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Elahi MM, Witt AN, Pryzdial ELG, McBeth PB. Thrombotic triad in microgravity. Thromb Res 2024; 233:82-87. [PMID: 38029549 DOI: 10.1016/j.thromres.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/11/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Abstract
Thrombotic disease may be an underdiagnosed condition of prolonged exposure to microgravity and yet the underlying factors remain poorly defined. Recently, an internal jugular vein thrombosis was diagnosed in a low-risk female astronaut after an approximately 7-week space mission. Six of the additional 10 crew members demonstrated jugular venous flow risk factors, such as suspicious stagnation or retroversion. Fortunately, all were asymptomatic. Observations in space as well as clinical and in vitro microgravity studies on Earth, where experiments are designed to recapitulate the conditions of space, suggest effects on blood flow stasis, coagulation, and vascular function. In this article, the related literature on thrombotic disease in space is reviewed, with consideration of these elements of Virchow's triad.
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Affiliation(s)
- Mohammad M Elahi
- Faculty of Medicine, University of British Columbia, Canada; Centre for Blood Research, Life Sciences Institute, University of British Columbia, Canada.
| | - Alexandra N Witt
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Canada; Canadian Blood Services, Medical Affairs and Innovation, Canada
| | - Edward L G Pryzdial
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Canada; Canadian Blood Services, Medical Affairs and Innovation, Canada
| | - Paul B McBeth
- Faculty of Medicine, Department of Surgery, University of Calgary, Canada; Faculty of Medicine, Department of Critical Care Medicine, University of Calgary, Canada
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2
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Sagirov AF, Sergeev TV, Shabrov AV, Yurov AY, Guseva NL, Agapova EA. Postural influence on intracranial fluid dynamics: an overview. J Physiol Anthropol 2023; 42:5. [PMID: 37055862 PMCID: PMC10100470 DOI: 10.1186/s40101-023-00323-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/01/2023] [Indexed: 04/15/2023] Open
Abstract
This review focuses on the effects of different body positions on intracranial fluid dynamics, including cerebral arterial and venous flow, cerebrospinal fluid (CSF) hydrodynamics, and intracranial pressure (ICP). It also discusses research methods used to quantify these effects. Specifically, the implications of three types of body positions (orthostatic, supine, and antiorthostatic) on cerebral blood flow, venous outflow, and CSF circulation are explored, with a particular emphasis on cerebrovascular autoregulation during microgravity and head-down tilt (HDT), as well as posture-dependent changes in cerebral venous and CSF flow, ICP, and intracranial compliance (ICC). The review aims to provide a comprehensive analysis of intracranial fluid dynamics during different body positions, with the potential to enhance our understanding of intracranial and craniospinal physiology.
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Affiliation(s)
- Arlan Faritovich Sagirov
- Department of Ecological Physiology, Federal State Budgetary Scientific Institution "Institute of Experimental Medicine", 12 Academic Pavlov St, Saint-Petersburg, 197022, Russia.
| | - Timofey Vladimirovich Sergeev
- Department of Ecological Physiology, Federal State Budgetary Scientific Institution "Institute of Experimental Medicine", 12 Academic Pavlov St, Saint-Petersburg, 197022, Russia
| | - Aleksandr Vladimirovich Shabrov
- Department of Ecological Physiology, Federal State Budgetary Scientific Institution "Institute of Experimental Medicine", 12 Academic Pavlov St, Saint-Petersburg, 197022, Russia
| | - Andrey Yur'evich Yurov
- Department of Ecological Physiology, Federal State Budgetary Scientific Institution "Institute of Experimental Medicine", 12 Academic Pavlov St, Saint-Petersburg, 197022, Russia
| | - Nadezhda Leonidovna Guseva
- Department of Ecological Physiology, Federal State Budgetary Scientific Institution "Institute of Experimental Medicine", 12 Academic Pavlov St, Saint-Petersburg, 197022, Russia
| | - Elizaveta Aleksandrovna Agapova
- Department of Ecological Physiology, Federal State Budgetary Scientific Institution "Institute of Experimental Medicine", 12 Academic Pavlov St, Saint-Petersburg, 197022, Russia
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Boschert AL, Gauger P, Bach A, Gerlach D, Johannes B, Jordan J, Li Z, Elmenhorst D, Bauer A, Marshall-Goebel K, Tank J, Zange J, Rittweger J. External to internal cranial perfusion shifts during simulated weightlessness: Results from a randomized cross-over trial. NPJ Microgravity 2023; 9:25. [PMID: 36977696 PMCID: PMC10050182 DOI: 10.1038/s41526-023-00267-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
The exact pathophysiology of the spaceflight-associated neuro-ocular syndrome (SANS) has so far not been completely elucidated. In this study we assessed the effect of acute head-down tilt position on the mean flow of the intra- and extracranial vessels. Our results suggest a shift from the external to the internal system that might play an important role in the pathomechanism of SANS.
