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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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2
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Hedge ET, Patterson CA, Mastrandrea CJ, Sonjak V, Hajj-Boutros G, Faust A, Morais JA, Hughson RL. Implementation of exercise countermeasures during spaceflight and microgravity analogue studies: Developing countermeasure protocols for bedrest in older adults (BROA). Front Physiol 2022; 13:928313. [PMID: 36017336 PMCID: PMC9395735 DOI: 10.3389/fphys.2022.928313] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/27/2022] [Indexed: 12/18/2022] Open
Abstract
Significant progress has been made in the development of countermeasures to attenuate the negative consequences of prolonged exposure to microgravity on astronauts’ bodies. Deconditioning of several organ systems during flight includes losses to cardiorespiratory fitness, muscle mass, bone density and strength. Similar deconditioning also occurs during prolonged bedrest; any protracted time immobile or inactive, especially for unwell older adults (e.g., confined to hospital beds), can lead to similar detrimental health consequences. Due to limitations in physiological research in space, the six-degree head-down tilt bedrest protocol was developed as ground-based analogue to spaceflight. A variety of exercise countermeasures have been tested as interventions to limit detrimental changes and physiological deconditioning of the musculoskeletal and cardiovascular systems. The Canadian Institutes of Health Research and the Canadian Space Agency recently provided funding for research focused on Understanding the Health Impact of Inactivity to study the efficacy of exercise countermeasures in a 14-day randomized clinical trial of six-degree head-down tilt bedrest study in older adults aged 55–65 years old (BROA). Here we will describe the development of a multi-modality countermeasure protocol for the BROA campaign that includes upper- and lower-body resistance exercise and head-down tilt cycle ergometry (high-intensity interval and continuous aerobic exercise training). We provide reasoning for the choice of these modalities following review of the latest available information on exercise as a countermeasure for inactivity and spaceflight-related deconditioning. In summary, this paper sets out to review up-to-date exercise countermeasure research from spaceflight and head-down bedrest studies, whilst providing support for the proposed research countermeasure protocols developed for the bedrest study in older adults.
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Affiliation(s)
- Eric T. Hedge
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | | | - Vita Sonjak
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Guy Hajj-Boutros
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Andréa Faust
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - José A. Morais
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
- Division of Geriatric Medicine, McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Richard L. Hughson
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
- *Correspondence: Richard L. Hughson,
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3
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Shankhwar V, Singh D, Deepak KK. Cardiac-vascular-respiratory coupling analysis during 6-degree head-down tilt microgravity analogue. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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4
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Kermorgant M, Hammoud S, Mahieu L, Geeraerts T, Beck A, Bareille MP, Soler V, Pavy-Le Traon A, Quintyn JC. Effects of Resistance Exercise with or without Whey Protein Supplementation on Ocular Changes after a 21-Day Head-Down Bed Rest. Life (Basel) 2021; 11:life11080741. [PMID: 34440485 PMCID: PMC8401897 DOI: 10.3390/life11080741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022] Open
Abstract
Neuro-ophthalmological changes have been reported after prolonged exposure to microgravity; however, the pathophysiology remains unclear. The objectives of the present study were twofold: (1) to assess the neuro-ophthalmological impact of 21 days of head-down bed rest (HDBR) and (2) to determine the effects of resistance vibration exercise (RVE) alone or combined with nutritional supplementation (NeX). In this case, 12 healthy male subjects completed three interventions of a 21-day HDBR: a control condition without countermeasure (CON), a condition with resistance vibration exercise (RVE) comprising of squats, single leg heel and bilateral heel raises and a condition using also RVE associated with nutritional supplementation (NeX). Intraocular pressure (IOP) was assessed by applanation tonometry. Retinal nerve fiber layer thickness (RNFLT) was assessed with spectral-domain optical coherence tomography, before HDBR and between Day 2 and Day 4 after each session of HDBR. In CON condition, IOP was preserved; while in RVE and NeX conditions, IOP was increased. In CON condition, RNFLT was preserved after HDBR. RVE and NeX conditions did not have significant effects on RNFLT. This study showed that a 3-week HDBR did not induce significant ophthalmological changes. However, RVE induced an elevation in IOP after HDBR. Nutritional supplementation did not reduce or exacerbate the side effects of RVE.
