanced Raman Spectroscopy; Treated Carbon Nanofibers for Storing Energy in Aqueous KOH; Advanced Infant Car Seat Would Increase Highway Safety; Development of Biomorphic Flyers; Second-Generation Six-Limbed Experimental Robot; Miniature Linear Actuator for Small Spacecraft; Process for Making Single-Domain Magnetite Crystals; A New Process for Fabricating Random Silicon Nanotips; Resin-Transfer-Molding of a Tool Face; Improved Phase-Mask Fabrication of Fiber Bragg Gratings; Tool for Insertion of a Fiber-Optic Terminus in a Connector; Nanofluidic Size-Exclusion Chromatograph; Lightweight, Low-CTE Tubes Made From Biaxially Oriented LCPs; Using Redundancy To Reduce Errors in Magnetometer Readings; Compact Instrument for Measuring Profile of a Light Beam; Multilayer Dielectric Transmissive Optical Phase Modulator; Second-Generation Multi-Angle Imaging Spectroradiometer; Real-Time Adaptive Color Segmentation by Neural Networks; Research and Development in Optical Communications; Tests of Multibeam Scintillation Mitigation on Laser Uplinks; and Spaceborne Infrared Atmospheric Sounder.

Source record

Motor and cognitive testing of bone marrow transplant patients after chemoradiotherapy

Assessment of cognitive and motor performance of bone marrow transplant patients prior to, during, and following intensive toxic chemoradiotherapy may provide an important adjunct to measures of physiological and medical status. The present study is an attempt to assess whether, as side-effects, these aggressive treatments result in cognitive performance deficits, and if so, whether such changes recover posttreatment. Measurement of cognitive ability in this situation presents special problems not encountered with one-time tests intended for healthy adults. Such tests must be sensitive to changes within a single individual, which emphasizes the crucial importance of high reliability, stability across repeated-measures, and resistance to confounding factors such as motivation and fatigue. The present research makes use of a microbased portable test battery developed to have reliable and sensitive tests which were adapted to study the special requirements of transplant patients who may suffer cognitive deficits as a result of treatment. The results showed slight but significant changes in neuropsychological capacity when compared to baseline levels and controls, particularly near the beginning of treatment. The sensitivity of the battery in detecting such subtle temporary changes is discussed in terms of past research showing effects of other stressors, such as stimulated high altitude and ingestion of alcohol, on these measures.

Non-NASA Center

Development of microcomputer-based mental acuity tests

Recent disasters have focused attention on performance problems due to the use of alcohol and controlled substances in the workplace. Environmental stressors such as thermal extremes, mixed gases, noise, motion, and vibration also have adverse effects on human performance and operator efficiency. However, the lack of a standardized, sensitive, human performance assessment battery has probably delayed the systematic study of the deleterious effects of various toxic chemicals and drugs at home and in the workplace. The collective goal of the research reported here is the development of a menu of tests embedded in a coherent package of hardware and software that may be useful in repeated-measures studies of a broad range of agents that can degrade human performance. A menu of 40 tests from the Automated Performance Test System (APTS) is described, and the series of interlocking studies supporting its development is reviewed. The APTS tests, which run on several versions of laptop portables and desktop personal computers, have been shown to be stable, reliable, and factorially rich, and to have predictive validities with holistic measures of intelligence and simulator performances. In addition, sensitivity studies have been conducted in which performance changes due to stressors, agents, and treatments were demonstrated. We believe that tests like those described here have prospective use as an adjunct to urine testing for the screening for performance loss of individuals who are granted access to workplaces and stations that impact public safety.

Non-NASA Center

Working and strategic memory deficits in schizophrenia

Working memory and its contribution to performance on strategic memory tests in schizophrenia were studied. Patients (n = 18) and control participants (n = 15), all men, received tests of immediate memory (forward digit span), working memory (listening, computation, and backward digit span), and long-term strategic (free recall, temporal order, and self-ordered pointing) and nonstrategic (recognition) memory. Schizophrenia patients performed worse on all tests. Education, verbal intelligence, and immediate memory capacity did not account for deficits in working memory in schizophrenia patients. Reduced working memory capacity accounted for group differences in strategic memory but not in recognition memory. Working memory impairment may be central to the profile of impaired cognitive performance in schizophrenia and is consistent with hypothesized frontal lobe dysfunction associated with this disease. Additional medial-temporal dysfunction may account for the recognition memory deficit.

