Larry A Kramer1, Khader M Hasan1, Ashot E Sargsyan2, Jerry S Wolinsky3, Douglas R Hamilton4, Roy F Riascos1, William K Carson1, Jared Heimbigner1, Vipulkumar S Patel1, Seferino Romo1, Christian Otto5,6. 1. Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, Texas, USA. 2. Wyle Integrated Science and Engineering, Houston, Texas, USA. 3. Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA. 4. Division of General Internal Medicine, University of Calgary, Calgary, Alberta, Canada. 5. Universities Space Research Association, Houston, Texas, USA. 6. Baylor College of Medicine, Section of Emergency Medicine, Houston, Texas, USA.
Abstract
PURPOSE: To quantify the change in cerebral spinal fluid (CSF) production rate and maximum systolic velocity in astronauts before and after exposure to microgravity and identify any physiologic trend and/or risk factor related to intracranial hypertension. MATERIALS AND METHODS: Following Institutional Review Board (IRB) approval, with waiver of informed consent, a retrospective review of 27 astronauts imaged at 3T was done. Qualitative analysis was performed on T2 -weighted axial images through the orbits for degree of flattening of the posterior globe according to the following grades: 0 = none, 1 = mild, 2 = moderate, and 3 = severe. One grade level change postflight was considered significant for exposure to intracranial hypertension. CSF production rate and maximum systolic velocity was calculated from cine phase-contrast magnetic resonance imaging and compared to seven healthy controls. RESULTS: Fourteen astronauts were studied. The preflight CSF production rate in astronauts was similar to controls (P = 0.83). Six astronauts with significant posterior globe flattening demonstrated a 70% increase in CSF production rate postflight compared to baseline (P = 0.01). There was a significant increase in CSF maximum systolic velocity in the subgroup without posterior globe flattening (P = 0.01). CONCLUSION: The increased postflight CSF production rate in astronauts with positive flattening is compatible with the hypothesis of microgravity-induced intracranial hypertension inferring downregulation in CSF production in microgravity that is upregulated upon return to normal gravity. Increased postflight CSF maximum systolic velocity in astronauts with negative flattening suggests increased craniospinal compliance and a potential negative risk factor to microgravity-induced intracranial hypertension.
PURPOSE: To quantify the change in cerebral spinal fluid (CSF) production rate and maximum systolic velocity in astronauts before and after exposure to microgravity and identify any physiologic trend and/or risk factor related to intracranial hypertension. MATERIALS AND METHODS: Following Institutional Review Board (IRB) approval, with waiver of informed consent, a retrospective review of 27 astronauts imaged at 3T was done. Qualitative analysis was performed on T2 -weighted axial images through the orbits for degree of flattening of the posterior globe according to the following grades: 0 = none, 1 = mild, 2 = moderate, and 3 = severe. One grade level change postflight was considered significant for exposure to intracranial hypertension. CSF production rate and maximum systolic velocity was calculated from cine phase-contrast magnetic resonance imaging and compared to seven healthy controls. RESULTS: Fourteen astronauts were studied. The preflight CSF production rate in astronauts was similar to controls (P = 0.83). Six astronauts with significant posterior globe flattening demonstrated a 70% increase in CSF production rate postflight compared to baseline (P = 0.01). There was a significant increase in CSF maximum systolic velocity in the subgroup without posterior globe flattening (P = 0.01). CONCLUSION: The increased postflight CSF production rate in astronauts with positive flattening is compatible with the hypothesis of microgravity-induced intracranial hypertension inferring downregulation in CSF production in microgravity that is upregulated upon return to normal gravity. Increased postflight CSF maximum systolic velocity in astronauts with negative flattening suggests increased craniospinal compliance and a potential negative risk factor to microgravity-induced intracranial hypertension.
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Authors: Angelique Van Ombergen; Steven Jillings; Ben Jeurissen; Elena Tomilovskaya; Alena Rumshiskaya; Liudmila Litvinova; Inna Nosikova; Ekaterina Pechenkova; Ilya Rukavishnikov; Olga Manko; Sergey Danylichev; R Maxine Rühl; Inessa B Kozlovskaya; Stefan Sunaert; Paul M Parizel; Valentin Sinitsyn; Steven Laureys; Jan Sijbers; Peter Zu Eulenburg; Floris L Wuyts Journal: Proc Natl Acad Sci U S A Date: 2019-05-06 Impact factor: 11.205
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