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Lower body negative pressure reduces optic nerve sheath diameter during head-down tilt

Marshall-Goebel, K. and Terlevic, R. and Gerlach, Darius A. and Kuehn, S. and Mulder, E. and Rittweger, Jörn (2017) Lower body negative pressure reduces optic nerve sheath diameter during head-down tilt. Journal of Applied Physiology, 123 (5), pp. 1139-1144. American Physiological Society. DOI: 10.1152/japplphysiol.00256.2017 ISSN 8750-7587

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Abstract

The microgravity ocular syndrome (MOS) results in significant structural and functional ophthalmic changes during 6-mo spaceflight missions consistent with an increase in cerebrospinal fluid (CSF) pressure compared with the preflight upright position. A ground-based study was performed to assess two of the major hypothesized contributors to MOS, headward fluid shifting and increased ambient CO2, on intracranial and periorbital CSF. In addition, lower body negative pressure (LBNP) was assessed as a countermeasure to headward fluid shifting. Nine healthy male subjects participated in a crossover design study with five head-down tilt (HDT) conditions: -6, -12, and -18° HDT, -12° HDT with -20 mmHg LBNP, and -12° HDT with a 1% CO2 environment, each for 5 h total. A three-dimensional volumetric scan of the cranium and transverse slices of the orbita were collected with MRI, and intracranial CSF volume and optic nerve sheath diameter (ONSD) were measured after 4.5 h HDT. ONSD increased during -6° (P < 0.001), -12° (P < 0.001), and -18° HDT (P < 0.001) and intracranial CSF increased during -12° HDT (P = 0.01) compared with supine baseline. Notably, LBNP was able to reduce the increases in ONSD and intracranial CSF during HDT. The addition of 1% CO2 during HDT, however, had no further effect on ONSD, but rather ONSD increased from baseline in a similar magnitude to -12° HDT with ambient air (P = 0.001). These findings demonstrate the ability of LBNP, a technique that targets fluid distribution in the lower limbs, to directly influence CSF and may be a promising countermeasure to help reduce increases in CSF.NEW & NOTEWORTHY This is the first study to demonstrate the ability of lower body negative pressure to directly influence cerebrospinal fluid surrounding the optic nerve, indicating potential use as a countermeasure for increased cerebrospinal fluid on Earth or in space.

Item URL in elib:https://elib.dlr.de/114151/
Document Type:Article
Title:Lower body negative pressure reduces optic nerve sheath diameter during head-down tilt
Authors:
AuthorsInstitution or Email of AuthorsAuthors ORCID iD
Marshall-Goebel, K.institute of aerospace medicine, german aerospace center (dlr)UNSPECIFIED
Terlevic, R.International Space University, Illkirch-Graffenstaden, FranceUNSPECIFIED
Gerlach, Darius A.Darius.Gerlach (at) dlr.dehttps://orcid.org/0000-0001-7044-6065
Kuehn, S.University Clinic Hamburg-Eppendorf, Clinic for Psychiatry and Psychotherapy, HamburgUNSPECIFIED
Mulder, E.german aerospace center (dlr), institute of aerospace medicine, space physiology, cologne, germanyUNSPECIFIED
Rittweger, JörnJoern.Rittweger (at) dlr.dehttps://orcid.org/0000-0002-2223-8963
Date:1 November 2017
Journal or Publication Title:Journal of Applied Physiology
Refereed publication:Yes
Open Access:No
Gold Open Access:No
In SCOPUS:Yes
In ISI Web of Science:Yes
Volume:123
DOI :10.1152/japplphysiol.00256.2017
Page Range:pp. 1139-1144
Publisher:American Physiological Society
ISSN:8750-7587
Status:Published
Keywords:carbon dioxide; cerebrospinal fluid; intracranial pressure; intracranial volumes; microgravity
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Forschung unter Weltraumbedingungen
DLR - Research theme (Project):R - Vorhaben Systemphysiologie
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine > Muscle and Bone Metabolism
Deposited By: Becker, Christine
Deposited On:30 Jan 2018 09:54
Last Modified:06 Sep 2019 15:27

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