Memory Disorders/etiology/physiopathology

Sustained attention performance during sleep deprivation: evidence of state instability

Nathaniel Kleitman was the first to observe that sleep deprivation in humans did not eliminate the ability to perform neurobehavioral functions, but it did make it difficult to maintain stable performance for more than a few minutes. To investigate variability in performance as a function of sleep deprivation, n = 13 subjects were tested every 2 hours on a 10-minute, sustained-attention, psychomotor vigilance task (PVT) throughout 88 hours of total sleep deprivation (TSD condition), and compared to a control group of n = 15 subjects who were permitted a 2-hour nap every 12 hours (NAP condition) throughout the 88-hour period. PVT reaction time means and standard deviations increased markedly among subjects and within each individual subject in the TSD condition relative to the NAP condition. TSD subjects also had increasingly greater performance variability as a function of time on task after 18 hours of wakefulness. During sleep deprivation, variability in PVT performance reflected a combination of normal timely responses, errors of omission (i.e., lapses), and errors of commission (i.e., responding when no stimulus was present). Errors of omission and errors of commission were highly intercorrelated across deprivation in the TSD condition (r = 0.85, p = 0.0001), suggesting that performance instability is more likely to include compensatory effort than a lack of motivation. The marked increases in PVT performance variability as sleep loss continued supports the "state instability" hypothesis, which posits that performance during sleep deprivation is increasingly variable due to the influence of sleep initiating mechanisms on the endogenous capacity to maintain attention and alertness, thereby creating an unstable state that fluctuates within seconds and that cannot be characterized as either fully awake or asleep.

Non-NASA Center

The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation

OBJECTIVES: To inform the debate over whether human sleep can be chronically reduced without consequences, we conducted a dose-response chronic sleep restriction experiment in which waking neurobehavioral and sleep physiological functions were monitored and compared to those for total sleep deprivation. DESIGN: The chronic sleep restriction experiment involved randomization to one of three sleep doses (4 h, 6 h, or 8 h time in bed per night), which were maintained for 14 consecutive days. The total sleep deprivation experiment involved 3 nights without sleep (0 h time in bed). Each study also involved 3 baseline (pre-deprivation) days and 3 recovery days. SETTING: Both experiments were conducted under standardized laboratory conditions with continuous behavioral, physiological and medical monitoring. PARTICIPANTS: A total of n = 48 healthy adults (ages 21-38) participated in the experiments. INTERVENTIONS: Noctumal sleep periods were restricted to 8 h, 6 h or 4 h per day for 14 days, or to 0 h for 3 days. All other sleep was prohibited. RESULTS: Chronic restriction of sleep periods to 4 h or 6 h per night over 14 consecutive days resulted in significant cumulative, dose-dependent deficits in cognitive performance on all tasks. Subjective sleepiness ratings showed an acute response to sleep restriction but only small further increases on subsequent days, and did not significantly differentiate the 6 h and 4 h conditions. Polysomnographic variables and delta power in the non-REM sleep EEG-a putative marker of sleep homeostasis--displayed an acute response to sleep restriction with negligible further changes across the 14 restricted nights. Comparison of chronic sleep restriction to total sleep deprivation showed that the latter resulted in disproportionately large waking neurobehavioral and sleep delta power responses relative to how much sleep was lost. A statistical model revealed that, regardless of the mode of sleep deprivation, lapses in behavioral alertness were near-linearly related to the cumulative duration of wakefulness in excess of 15.84 h (s.e. 0.73 h). CONCLUSIONS: Since chronic restriction of sleep to 6 h or less per night produced cognitive performance deficits equivalent to up to 2 nights of total sleep deprivation, it appears that even relatively moderate sleep restriction can seriously impair waking neurobehavioral functions in healthy adults. Sleepiness ratings suggest that subjects were largely unaware of these increasing cognitive deficits, which may explain why the impact of chronic sleep restriction on waking cognitive functions is often assumed to be benign. Physiological sleep responses to chronic restriction did not mirror waking neurobehavioral responses, but cumulative wakefulness in excess of a 15.84 h predicted performance lapses across all four experimental conditions. This suggests that sleep debt is perhaps best understood as resulting in additional wakefulness that has a neurobiological "cost" which accumulates over time.

NASA Discipline Regulatory Physiology

The intersection of risk assessment and neurobehavioral toxicity

Neurobehavioral toxicology is now established as a core discipline of the environmental health sciences. Despite its recognized scientific prowess, stemming from its deep roots in psychology and neuroscience and its acknowledged successes, it faces additional demands and challenges. The latter, in fact, are a product of its achievements because success at one level leads to new and higher expectations. Now the discipline is counted upon to provide more definitive and extensive risk assessments than in the past. These new demands are the basis for the appraisals presented in the SGOMSEC 11 workshop. They extend beyond what would be offered in a primer of methodology. Instead, these appraisals are framed as issues into which what are usually construed as methodologies have been embedded.