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Affiliation(s)
- Alessa L Boschert
- Department of Muscle and Bone Metabolism, German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany.
- Institute of Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany.
| | - Peter Gauger
- Department of Cardiovascular Aerospace Medicine, German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Anja Bach
- Department of Cardiovascular Aerospace Medicine, German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Darius Gerlach
- Department of Cardiovascular Aerospace Medicine, German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Bernd Johannes
- Department of Muscle and Bone Metabolism, German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Jens Jordan
- Institute of Aerospace Medicine, German Aerospace Center (DLR) and Chair of Aerospace Medicine, Cologne, Germany
| | - Zhili Li
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, Beijing, China
| | - David Elmenhorst
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-2), Jülich, Germany
| | - Andreas Bauer
- Forschungszentrum Jülich, Institute of Neuroscience and Medicine (INM-2), Jülich, Germany
| | | | - Jens Tank
- Department of Cardiovascular Aerospace Medicine, German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Jochen Zange
- Department of Muscle and Bone Metabolism, German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Jörn Rittweger
- Department of Muscle and Bone Metabolism, German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
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Saehle T. Cerebral Hemodynamics During Exposure to Hypergravity (+G z) or Microgravity (0 G). Aerosp Med Hum Perform 2022; 93:581-592. [DOI: 10.3357/amhp.6008.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Optimal human performance and health is dependent on steady blood supply to the brain. Hypergravity (+Gz) may impair cerebral blood flow (CBF), and several investigators have also reported that microgravity (0 G) may influence cerebral hemodynamics. This
has led to concerns for safe performance during acceleration maneuvers in aviation or the impact long-duration spaceflights may have on astronaut health.METHODS: A systematic PEO (Population, Exposure, Outcome) search was done in PubMed and Web of Science, addressing studies on
how elevated +Gz forces or absence of such may impact cerebral hemodynamics. All primary research containing anatomical or physiological data on relevant intracranial parameters were included. Quality of the evidence was analyzed using the GRADE tool.RESULTS: The search
revealed 92 eligible articles. It is evident that impaired CBF during +Gz acceleration remains an important challenge in aviation, but there are significant variations in individual tolerance. The reports on cerebral hemodynamics during weightlessness are inconsistent, but published
data indicate that adaptation to sustained microgravity is also characterized by significant variations among individuals.DISCUSSION: Despite a high number of publications, the quality of evidence is limited due to observational study design, too few included subjects, and methodological
challenges. Clinical consequences of high +Gz exposure are well described, but there are significant gaps in knowledge regarding the intracranial pathophysiology and individual hemodynamic tolerance to both hypergravity and microgravity environments.Saehle T. Cerebral
hemodynamics during exposure to hypergravity (+Gz) or microgravity (0 G). Aerosp Med Hum Perform. 2022; 93(7):581–592.
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Yildiz S, Grinstead J, Hildebrand A, Oshinski J, Rooney WD, Lim MM, Oken B. Immediate impact of yogic breathing on pulsatile cerebrospinal fluid dynamics. Sci Rep 2022; 12:10894. [PMID: 35764793 PMCID: PMC9240010 DOI: 10.1038/s41598-022-15034-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/16/2022] [Indexed: 01/10/2023] Open
Abstract
Cerebrospinal fluid (CSF), a clear fluid bathing the central nervous system (CNS), undergoes pulsatile movements. Together with interstitial fluid, CSF plays a critical role for the removal of waste products from the brain, and maintenance of the CNS health. As such, understanding the mechanisms driving CSF movement is of high scientific and clinical impact. Since pulsatile CSF dynamics is sensitive and synchronous to respiratory movements, we are interested in identifying potential integrative therapies such as yogic breathing to regulate CSF dynamics, which has not been reported before. Here, we investigated the pre-intervention baseline data from our ongoing randomized controlled trial, and examined the impact of four yogic breathing patterns: (i) slow, (ii) deep abdominal, (iii) deep diaphragmatic, and (iv) deep chest breathing with the last three together forming a yogic breathing called three-part breath. We utilized our previously established non-invasive real-time phase contrast magnetic resonance imaging approach using a 3T MRI instrument, computed and tested differences in single voxel CSF velocities (instantaneous, respiratory, cardiac 1st and 2nd harmonics) at the level of foramen magnum during spontaneous versus yogic breathing. In examinations of 18 healthy participants (eight females, ten males; mean age 34.9 ± 14 (SD) years; age range: 18-61 years), we observed immediate increase in cranially-directed velocities of instantaneous-CSF 16-28% and respiratory-CSF 60-118% during four breathing patterns compared to spontaneous breathing, with the greatest changes during deep abdominal breathing (28%, p = 0.0008, and 118%, p = 0.0001, respectively). Cardiac pulsation was the primary source of pulsatile CSF motion except during deep abdominal breathing, when there was a comparable contribution of respiratory and cardiac 1st harmonic power [0.59 ± 0.78], suggesting respiration can be the primary regulator of CSF depending on the individual differences in breathing techniques. Further work is needed to investigate the impact of sustained training yogic breathing on pulsatile CSF dynamics for CNS health.
