On tracking the course of cerebral oxygen saturation and pilot performance during gravity-induced loss of consciousness

Relationship Between Acute Physical Fatigue and Cognitive Function During Orthostatic Challenge in Men and Women: A Neuroergonomics Investigation

BACKGROUND

Postflight orthostatic challenge (OC), resulting from blood pooling in lower extremities, is a major health concern among astronauts that fly long-duration missions. Additionally, astronauts undergo physical demanding tasks resulting in acute fatigue, which can affect performance. However, the effects of concurrent OC and acute physical fatigue on performance have not been adequately investigated.

OBJECTIVE

The purpose of this study was to determine the relationship between acute physical fatigue and cognitive function during OC.

METHODS

Sixteen healthy participants performed the mental arithmetic task and psychomotor tracking tasks in the absence and presence of a prior 1-hour physically fatiguing exercise, on separate days under OC (induced via lower body negative pressure). We recorded task performances on the cognitive tests and prefrontal cortex oxygenation using functional near-infrared spectroscopy, along with physiological and subjective responses.

RESULTS

The introduction of the cognitive tasks during OC increased cerebral oxygenation; however, oxygenation decreased significantly with the cognitive tasks under the acute fatigue conditions, particularly during the tracking task and in males. These differences were accompanied by comparable task performances.

DISCUSSION

The findings suggest that mental arithmetic is a more effective countermeasure than psychomotor tracking under acute physical fatigue during OC. Whereas females did not show a significant difference in cerebral oxygenation due to task, males did, suggesting that it may be important to consider gender differences when developing countermeasures against OC.

Effects of Acceleration-Induced Reductions in Retinal and Cerebral Oxygenation on Human Performance

BACKGROUND: Ischemic hypoxia induced by suprathreshold G-force loading can adversely affect vision, cognition, and lead to loss of consciousness (LOC). The purpose of this study was to determine whether reductions in cerebral oxygenation, caused by subthreshold G-forces (up to 4 G_z and of limited durations that do not lead to LOC), would affect visual perception and working memory performance.METHODS: Sixteen subjects performed visual perception and working memory tasks both before and during G_z exposures (1, 2.2, 3, 4 with leg pressurization, 4 with leg and abdomen pressurization) within a human-use centrifuge.RESULTS: As measured using near-infrared spectroscopy, blood oxygenation over medial prefrontal cortex was similar in the 1 and 2.2 G_z conditions, but was reduced to a similar extent in the 3 and 4 G_z conditions. In parallel, visual perception accuracy was reduced in the 3 and 4 G_z conditions, with no difference between the 3 and 4 G_z conditions. No change in reaction time was seen. Conversely, neither accuracy nor reaction time changes were observed for the visual working memory task.DISCUSSION: These results indicate that although visual working memory is not affected, the ability to visually discriminate between stimuli is reduced at G-forces as low as 3 and 4 G_z. This may have important ramifications for pilots who are routinely subjected to such forces.Croft RJ, Klegrd R, Tribukait A, Taylor NAS, Eiken O. Effects of acceleration-induced reductions in retinal and cerebral oxygenation on human performance. Aerosp Med Hum Perform. 2021; 92(2):7582.

Limb Skin Temperature as a Tool to Predict Orthostatic Instability

Orthostatic instability is one of the main consequences of weightlessness or gravity challenge and plays as well a crucial role in public health, being one of the most frequent disease of aging. Therefore, the assessment of effective countermeasures, or even the possibility to predict, and thus prevent orthostatic instability is of great importance. Heat stress affects orthostatic stability and may lead to impaired consciousness and decrease in cerebral perfusion, specifically during the exposure to G-forces. Conversely, peripheral cooling can prevent orthostatic intolerance – even in normothermic healthy subjects. Indicators of peripheral vasodilation, as elevated skin surface temperatures, may mirror blood decentralization and an increased risk of orthostatic instability. Therefore, the aim of this study was to quantify orthostatic instability risk, by assessing in 20 fighter jet pilot candidates’ cutaneous limb temperatures, with respect to the occurrence of G-force-induced almost loss of consciousness (ALOC), before and during exposure to a push-pull maneuver, i.e., head-down tilt, combined with lower body negative pressure. Peripheral skin temperatures from the upper and lower (both proximal and distal) extremities and core body temperature via heat-flux approach (i.e., the Double Sensor), were continuously measured before and during the maneuver. The 55% of subjects that suffered an ALOC during the procedure had higher upper arm and thigh temperatures at baseline compared to the 45% that remained stable. No difference in baseline core body temperature and distal limbs (both upper and lower) skin temperatures were found between the two groups. Therefore, peripheral skin temperature data could be considered a predicting factor for ALOC, prior to rapid onset acceleration. Moreover, these findings could also find applications in patient care settings such as in intensive care units.

