Intracranial pressure dynamics assessed by noninvasive ultrasound during 30 days of bed rest

Intracranial pressure (ICP) may be an important contributor to symptoms of space adaptation syndrome during the initial days of microgravity exposure. The temporary nature of these symptoms suggests that some physiologic adaptation or compensation occurs. Fluid shifts similar to those in microgravity can be simulated on Earth using head-down tilt (HDT) bed rest. This study was performed to calibrate a new noninvasive ICP instrument and to investigate ICP adaptation during 30 d of HDT bed rest.

A noninvasive ultrasound technique that measures small skull expansions with fluctuations in ICP was used to measure cranial oscillations before and near the end of 30-d HDT bed rest in eight healthy, male volunteers. Pulse phase-locked loop (PPLL) output voltage and arterial BP were continuously monitored and correlated.

The amplitude of intracranial distance pulsation decreased during 30-d bed rest. Prior to bed rest, the PPLL amplitude was 25 +/- 9 mV and this amplitude was reduced by 60% to 9 +/- 4 mV (a value consistent with that of upright posture) at the end of HDT bed rest (p = 0.01).

PPLL measurements of skull pulsations are acutely posture dependent, being significantly higher in supine and HDT as compared with upright posture. A cephalad fluid shift is probably the responsible mechanism. Our results indicate that there are adaptations to intracranial pooling of blood and tissue fluid during bed rest that reduce skull pulsation amplitudes to values similar to those obtained in normal upright posture. Detailed studies of the time course of cranial vessel and bone adaptations may provide insights into the potential adaptative mechanisms.