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Affiliation(s)
- Marc Kermorgant
- INSERM DR Midi-Pyrénées Limousin, Institute of Cardiovascular and Metabolic Diseases (I2MC) UMR1297, University Hospital of Toulouse, 31432 Toulouse, France;
- Department of Neurology, University Hospital of Toulouse, 31059 Toulouse, France
| | - Sirine Hammoud
- Department of Ophthalmology, Glaucoma Institute, Saint Joseph Hospital, 75014 Paris, France;
| | - Laurence Mahieu
- Department of Ophthalmology, University Hospital of Toulouse, 31059 Toulouse, France; (L.M.); (V.S.)
| | - Thomas Geeraerts
- Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, 31059 Toulouse, France;
| | - Arnaud Beck
- Institute for Space Medicine and Physiology (MEDES), 31405 Toulouse, France; (A.B.); (M.-P.B.)
| | - Marie-Pierre Bareille
- Institute for Space Medicine and Physiology (MEDES), 31405 Toulouse, France; (A.B.); (M.-P.B.)
| | - Vincent Soler
- Department of Ophthalmology, University Hospital of Toulouse, 31059 Toulouse, France; (L.M.); (V.S.)
| | - Anne Pavy-Le Traon
- INSERM DR Midi-Pyrénées Limousin, Institute of Cardiovascular and Metabolic Diseases (I2MC) UMR1297, University Hospital of Toulouse, 31432 Toulouse, France;
- Department of Neurology, University Hospital of Toulouse, 31059 Toulouse, France
- Correspondence: (A.P.-L.T.); (J.-C.Q.)
| | - Jean-Claude Quintyn
- Department of Ophthalmology, Unicaen, University Hospital of Caen, 14033 Caen, France
- Correspondence: (A.P.-L.T.); (J.-C.Q.)
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5
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Olsen MH, Riberholt CG, Plovsing RR, Møller K, Berg RMG. Reliability of the mean flow index (Mx) for assessing cerebral autoregulation in healthy volunteers. Physiol Rep 2021; 9:e14923. [PMID: 34173717 PMCID: PMC8234479 DOI: 10.14814/phy2.14923] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Mean flow index (Mxa) for evaluating dynamic cerebral autoregulation is derived using varying approaches for calculation, which may explain that the reliability ranges from poor to excellent. The comparability, repeatability, stability, and internal consistency of approaches have not previously been assessed. METHODS We included 60 recordings from resting healthy volunteers and calculated Mxa using four different approaches: three without overlapping calculations, using intervals for averaging wave-form data (blocks) of 3, 6, and 10 s, and correlation periods (epochs) of 60, 240, and 300 s (3-60-F, 6-240-F, and 10-300-F); and one using 10-second blocks, 300 s epochs, and overlaps of 60 s (10-300-60). The comparability between the approaches was assessed using Student's t test, intraclass correlation coefficients (ICC), and Bland-Altman plot. RESULTS Overall, 3-60-F resulted in a higher Mxa than the other indices (p < 0.001, for all). The reliability when comparing all the approaches ranged from moderate to good (ICC: 0.68; 95%CI: 0.59-0.84), which was primarily due to similarities between 10-300-F and 10-300-60 (ICC: 0.94; 95%CI: 0.86-0.98). The reliability when comparing the first and last half was poor for 10-300-F and ranged from poor to moderate for the other approaches. Additional random artifacts resulted in poor reliability for 10-300-F, while the other approaches were more stable. CONCLUSIONS Mxa in general has a low sensitivity to artifacts, but otherwise seems highly dependent on the approach, with a repeatability that is moderate at best. The varying accuracy and precision renders Mxa unreliable for classifying impaired cerebral autoregulation when using healthy adults for comparison.