Intraocular pressure and cerebral oxygenation during prolonged headward acceleration

PURPOSE

Supra-tolerance head-to-foot directed gravitoinertial load (+Gz) typically induces a sequence of symptoms/signs, including loss of: peripheral vision-central vision-consciousness. The risk of unconsciousness is greater when anti-G-garment failure occurs after prolonged rather than brief exposures, presumably because, in the former condition, mental signs are not consistently preceded by impaired vision. The aims were to investigate if prolonged exposure to moderately elevated +Gz reduces intraocular pressure (IOP; i.e., improves provisions for retinal perfusion), or the cerebral anoxia reserve.

METHODS

Subjects were exposed to 4-min +Gz plateaux either at 2 and 3 G (n = 10), or at 4 and 5 G (n = 12). Measurements included eye-level mean arterial pressure (MAP), oxygenation of the cerebral frontal cortex, and at 2 and 3 G, IOP.

RESULTS

IOP was similar at 1 (14.1 ± 1.6 mmHg), 2 (14.0 ± 1.6 mmHg), and 3 G (14.0 ± 1.6 mmHg). During the G exposures, MAP exhibited an initial prompt drop followed by a partial recovery, end-exposure values being reduced by ≤30 mmHg. Cerebral oxygenation showed a similar initial drop, but without recovery, and was followed by either a plateau or a further slight decrement to a minimum of about -14 μM.

CONCLUSION

Gz loading did not affect IOP. That cerebral oxygenation remained suppressed throughout these G exposures, despite a concomitant partial recovery of MAP, suggests that the increased risk of unconsciousness upon G-garment failure after prolonged +Gz exposure is due to reduced cerebral anoxia reserve.

Development of motion resistant instrumentation for ambulatory near-infrared spectroscopy

Ambulatory near-infrared spectroscopy (aNIRS) enables recording of systemic or tissue-specific hemodynamics and oxygenation during a person's normal activities. It has particular potential for the diagnosis and management of health problems with unpredictable and transient hemodynamic symptoms, or medical conditions requiring continuous, long-duration monitoring. aNIRS is also needed in conditions where regular monitoring or imaging cannot be applied, including remote environments such as during spaceflight or at high altitude. One key to the successful application of aNIRS is reducing the impact of motion artifacts in aNIRS recordings. In this paper, we describe the development of a novel prototype aNIRS monitor, called NINscan, and our efforts to reduce motion artifacts in aNIRS monitoring. Powered by 2 AA size batteries and weighting 350 g, NINscan records NIRS, ECG, respiration, and acceleration for up to 14 h at a 250 Hz sampling rate. The system's performance and resistance to motion is demonstrated by long term quantitative phantom tests, Valsalva maneuver tests, and multiparameter monitoring during parabolic flight and high altitude hiking. To the best of our knowledge, this is the first report of multiparameter aNIRS monitoring and its application in parabolic flight.

Investigation of spectral interferences on the accuracy of broadband CW-NIRS tissue SO(2) determination

An accurate SO(2) prediction method for using broadband continuous-wave diffuse reflectance near infrared (NIR) spectroscopy is proposed. The method fitted the NIR spectra to a Taylor expansion attenuation model, and used the simulated annealing method to initialize the nonlinear least squares fit. This paper investigated the effect of potential spectral interferences that are likely to be encountered in clinical use, on SO(2) prediction accuracy. The factors include the concentration of hemoglobin in blood, the volume of blood and volume of water in the tissue under the sensor, reduced scattering coefficient, µ(s)', of the muscle, fat thickness and the source-detector spacing. The SO(2) prediction method was evaluated on simulated muscle spectra as well as on dual-dye phantoms which simulate the absorbance of oxygenated and deoxygenated hemoglobin.