Space headache on Earth: Head-down-tilted bed rest studies simulating outer-space microgravity

Oosterhout, Wpj van; Terwindt, GM; Vein, Alla A.; Ferrari, Michel D.

doi:10.1177/0333102414536058

Cited by 15 publications

(9 citation statements)

References 23 publications

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“…[ 145 ] concluded that spaceflight triggered headaches, even without space motion sickness, in “super-healthy” men. In another study, HDT was identified as the cause of headache episodes, particularly on day one [ 146 ]. All of the data presented above supports the hypothesis that ICP spikes initially upon entry into space and may then undergo a relaxation process, although it may not necessarily recover to the 1 g baseline.…”

Section: The Ocular Environment In Spaceflightmentioning

confidence: 99%

Microgravity-Induced Fluid Shift and Ophthalmic Changes

Nelson

Mulugeta

Myers

2014

Life

121

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Although changes to visual acuity in spaceflight have been observed in some astronauts since the early days of the space program, the impact to the crew was considered minor. Since that time, missions to the International Space Station have extended the typical duration of time spent in microgravity from a few days or weeks to many months. This has been accompanied by the emergence of a variety of ophthalmic pathologies in a significant proportion of long-duration crewmembers, including globe flattening, choroidal folding, optic disc edema, and optic nerve kinking, among others. The clinical findings of affected astronauts are reminiscent of terrestrial pathologies such as idiopathic intracranial hypertension that are characterized by high intracranial pressure. As a result, NASA has placed an emphasis on determining the relevant factors and their interactions that are responsible for detrimental ophthalmic response to space. This article will describe the Visual Impairment and Intracranial Pressure syndrome, link it to key factors in physiological adaptation to the microgravity environment, particularly a cephalad shifting of bodily fluids, and discuss the implications for ocular biomechanics and physiological function in long-duration spaceflight.

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Section: The Ocular Environment In Spaceflightmentioning

confidence: 99%

Microgravity-Induced Fluid Shift and Ophthalmic Changes

Nelson

Mulugeta

Myers

2014

Life

121

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“…This is commonly accomplished through long duration head-down tilt bed rest studies, which have been shown to be a reliable simulation model. 21,22 An alternative model to bed rest is dry immersion, which involves immersing the participant in water with an elastic waterproof membrane. 23,24 The main drawback is that dry immersion studies typically last between 3 and 7 days and rarely beyond 56 days, which is a significantly shorter duration than most bed rest studies.…”

Section: Introductionmentioning

confidence: 99%

A comparison of exercise interventions from bed rest studies for the prevention of musculoskeletal loss

et al. 2019

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Musculoskeletal loss in actual or simulated microgravity occurs at a high rate. Bed rest studies are a reliable ground-based spaceflight analogue that allow for direct comparison of intervention and control participants. The aim of this review was to investigate the impact of exercise compared to no intervention on bone mineral density (BMD) and muscle cross-sectional area (muscle CSA) in bed rest studies relative to other terrestrial models. Eligible bed rest studies with healthy participants had an intervention arm with an exercise countermeasure and a control arm. A search strategy was implemented for MEDLINE. After screening, eight studies were identified for inclusion. Interventions included resistive exercise (RE), resistive vibration exercise (RVE), flywheel resistive exercise, treadmill exercise with lower body negative pressure (LBNP) and a zero-gravity locomotion simulator (ZLS). Lower limb skeletal sites had the most significant BMD losses, particularly at the hip which reduced in density by 4.59% ( p < 0.05) and the tibial epiphysis by 6% ( p < 0.05). Exercise attenuated bone loss at the hip and distal tibia compared to controls ( p < 0.05). Muscle CSA changes indicated that the calf and quadriceps were most affected by bed rest. Exercise interventions significantly attenuated loss of muscle mass. ZLS, LBNP treadmill and RE significantly attenuated bone and muscle loss at the hip compared to baseline and controls. Despite exercise intervention, high rates of bone loss were still observed. Future studies should consider adding bisphosphonates and pharmacological/nutrition-based interventions for consideration of longer-duration missions. These findings correlate to terrestrial bed rest settings, for example, stroke or spinal-injury patients.

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“…12 Previously, we reported that headache intensity and accompanying symptoms decreased with countermeasures in an on-Earth simulation model. 19 High-intensity exercise is suggested to decrease intracranial pressure 12 and could thereby also limit the burden of microgravity-induced headaches. Although our study was not primarily aimed at assessing the effects of countermeasures, astronauts did often report headache relief after sleep, exercise, rehydration, and coffee intake.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Clinical Features of Space Headache Experienced by Astronauts During Long-Haul Space Flights

van Oosterhout,

Perenboom,

Terwindt

et al. 2024

Neurology

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Background and Objectives Few anecdotal cases and 1 small retrospective study during short-duration space missions suggest that headache may occur early in flight, as part of the space motion syndrome. Whether headaches may also occur at later stages of space flights is unknown. We aimed to prospectively characterize the incidence, timing, clinical features, and management of space headaches during long-duration flights. Methods We prospectively evaluated the occurrence, characteristics, and evolution of space headaches and the effects of treatment and countermeasures during long-haul flights with onboard questionnaires and correlated them with prevailing temperature, pressure, and ambient O 2 and CO 2 levels, measured within the International Space Station. In addition, we analyzed retrospective headache data from a different astronaut cohort. Headache data were reported using descriptive statistics and correlation data with intraindividual logistic regression models. Astronauts were included through (inter)national aerospace organizations. Results In the prospective study, 22/24 (91.7%) astronauts (mean ± SD age: 46.6 ± 6.5 years, 95.8% male) experienced ≥1 episode of headache during a total of 3,596 space days. A total of 378 episodes were reported (median 9; range 1–128) with detailed information on 189. Phenotypically, 170/189 (89.9%) episodes were tension-type headache (TTH) and 19/189 (10.1%) were migraine. Episodes in the first week differed from those in later periods in terms of phenotype (migraine 12/51 [23.5%] vs 7/138 [5.1%]; TTH 39/51 [86.5%] vs 131/138 [94.9%]; overall p = 0.0002) and accompanying symptoms: nausea: 17.6% vs 6.9%, p = 0.05; vomiting: 9.8% vs 0.7%, p = 0.005; nasal congestion: 52.9% vs 29.7%, p = 0.004; facial edema: 41.2% vs 1.4%, p < 0.001; and duration ( p = 0.001). Severity and treatments were similar: acute antiheadache medication: 55.6%; other medication: 22.4%; and alternative treatments: 41.1%. Headache occurrence was not associated with temperature or ambient pressure/levels of O 2 and CO 2 (all p > 0.05). In the retrospective study, 23/42 (54.8%) astronauts (43.5 ± 7.2 years, 90.5% male) reported experiencing ≥1 headache episode during mission. Nasal congestion was the most common (8/33; 24.2%) accompanying symptom. Seventeen of 42 astronauts have been previously described. Discussion Astronauts during space flights frequently experience headaches. These most often have characteristics of TTHs but sometimes have migrainous features, particularly during the first week of flight in astronauts without a history of recurrent headaches before or after the space flight.

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Space headache on Earth: Head-down-tilted bed rest studies simulating outer-space microgravity

Cited by 15 publications

References 23 publications

Microgravity-Induced Fluid Shift and Ophthalmic Changes

Microgravity-Induced Fluid Shift and Ophthalmic Changes

A comparison of exercise interventions from bed rest studies for the prevention of musculoskeletal loss

Frequency and Clinical Features of Space Headache Experienced by Astronauts During Long-Haul Space Flights

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