From the Department of Radiology and Radiological Science, Division of Neuroradiology (D.R.R., M.H.A., H.R.C., D.A., A.R.C., M.V.S., M.U.A.), and the Department of Neurology (M.I.C.), Medical University of South Carolina, Charleston; the Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany (M.H.A.); and the Department of Psychology, Normal College, Shihezi University, Xinjiang, China (X.Z.).
N Engl J Med. 2017 Nov 2;377(18):1746-1753. doi: 10.1056/NEJMoa1705129.
There is limited information regarding the effects of spaceflight on the anatomical configuration of the brain and on cerebrospinal fluid (CSF) spaces.
We used magnetic resonance imaging (MRI) to compare images of 18 astronauts' brains before and after missions of long duration, involving stays on the International Space Station, and of 16 astronauts' brains before and after missions of short duration, involving participation in the Space Shuttle Program. Images were interpreted by readers who were unaware of the flight duration. We also generated paired preflight and postflight MRI cine clips derived from high-resolution, three-dimensional imaging of 12 astronauts after long-duration flights and from 6 astronauts after short-duration flights in order to assess the extent of narrowing of CSF spaces and the displacement of brain structures. We also compared preflight ventricular volumes with postflight ventricular volumes by means of an automated analysis of T-weighted MRIs. The main prespecified analyses focused on the change in the volume of the central sulcus, the change in the volume of CSF spaces at the vertex, and vertical displacement of the brain.
Narrowing of the central sulcus occurred in 17 of 18 astronauts after long-duration flights (mean flight time, 164.8 days) and in 3 of 16 astronauts after short-duration flights (mean flight time, 13.6 days) (P<0.001). Cine clips from a subgroup of astronauts showed an upward shift of the brain after all long-duration flights (12 astronauts) but not after short-duration flights (6 astronauts) and narrowing of CSF spaces at the vertex after all long-duration flights (12 astronauts) and in 1 of 6 astronauts after short-duration flights. Three astronauts in the long-duration group had optic-disk edema, and all 3 had narrowing of the central sulcus. A cine clip was available for 1 of these 3 astronauts, and the cine clip showed upward shift of the brain.
Narrowing of the central sulcus, upward shift of the brain, and narrowing of CSF spaces at the vertex occurred frequently and predominantly in astronauts after long-duration flights. Further investigation, including repeated postflight imaging conducted after some time on Earth, is required to determine the duration and clinical significance of these changes. (Funded by the National Aeronautics and Space Administration.).
关于航天飞行对大脑解剖结构和脑脊液(CSF)空间的影响,信息有限。
我们使用磁共振成像(MRI)比较了 18 名宇航员在长期任务前后(包括在国际空间站停留)和 16 名宇航员在短期任务前后(包括参与航天飞机计划)的大脑图像。阅读者在不知道飞行时间的情况下对图像进行了解读。我们还生成了来自 12 名宇航员在长期飞行后和 6 名宇航员在短期飞行后的高分辨率三维成像的配对飞行前和飞行后的 MRI 电影剪辑,以评估 CSF 空间变窄和脑结构移位的程度。我们还通过对 T 加权 MRI 的自动分析比较了飞行前和飞行后的脑室容积。主要的预设分析集中在中央沟体积的变化、顶点 CSF 空间体积的变化和大脑的垂直位移上。
在 18 名进行长期飞行(平均飞行时间 164.8 天)的宇航员中有 17 名和在 16 名进行短期飞行(平均飞行时间 13.6 天)的宇航员中有 3 名出现中央沟变窄(P<0.001)。来自亚组宇航员的电影剪辑显示,所有 12 名进行长期飞行的宇航员的大脑向上移位,但没有进行短期飞行的宇航员出现这种情况,所有 12 名进行长期飞行的宇航员的顶点 CSF 空间变窄,但只有 6 名进行短期飞行的宇航员出现这种情况。长期组中有 3 名宇航员出现视盘水肿,且所有 3 名宇航员都出现中央沟变窄。其中 1 名宇航员的电影剪辑可用,电影剪辑显示大脑向上移位。
中央沟变窄、大脑向上移位和顶点 CSF 空间变窄在长期飞行的宇航员中频繁发生,主要发生在这些宇航员中。需要进一步调查,包括在地球上一段时间后进行重复的飞行后成像,以确定这些变化的持续时间和临床意义。(由美国国家航空航天局资助)。