Thoracolumbar spine muscle size and composition changes in long-duration space missions

Muscle atrophy occurs with extended exposure to microgravity. This study quantified the overall muscle size, lean muscle area and fat infiltration changes pre- to post-flight that occur in the thoracic and lumbar spine with long-duration spaceflight. Pre- and post-flight magnetic resonance imaging (MRI) scans were obtained from 9 crewmembers on long-duration (≥6 months) International Space Station (ISS) missions. Muscle size was measured by the cross-sectional area (CSA) and lean muscle tissue by the functional cross-sectional area (FCSA). Muscle-fat infiltration (MFI) was measured by the mean pixel intensities of the MRI in fat and water phases. A mixed model with random subject effect was used to analyze pre- to post-flight changes. Significant decreases were seen in the quadratus lumborum muscle size (-1.8 ± 0.6% per month, p = 0.002) and lean muscle tissue content in the paraspinal muscles (-0.7 ± 0.2% per month, p ≤ 0.001). Fat infiltration increased significantly in the transversospinalis (+4.1 ± 1.0% per month, p ≤ 0.01) muscle. Treadmill exercise had a tendency to reduce fat content in the paraspinal and quadratus lumborum muscles, while counteracting muscle build-up only in the paraspinal muscles. Cycle ergometer exercise suggested benefits for the psoas muscle. Resistance training appeared to benefit lean muscle mass of most thoracolumbar muscles. Our findings highlight the need for countermeasures to prevent muscle atrophy and detrimental effects in muscle composition during long-duration spaceflight.