NASA Discipline Environmental Health

Monitoring cognitive function and need with the automated neuropsychological assessment metrics in Decompression Sickness (DCS) research

Hypobaric decompression sickness (DCS) research presents the medical monitor with the difficult task of assessing the onset and progression of DCS largely on the basis of subjective symptoms. Even with the introduction of precordial Doppler ultrasound techniques for the detection of venous gas emboli (VGE), correct prediction of DCS can be made only about 65 percent of the time according to data from the Armstrong Laboratory's (AL's) hypobaric DCS database. An AL research protocol concerned with exercise and its effects on denitrogenation efficiency includes implementation of a performance assessment test battery to evaluate cognitive functioning during a 4-h simulated 30,000 ft (9144 m) exposure. Information gained from such a test battery may assist the medical monitor in identifying early signs of DCS and subtle neurologic dysfunction related to cases of asymptomatic, but advanced, DCS. This presentation concerns the selection and integration of a test battery and the timely graphic display of subject test results for the principal investigator and medical monitor. A subset of the Automated Neuropsychological Assessment Metrics (ANAM) developed through the Office of Military Performance Assessment Technology (OMPAT) was selected. The ANAM software provides a library of simple tests designed for precise measurement of processing efficiency in a variety of cognitive domains. For our application and time constraints, two tests requiring high levels of cognitive processing and memory were chosen along with one test requiring fine psychomotor performance. Accuracy, speed, and processing throughout variables as well as RMS error were collected. An automated mood survey provided 'state' information on six scales including anger, happiness, fear, depression, activity, and fatigue. An integrated and interactive LOTUS 1-2-3 macro was developed to import and display past and present task performance and mood-change information.

Nesthus, Thomas E.

Factor analysis and predictive validity of microcomputer-based tests

11 tests were selected from two microcomputer-based performance test batteries because previously these tests exhibited rapid stability (less than 10 min, of practice) and high retest reliability efficiencies (r greater than 0.707 for each 3 min. of testing). The battery was administered three times to each of 108 college students (48 men and 60 women) and a factor analysis was performed. Two of the three identified factors appear to be related to information processing ("encoding" and "throughput/decoding"), and the third named an "output/speed" factor. The spatial, memory, and verbal tests loaded on the "encoding" factor and included Grammatical Reasoning, Pattern Comparison, Continuous Recall, and Matrix Rotation. The "throughput/decoding" tests included perceptual/numerical tests like Math Processing, Code Substitution, and Pattern Comparison. The output speed factor was identified by Tapping and Reaction Time tests. The Wonderlic Personnel Test was group administered before the first and after the last administration of the performance tests. The multiple Rs in the total sample between combined Wonderlic as a criterion and less than 5 min. of microcomputer testing on Grammatical Reasoning and Math Processing as predictors ranged between 0.41 and 0.52 on the three test administrations. Based on these results, the authors recommend a core battery which, if time permits, would consist of two tests from each factor. Such a battery is now known to permit stable, reliable, and efficient assessment.

Non-NASA Center

Psychology of computer use: IX. A menu of self-administered microcomputer-based neurotoxicology tests

This study examined the feasibility of repeated self-administration of a newly developed battery of mental acuity tests which may have application in screening for fitness-for-duty or for persons who may be exposed to environmental stress, toxic agents, or disease. 16 subjects self-administered 18 microcomputer-based tests (13 new, 5 "core"), without proctors, over 10 sessions. The hardware performed well throughout the study and the tests appeared to be easily self-administered. Stabilities and reliabilities of the tests from the "core" battery were comparable to those obtained previously under more controlled experimental conditions. Eight of the new tests exceeded minimum criteria for metric and practical requirements and can be recommended as additions to the menu. Although the average retest reliability was high, cross-correlations between tests were low, implying factorial diversity. The menu can be used to form batteries with flexible total testing time which are likely to tap different mental processes and functions.