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Affiliation(s)
- Markus H. Olsen
- Department of NeuroanaesthesiologyCopenhagen University HospitalRigshospitaletDenmark
| | - Christian G. Riberholt
- Department of NeuroanaesthesiologyCopenhagen University HospitalRigshospitaletDenmark
- Department of Neurorehabilitation / Traumatic Brain Injury UnitCopenhagen University HospitalRigshospitaletDenmark
| | - Ronni R. Plovsing
- Department of AnaesthesiaHvidovre HospitalUniversity of CopenhagenCopenhagenDenmark
- Institute of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Kirsten Møller
- Department of NeuroanaesthesiologyCopenhagen University HospitalRigshospitaletDenmark
- Institute of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Ronan M. G. Berg
- Department of Clinical Physiology, Nuclear Medicine & PETCopenhagen University HospitalRigshospitaletDenmark
- Centre for Physical Activity ResearchCopenhagen University HospitalRigshospitaletDenmark
- Department of Biomedical SciencesFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Neurovascular Research LaboratoryFaculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
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6
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Du J, Cui J, Yang J, Wang P, Zhang L, Luo B, Han B. Alterations in Cerebral Hemodynamics During Microgravity: A Literature Review. Med Sci Monit 2021; 27:e928108. [PMID: 33446627 PMCID: PMC7814510 DOI: 10.12659/msm.928108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Most reported neurological symptoms that happen after exposure to microgravity could be originated from alterations in cerebral hemodynamics. The complicated mechanisms involved in the process of hemodynamics and the disparate experimental protocols designed to study the process may have contributed to the discrepancies in results between studies and the lack of consensus among researchers. This literature review examines spaceflight and ground-based studies of cerebral hemodynamics and aims to summarize the underlying physiological mechanisms that are altered in cerebral hemodynamics during microgravity. We reviewed studies that were published before July 2020 and sought to provide a comprehensive summary of the physiological or pathological theories of hemodynamics and to arrive at firm conclusions from incongruous results that were reported in those related articles. We give plausible explanations of inconsistent results on factors including intracranial pressure, cerebral blood flow, and cerebrovascular autoregulation. Although there are no definitive data to confirm how cerebral hemodynamics changes during microgravity, every discrepancy in results was interpreted by existing theories, which were derived from physiological and pathological processes. We conclude that microgravity-induced alterations of hemodynamics at the brain level are multifaceted. Factors including duration, partial pressures of carbon dioxide, and individual adaptability contribute to this process and are unpredictable. With a growing understanding of this hemodynamics model, additional factors will likely be considered. Aiming for a full understanding of the physiological and/or pathological changes of hemodynamics will enable researchers to investigate its cellular and molecular mechanisms in future studies, which are desperately needed.
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Affiliation(s)
- Jichen Du
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Jiangbo Cui
- Aerospace Clinic Academy, Peking University Health Science Center, Beijing, China (mainland)
| | - Jing Yang
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Peifu Wang
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Lvming Zhang
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Bin Luo
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Bailin Han
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
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7
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Buoite Stella A, Ajčević M, Furlanis G, Manganotti P. Neurophysiological adaptations to spaceflight and simulated microgravity. Clin Neurophysiol 2020; 132:498-504. [PMID: 33450569 DOI: 10.1016/j.clinph.2020.11.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 11/12/2020] [Accepted: 11/29/2020] [Indexed: 01/03/2023]
Abstract
Changes in physiological functions after spaceflight and simulated spaceflight involve several mechanisms. Microgravity is one of them and it can be partially reproduced with models, such as head down bed rest (HDBR). Yet, only a few studies have investigated in detail the complexity of neurophysiological systems and their integration to maintain homeostasis. Central nervous system changes have been studied both in their structural and functional component with advanced techniques, such as functional magnetic resonance (fMRI), showing the main involvement of the cerebellum, cortical sensorimotor, and somatosensory areas, as well as vestibular-related pathways. Analysis of electroencephalography (EEG) led to contrasting results, mainly due to the different factors affecting brain activity. The study of corticospinal excitability may enable a deeper understanding of countermeasures' effect, since greater excitability has been shown being correlated with better preservation of functions. Less is known about somatosensory evoked potentials and peripheral nerve function, yet they may be involved in a homeostatic mechanism fundamental to thermoregulation. Extending the knowledge of such alterations during simulated microgravity may be useful not only for space exploration, but for its application in clinical conditions and for life on Earth, as well.
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Affiliation(s)
- Alex Buoite Stella
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Miloš Ajčević
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy; Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio, 6/1, 34127 Trieste, Italy
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy.
