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Long duration spaceflight microgravity results in cephalad fluid shifts and deficits in posture control and locomotion. Effects of microgravity on sensorimotor function have been investigated on Earth using head down tilt bed rest (HDBR). HDBR serves as a spaceflight analogue because it mimics microgravity in body unloading and bodily fluid shifts. Preliminary results from our prior 70 days HDBR studies showed that HDBR is associated with focal gray matter (GM) changes and gait and balance deficits, as well as changes in brain functional connectivity. In consideration of the health and performance of crewmembers we investigated whether exercise reduces the effects of HDBR on GM, functional connectivity, and motor performance. Numerous studies have shown beneficial effects of exercise on brain health. We therefore hypothesized that an exercise intervention during HDBR could potentially mitigate the effects of HDBR on the central nervous system. Eighteen subjects were assessed before (12 and 7 days), during (7, 30, and ~70 days) and after (8 and 12 days) 70 days of 6-degrees HDBR at the NASA HDBR facility in UTMB, Galveston, TX, US. Each subject was randomly assigned to a control group or one of two exercise groups. Exercise consisted of daily supine exercise which started 20 days before the start of HDBR. The exercise subjects participated either in regular aerobic and resistance exercise (e.g. squat, heel raise, leg press, cycling and treadmill running), or aerobic and resistance exercise using a flywheel apparatus (rowing). Aerobic and resistance exercise intensity in both groups was similar, which is why we collapsed the two exercise groups for the current experiment. During each time point T1-weighted MRI scans and resting state functional connectivity scans were obtained using a 3T Siemens scanner. Focal changes over time in GM density were assessed using voxel based morphometry (VBM8) under SPM. Changes in resting state functional connectivity was assessed using both a region of interest (ROI, or seed-to-voxel) approach as well as a whole brain intrinsic connectivity (i.e., voxel-to-voxel) analysis. For the ROI analysis we selected 11 ROIs of brain regions that are involved in sensorimotor function (i.e., L. Insular C., L. Putamen, R. Premotor C., L.+R. Primary Motor C., R. Vestibular C., L. Posterior Cingulate G., R. Cerebellum Lobule V + VIIIb + Crus I, and the R. Superior Parietal G.) and correlated their time course of brain activation during rest with all other voxels in the brain. The whole brain connectivity analysis tests changes in the strength of the global connectivity pattern between each voxel and the rest of the brain. Functional mobility was assessed using an obstacle course. Vestibular contribution to balance was measured using Neurocom Sensory Organization Test 5. Behavioral measures were assessed pre-HDBR, and 0, 8 and 12 days post-HDBR. Linear mixed models were used to test for effects of time, group, and group-by-time interactions. Family-wise error corrected VBM revealed significantly larger increases in GM volume in the right primary motor cortex in bed rest control subjects than in bed rest exercise subjects. No other significant group by time interactions in gray matter changes with bed rest were observed. Functional connectivity MRI revealed that the increase in connectivity during bed rest of the left putamen with the bilateral midsagittal precunes and the right cingulate gyrus was larger in bed rest control subjects than in bed rest exercise subjects. Furthermore, the increase in functional connectivity with bed rest of the right premotor cortex with the right inferior frontal gyrus and the right primary motor cortex with the bilateral premotor cortex was smaller in bed rest control subjects than in bed rest exercise subjects. Functional mobility performance was less affected by HDBR in exercise subjects than in control subjects and post HDBR exercise subjects recovered faster than control subjects. The group performance differences and GM changes were not related. Exercise in HDBR partially mitigates the adverse effect of HDBR on functional mobility, particularly during the post-bed rest recovery phase. In addition, exercise appears to result in differential brain structural and functional changes in motor regions such as the primary motor cortex, the premotor cortex and the putamen. Whether these central nervous system changes are related to motor behavioral changes including gait and balance warrants further research.