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Affiliation(s)
- Selda Yildiz
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
| | - John Grinstead
- Siemens Medical Solutions USA, Inc, Portland, OR, 97239, USA
| | - Andrea Hildebrand
- Biostatistics and Design Program, Oregon Health & Science University, Portland, OR, 97239, USA
| | - John Oshinski
- Radiology & Imaging Sciences and Biomedical Engineering, Emory School of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - William D Rooney
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, 97239, USA
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, 97239, USA
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Miranda M Lim
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, 97239, USA
- VA Portland Health Care System, Portland, OR, 97239, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, 97239, USA
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Barry Oken
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, 97239, USA
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Yoshikawa M, Ishikawa C, Li H, Kudo T, Shiba D, Shirakawa M, Murtani M, Takahashi S, Aizawa S, Shiga T. Comparing effects of microgravity and amyotrophic lateral sclerosis in the mouse ventral lumbar spinal cord. Mol Cell Neurosci 2022; 121:103745. [PMID: 35660087 DOI: 10.1016/j.mcn.2022.103745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022] Open
Abstract
Microgravity (MG) exposure and motor neuron diseases, such as amyotrophic lateral sclerosis (ALS), lead to motor deficits, including muscle atrophy and loss of neuronal activity. Abnormalities in motor neurons and muscles caused by MG exposure can be recovered by subsequent ground exercise. In contrast, the degeneration that occurs in ALS is irreversible. A common phenotype between MG exposure and ALS pathology is motor system abnormality, but the causes may be different. In this study, to elucidate the motor system that is affected by each condition, we investigated the effects of MG and the human SOD1 ALS mutation on gene expression in various cell types of the mouse ventral lumbar spinal cord, which is rich in motor neurons innervating the lower limb. To identify cell types affected by MG or ALS pathogenesis, we analyzed differentially expressed genes with known cell-type markers, which were determined from previous single-cell studies of the spinal cord in MG-exposed and SOD1G93A mice, an ALS mouse model. Differentially expressed genes were observed in MG mice in various spinal cord cell types, including neurons, microglia, astrocytes, oligodendrocytes, oligodendrocyte precursor cells, meningeal cells/Schwann cells, and vascular cells. We also examined neuronal populations in the spinal cord. Gene expression in putative excitatory and inhibitory neurons changed more than that in cholinergic motor neurons of the spinal cord in both MG and SOD1G93A mice. Many putative neuron types, especially visceral motor neurons, and axon initial segments (AIS) were affected in MG mice. In contrast, the effect on neurons and AIS in SOD1G93A mice was slight at P30 but progressed with aging. Interestingly, changes in dopaminergic system-related genes were specifically altered in the spinal cord of MG mice. These results indicate that MG and ALS pathology in various cell types contribute to motor neuron degeneration. Furthermore, there were more alterations in neurons in MG-exposed mice than in SOD1G93A mice. A large number of differentially expressed genes (DEGs) in MG mice represent more than SOD1G93A mice with ALS pathology. Elucidation of MG pathogenesis may provide more insight into the pathophysiology of neurodegenerative diseases.
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Affiliation(s)
- Masaaki Yoshikawa
- Division of Anatomical Science, Department of Functional Morphology, Nihon University School of Medicine, Itabashi, Tokyo 173-8610, Japan.
| | - Chihiro Ishikawa
- Laboratory of Neurobiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Haiyan Li
- Laboratory of Neurobiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Takashi Kudo
- Department of Anatomy and Embryology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Dai Shiba
- JEM Utilization Center, Human Spaceflight Technology Directorate, JAXA, Tsukuba, Ibaraki 305-8505, Japan
| | - Masaki Shirakawa
- JEM Utilization Center, Human Spaceflight Technology Directorate, JAXA, Tsukuba, Ibaraki 305-8505, Japan
| | - Masafumi Murtani
- Department of Genome Biology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Satoru Takahashi
- Department of Anatomy and Embryology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Shin Aizawa
- Division of Anatomical Science, Department of Functional Morphology, Nihon University School of Medicine, Itabashi, Tokyo 173-8610, Japan
| | - Takashi Shiga
- Laboratory of Neurobiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan; Department of Neurobiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
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