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8
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Kashirina DN, Brzhozovskiy AG, Pastushkova LK, Kononikhin AS, Borchers CH, Nikolaev EN, Larina IM. Semiquantitative Proteomic Research of Protein Plasma Profile of Volunteers in 21-Day Head-Down Bed Rest. Front Physiol 2020; 11:678. [PMID: 32848806 PMCID: PMC7396636 DOI: 10.3389/fphys.2020.00678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/26/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
- Daria N Kashirina
- Institute of Biomedical Problems-Russian Federation State Scientific Research Center, Russian Academy of Sciences, Moscow, Russia
| | - Alexander G Brzhozovskiy
- Institute of Biomedical Problems-Russian Federation State Scientific Research Center, Russian Academy of Sciences, Moscow, Russia.,CDISE, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Ludmila Kh Pastushkova
- Institute of Biomedical Problems-Russian Federation State Scientific Research Center, Russian Academy of Sciences, Moscow, Russia
| | - Alexey S Kononikhin
- Institute of Biomedical Problems-Russian Federation State Scientific Research Center, Russian Academy of Sciences, Moscow, Russia.,CDISE, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Christoph H Borchers
- CDISE, Skolkovo Institute of Science and Technology, Moscow, Russia.,Department Oncology, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | | | - Irina M Larina
- Institute of Biomedical Problems-Russian Federation State Scientific Research Center, Russian Academy of Sciences, Moscow, Russia
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9
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Navasiolava N, Yuan M, Murphy R, Robin A, Coupé M, Wang L, Alameddine A, Gauquelin-Koch G, Gharib C, Li Y, Custaud MA. Vascular and Microvascular Dysfunction Induced by Microgravity and Its Analogs in Humans: Mechanisms and Countermeasures. Front Physiol 2020; 11:952. [PMID: 32973543 PMCID: PMC7468431 DOI: 10.3389/fphys.2020.00952] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/14/2020] [Indexed: 12/19/2022] Open
Abstract
Weightlessness and physical inactivity have deleterious cardiovascular effects. The space environment and its ground-based models offer conditions to study the cardiovascular effects of physical inactivity in the absence of other vascular risk factors, particularly at the macro- and microcirculatory levels. However, the mechanisms involved in vascular dysfunction and remodeling are not sufficiently studied in the context of weightlessness and its analogs including models of physical inactivity. Here, we summarize vascular and microvascular changes induced by space flight and observed in models of microgravity and physical inactivity and review the effects of prophylactic strategies (i.e., countermeasures) on vascular and microvascular function. We discuss physical (e.g., exercise, vibration, lower body negative pressure, and artificial gravity) and nutritional/pharmacological (e.g., caloric restriction, resveratrol, and other vegetal extracts) countermeasures. Currently, exercise countermeasure appears to be the most effective to protect vascular function. Although pharmacological countermeasures are not currently considered to fight vascular changes due to microgravity, nutritional countermeasures are very promising. Dietary supplements/natural health products, especially plant extracts, should be extensively studied. The best prophylactic strategy is likely a combination of countermeasures that are effective not only at the cardiovascular level but also for the organism as a whole, but this strategy remains to be determined.
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Affiliation(s)
| | - Ming Yuan
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center (ACC), Beijing, China
| | - Ronan Murphy
- School of Health and Human Performance, Faculty of Science & Health, Dublin City University, Dublin, Ireland
| | - Adrien Robin
- Clinical Research Center, CHU d'Angers, Angers, France.,Mitovasc, UMR INSERM 1083-CNRS 6015, Université d'Angers, Angers, France
| | - Mickael Coupé
- Mitovasc, UMR INSERM 1083-CNRS 6015, Université d'Angers, Angers, France
| | - Linjie Wang
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center (ACC), Beijing, China
| | - Asmaa Alameddine
- Mitovasc, UMR INSERM 1083-CNRS 6015, Université d'Angers, Angers, France
| | | | - Claude Gharib
- Institut NeuroMyoGène, Faculté de Médecine Lyon-Est, Université de Lyon, Lyon, France
| | - Yinghui Li
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center (ACC), Beijing, China
| | - Marc-Antoine Custaud
- Clinical Research Center, CHU d'Angers, Angers, France.,Mitovasc, UMR INSERM 1083-CNRS 6015, Université d'Angers, Angers, France
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10
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Guinet P, MacNamara JP, Berry M, Larcher F, Bareille MP, Custaud MA, Pavy-Le Traon A, Levine BD, Navasiolava N. MNX (Medium Duration Nutrition and Resistance-Vibration Exercise) Bed-Rest: Effect of Resistance Vibration Exercise Alone or Combined With Whey Protein Supplementation on Cardiovascular System in 21-Day Head-Down Bed Rest. Front Physiol 2020; 11:812. [PMID: 32765296 PMCID: PMC7378749 DOI: 10.3389/fphys.2020.00812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/18/2020] [Indexed: 12/20/2022] Open
Abstract