Background: Moderate and high intensity aerobic or resistance exercise has clearly identified benefits for cardiac, muscle, and bone health. However, the impact of such exercise - either as a mitigating or an exacerbating factor - on the development of the visual impairment and intracranial pressure syndrome (VIIP) is unknown. Accordingly, our aim was to characterize the effect of an acute bout of resistance (RE), moderate-intensity continuous (CE), and high-intensity interval exercise (IE) during a cephalad fluid shift on cerebral-ocular hemodynamics and pressures. Methods: 10 male subjects (36 plus or minus 9 years) completed 4 testing days in a 15 degree head-down tilt (HDT): (1) assessment of maximum volume of O (sub 2), (2) RE session (4 sets of 12 repetition maximum leg press exercise), (3) CE session (30 minutes of cycling at 60 percent maximum volume of O (sub 2)), and (4) IE session (4 by 4-minute intervals of exercise at 85 percent maximum volume of O (sub 2) with 3-minute active rest periods). During each session, blood flow (Vivid-e, GE Healthcare) in extracranial arteries (common carotid artery, CCA; internal carotid artery, ICA; external carotid artery, ECA and vertebral artery, VA), and mean blood flow velocity in middle cerebral artery (MCA), internal jugular pressure (IJP; VeinPress), and intraocular pressure (IOP; Icare PRO) were measured at rest, at the end of each resistance or interval set, and every 5 minutes during continuous exercise. Translaminar pressure gradient (TLPG) was estimated by subtracting IJP from IOP. Results: There were no differences across days in pre-exercise resting blood flows or pressures. IOP decreased slightly from HDT rest (20.2 plus or minus 2.3 millimeters of mercury) to exercise (RE: 19.2 plus or minus 2.8 millimeters of mercury; CE: 18.9 plus or minus 3.2 millimeters of mercury; IE: 20.1 plus or minus 2.8 millimeters of mercury), while IJP decreased during CE (31.6 plus or minus 9.5 millimeters of mercury) and RE (32.0 plus or minus 8.1 millimeters of mercury), and increased during IE (35.1 plus or minus 9.5 millimeters of mercury) from HDT rest (33.3 plus or minus 6.5 millimeters of mercury). Estimated TLPG was increased during IE only. Compared to RE and CE, IE resulted in the greatest increase in MCA blood flow velocity and extracranial artery blood flow. Conclusions: These preliminary results suggest that high-intensity IE acutely increases cerebral blood flow, IJP, and TLPG. Alterations in TLPG is one mechanism that may contribute to optic nerve sheath edema in astronauts. Accordingly, acutely raising IOP and/or orbital pressure during exercise could optimize cerebral-ocular pressures during spaceflight.

Exposure to the microgravity conditions of spaceflight causes astronauts to experience alterations in multiple physiological systems. These physiological changes include sensorimotor disturbances, cardiovascular deconditioning, and loss of muscle mass and strength. Some or all of these changes might affect the ability of crewmembers to perform critical mission tasks immediately after landing on a planetary surface. The goals of the Functional Task Test (FTT) study were to determine the effects of spaceflight on functional tests that are representative of critical exploration mission tasks and to identify the key physiological factors that contribute to decrements in performance. The FTT was comprised of seven functional tests and a corresponding set of interdisciplinary physiological measures targeting the sensorimotor, cardiovascular and muscular changes associated with exposure to spaceflight. Both Shuttle and ISS crewmembers participated in this study. Additionally, we conducted a supporting study using the FTT protocol on subjects before and after 70 days of 6 head-down bed rest. The bed rest analog allowed us to investigate the impact of body unloading in isolation on both functional tasks and on the underlying physiological factors that lead to decrements in performance, and then to compare them with the results obtained in our spaceflight study. Spaceflight data were collected on three sessions before flight, on landing day (Shuttle only) and 1, 6 and 30 days after landing. Bed rest subjects were tested three times before bed rest and immediately after getting up from bed rest as well as 1, 6, and 12 days after reambulation. We have shown that for Shuttle, ISS and bed rest subjects, functional tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for postural stability (i.e. hatch opening, ladder climb, manual manipulation of objects and tool use) showed little reduction in performance. These changes in functional performance were paralleled by similar decrements in sensorimotor tests designed to specifically assess postural equilibrium and dynamic gait control. Bed rest subjects experienced similar deficits both in functional tests with balance challenges and in sensorimotor tests designed to evaluate postural and gait control as spaceflight subjects indicating that body support unloading experienced during spaceflight plays a central role in post-flight alteration of functional task performance. To determine how differences in body-support loading experienced during in-flight treadmill exercise affect postflight functional performance, the loading history for each subject during in-flight treadmill (T2) exercise was correlated with postflight measures of performance. ISS crewmembers who walked on the treadmill with higher pull-down loads had enhanced post-flight performance on tests requiring mobility. Taken together the spaceflight and bed rest data point to the importance of supplementing inflight exercise countermeasures with balance and sensorimotor adaptability training. These data also support the notion that inflight treadmill exercise performed with higher body loading provides sensorimotor benefits leading to improved performance on functional tasks that require dynamic postural stability and mobility.

The goals of the Functional Task Test (FTT) study were to determine the effects of spaceflight on functional tests that are representative of critical exploration mission tasks and to identify the physiological factors that contribute to decrements in performance.

This abstract describes development work performed on the NASA Digital Astronaut Project Muscle Model. Muscle atrophy is a known physiological response to exposure to a low gravity environment. The DAP muscle model computationally predicts the change in muscle structure and function vs. time in a reduced gravity environment. The spaceflight muscle model can then be used in biomechanical models of exercise countermeasures and spaceflight tasks to: 1) develop site specific bone loading input to the DAP bone adaptation model over the course of a mission; 2) predict astronaut performance of spaceflight tasks; 3) inform effectiveness of new exercise countermeasures concepts.