NASA Discipline Neuroscience

Examining the Effects of 4He Exposure on the Gut-Brain Axis

Beyond low earth orbit, space radiation poses significant risks to astronaut health. Previous studies have shown that the microbial composition of the gastrointestinal (GI) microbiome changes upon exposure to high linear energy transfer radiation. Interestingly, radiation-induced shifts in GI microbiota composition are linked to various neuropsychological disorders. Herein, we aimed to study changes in GI microbiota and behaviors of rats exposed to whole-body radiation (0, 5, or 25 cGy 4 He, 250 MeV/n) at approximately 6 months of age. Fecal samples were collected 24 hours prior to 4 He radiation and 24 hours and 7 days post-exposure for quantitative PCR analyses to assess fecal levels of spore-forming bacteria (SFB), Bifidobacterium, Lactobacillus, and Akkermansia. Rats were also tested in the social odor recognition memory (SORM) test at 7 days following 4 He exposure. A subset of rats was euthanized 90 minutes following completion of the SORM test, and GI tissue from small intestine to colon were prepared for examining overall histological changes and immunohistochemical staining for serotonin (5-HT). No notable pathological changes were observed in GI tissues. Akkermansia spp. and SFB were significantly decreased the 25 cGy group at 24 hours and 7 days post-exposure compared to pre-exposure, respectively. Bifidobacterium and Lactobacillus spp. showed no significant changes. 5-HT production was significantly higher in the proximal small intestine and the cecum in the 25 cGy group compared to the sham group. The 25 cGy group exhibited deficits in recognition in SORM testing at 7 days post-exposure. Taken together, these results suggest a connection between GI microbiome 3 composition, serotonin production, and neurobehavioral performance, and that this connection may be disrupted upon exposure to 25 cGy of 4 He ions

Carli B Jones

The Cognition Battery: Developing a Normative Database for Spaceflight and Examining the Impact of Prolonged Isolation and Confinement on Cognitive Performance

INTRODUCTION: Astronauts on future long duration space exploration will be required to execute complex tasks in which even minor errors could have devastating consequences. Intact cognition is critical to maintain exceptional performance standards and it is possible that variability even at the highest ends of the performance spectrum will impact operational tasks. Exposure to spaceflight hazards could compromise cognitive performance, and decrements have been documented under conditions of altered gravity and radiation exposure. The cognitive impacts of prolonged isolation and confinement remain relatively unknown. Traditional neuropsychological assessments cannot support earth independent monitoring, do not have normative comparisons for high functioning individuals, and most are not sensitive enough to detect small performance decrements. The Cognition Battery was developed to address these limitations but currently lacks comprehensive normative data. In this project, we aimed to 1) develop a preliminary normative database for astronauts and astronaut surrogates using the Cognition Battery, and 2) characterize differences in cognitive performance after short and long duration analog missions. PARTICIPANTS & METHODS: We assessed baseline cognitive performance by administering the Cognition Battery to 97 astronaut and astronaut surrogates recruited to approximate astronaut demographics (mean age: 39.38, SD=7.62; 35.1% female; 91.7% advanced degrees). For aim 1, we calculated speed and accuracy outcomes for each subtest and summarized the data with descriptive statistics. We examined the relationship between age and performance with Pearsons’s correlations and the relationship between gender and performance with independent samples t-tests. A subset of individuals on short duration (n=48; mean age: 38.18, SD=7.14; 37.5% female; 91.7% advanced degrees) missions of 45 days and long duration (n=34; mean age: 42.12, SD=8.39; 38.2% female; 94.1% advanced degrees) missions ranging from 4-8 months were administered the Cognition Battery during and after their respective missions. For aim 2, we accounted for practice effects using published corrections, and z-transformed post-mission scores using the full sample’s baseline scores. One-way analysis of covariance tests determined the main effect of analog duration on post-mission performance, after accounting for age and gender. The False Discovery Rate method was applied to adjust for multiple comparisons. RESULTS: In the full normative sample, older age was associated with slower reaction times on a processing speed task (r=.39, p=.02), and men were more accurate on processing speed (t=-2.19, p=.03) and faster on sustained attention (t=2.02, p=.049) and risk-taking tasks (t=2.49, p=.02). We observed a main effect of duration on performance on tasks of visual memory (f(1)=5.62, p=.04), processing speed (f(1)=5.48, p=.03), and sensorimotor functioning (f(1)=39.52, p < .001), such that slower performance was observed after long duration missions relative to short. Only sensorimotor functioning was significant after adjustments for multiple comparisons (adjusted p<.001). DISCUSSION: The full sample represents the largest dataset of cognitive performance assessed by the Cognition Battery available and can be used for further research in spaceflight and high-performance populations. Relationships between performance and key demographic variables suggest future research that include age and gender stratification is needed. Our results also show minimal changes in cognitive performance between longer and shorter periods of isolation and confinement.

S I Dev