Current inflight countermeasures do not completely prevent bone and cardiovascular changes induced by microgravity. High load Resistance Exercise combined with whole body Vibration (RVE) demonstrated benefits on bone and cardiovascular system during previous Head-Down Bed Rest (HDBR) studies. We examined the effectiveness of RVE alone or combined with a nutritional supplementation of Whey protein (NeX) on cardiovascular deconditioning. Eight male subjects (age 34 ± 8 years) in a crossover design completed three 21-day HDBR campaigns (Control-CON, RVE, and NeX). Pre and post HDBR Orthostatic Tolerance (OT) was evaluated by a 15-min head-up tilt test followed by increasing levels of Lower Body Negative Pressure (LBNP). Heart rate (HR), blood pressure (BP), and Sympathetic Index (ΣI) through spectral analysis were measured during OT test. Plasma Volume (PV), and Maximal Oxygen Uptake (VO2max) were measured before and after each campaign. Left ventricular mass, left ventricular end diastolic (LVEDV), end systolic (LVESV), stroke (SV) volumes, and circumferential deformation at rest and during an orthostatic stress simulated by a 30 mmHg LBNP were measured by cardiac MRI. RVE failed to prevent any change in these variables and NeX did not have any additional effect over exercise alone. In the 3 groups, (1) OT time dropped similarly (bed rest p < 0.001), (2) HR and ΣI were increased at rest at the end of HDBR and HR increased markedly during LBNP-tilt test, with inability to increase further the ΣI, (3) PV dropped (bed rest p < 0.001), along with LVEDV, LVESV and SV (p = 0.08, p < 0.001, and p = 0.045, respectively), (4) Left ventricle mass did not change significantly, (5) Deformation of the heart assessed by global circumferential strain was preserved and early diastolic circumferential strain rate was increased during orthostatic stress at the end of HDBR, illustrating preserved systolic and diastolic function respectively, without any difference between groups. Despite the drop in PV and LV volumes, RVE and NeX tended to alleviate the decrease in VO2max. In conclusion, RVE and NeX failed to prevent the cardiovascular deconditioning induced by a 21 day-HDBR.
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Affiliation(s)
- Patrick Guinet
- Département d’Anesthésie Réanimation, Centre Hospitalier Universitaire de Rennes, Rennes, France
- Centre Hospitalier de Fougères, Fougères, France
| | - James Patrick MacNamara
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | | | - Françoise Larcher
- Laboratoire de Biochimie, Centre Hospitalier Universitaire d’Angers, Angers, France
| | | | - Marc-Antoine Custaud
- Centre de Recherche Clinique, Centre Hospitalier Universitaire d’Angers, Angers, France
- Mitovasc UMR INSERM 1083-CNRS 6015, Université d’Angers, Angers, France
| | - Anne Pavy-Le Traon
- Department of Neurology, French Reference Center for MSA, University Hospital of Toulouse, Toulouse, France
- Institute of Cardiovascular and Metabolic Diseases INSERM U 1048, Toulouse, France
| | - Benjamin D. Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Nastassia Navasiolava
- Centre de Recherche Clinique, Centre Hospitalier Universitaire d’Angers, Angers, France
- Mitovasc UMR INSERM 1083-CNRS 6015, Université d’Angers, Angers, France
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11
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Kermorgant M, Nasr N, Czosnyka M, Arvanitis DN, Hélissen O, Senard JM, Pavy-Le Traon A. Impacts of Microgravity Analogs to Spaceflight on Cerebral Autoregulation. Front Physiol 2020; 11:778. [PMID: 32719617 PMCID: PMC7350784 DOI: 10.3389/fphys.2020.00778] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/15/2020] [Indexed: 12/16/2022] Open
Abstract
It is well known that exposure to microgravity in astronauts leads to a plethora physiological responses such as headward fluid shift, body unloading, and cardiovascular deconditioning. When astronauts return to Earth, some encounter problems related to orthostatic intolerance. An impaired cerebral autoregulation (CA), which could be compromised by the effects of microgravity, has been proposed as one of the mechanisms responsible for orthostatic intolerance. CA is a homeostatic mechanism that maintains cerebral blood flow for any variations in cerebral perfusion pressure by adapting the vascular tone and cerebral vessel diameter. The ground-based models of microgravity are useful tools for determining the gravitational impact of spaceflight on human body. The head-down tilt bed rest (HDTBR), where the subject remains in supine position at -6 degrees for periods ranging from few days to several weeks is the most commonly used ground-based model of microgravity for cardiovascular deconditioning. head-down bed rest (HDBR) is able to replicate cephalic fluid shift, immobilization, confinement, and inactivity. Dry immersion (DI) model is another approach where the subject remains immersed in thermoneutral water covered with an elastic waterproof fabric separating the subject from the water. Regarding DI, this analog imitates absence of any supporting structure for the body, centralization of body fluids, immobilization and hypokinesia observed during spaceflight. However, little is known about the impact of microgravity on CA. Here, we review the fundamental principles and the different mechanisms involved in CA. We also consider the different approaches in order to assess CA. Finally, we focus on the effects of short- and long-term spaceflight on CA and compare these findings with two specific analogs to microgravity: HDBR and DI.
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Affiliation(s)
- Marc Kermorgant
- INSERM UMR 1048, Institute of Cardiovascular and Metabolic Diseases (I2MC), Toulouse, France
| | - Nathalie Nasr
- INSERM UMR 1048, Institute of Cardiovascular and Metabolic Diseases (I2MC), Toulouse, France
- Department of Neurology, Institute for Neurosciences, Toulouse University Hospital, Toulouse, France
| | - Marek Czosnyka
- Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge University Hospital, Cambridge, United Kingdom
- Institute of Electronic Systems, Warsaw University of Technology, Warsaw, Poland
| | - Dina N. Arvanitis
- INSERM UMR 1048, Institute of Cardiovascular and Metabolic Diseases (I2MC), Toulouse, France
| | - Ophélie Hélissen
- INSERM UMR 1048, Institute of Cardiovascular and Metabolic Diseases (I2MC), Toulouse, France
| | - Jean-Michel Senard
- INSERM UMR 1048, Institute of Cardiovascular and Metabolic Diseases (I2MC), Toulouse, France
- Department of Clinical Pharmacology, Toulouse University Hospital, Toulouse, France
| | - Anne Pavy-Le Traon
- INSERM UMR 1048, Institute of Cardiovascular and Metabolic Diseases (I2MC), Toulouse, France
- Department of Neurology, Institute for Neurosciences, Toulouse University Hospital, Toulouse, France
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Laurie SS, Christian K, Kysar J, Lee SMC, Lovering AT, Macias BR, Moestl S, Sies W, Mulder E, Young M, Stenger MB. Unchanged cerebrovascular CO 2 reactivity and hypercapnic ventilatory response during strict head-down tilt bed rest in a mild hypercapnic environment. J Physiol 2020; 598:2491-2505. [PMID: 32196672 DOI: 10.1113/jp279383] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/16/2020] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Carbon dioxide levels are mildly elevated on the International Space Station and it is unknown whether this chronic exposure causes physiological changes to astronauts. We combined ∼4 mmHg ambient P C O 2 with the strict head-down tilt bed rest model of spaceflight and this led to the development of optic disc oedema in one-half of the subjects. We demonstrate no change in arterialized P C O 2 , cerebrovascular reactivity to CO2 or the hypercapnic ventilatory response. Our data suggest that the mild hypercapnic environment does not contribute to the development of spaceflight associated neuro-ocular syndrome. ABSTRACT Chronically elevated carbon dioxide (CO2 ) levels can occur in confined spaces such as the International Space Station. Using the spaceflight analogue 30 days of strict 6° head-down tilt bed rest (HDTBR) in a mild hypercapnic environment ( P C O 2 = ∼4 mmHg), we investigated arterialized P C O 2 , cerebrovascular reactivity and the hypercapnic ventilatory response in 11 healthy subjects (five females) before, on days 1, 9, 15 and 30 of bed rest (BR), and 6 and 13 days after HDTBR. During all HDTBR time points, arterialized P C O 2 was not significantly different from the pre-HDTBR measured in the 6° HDT posture, with a mean (95% confidence interval) increase of 1.2 mmHg (-0.2 to 2.5 mmHg, P = 0.122) on day 30 of HDTBR. Respiratory acidosis was never detected, although a mild metabolic alkalosis developed on day 30 of HDTBR by a mean (95% confidence interval) pH change of 0.032 (0.022-0.043; P < 0.001), which remained elevated by 0.021 (0.011-0.031; P < 0.001) 6 days after HDTBR. Arterialized pH returned to pre-HDTBR levels 13 days after BR with a change of -0.001 (-0.009 to 0.007; P = 0.991). Compared to pre-HDTBR, cerebrovascular reactivity during and after HDTBR did not change. Baseline ventilation, ventilatory recruitment threshold and the slope of the ventilatory response were similar between pre-HDTBR and all other time points. Taken together, these data suggest that the mildly increased ambient P C O 2 combined with 30 days of strict 6° HDTBR did not change arterialized P C O 2 levels. Therefore, the experimental conditions were not sufficient to elicit a detectable physiological response.
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Affiliation(s)
| | - Kate Christian
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | - Jacob Kysar
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | | | - Andrew T Lovering
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
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