Cerebral Blood Flow Clinical Trial
Official title:
Effet de l'Impesanteur Sur la Distribution du débit Sanguin cérébral.
When astronauts return from space flight, they manifest a set of symptoms, the most striking
of which is orthostatic intolerance, that is, the inability to stay upright. This orthostatic
intolerance is related to cardiovascular adaptation and disappears in a few days, but the
prospect of long-term space travel makes this maladaptation a major concern of space
agencies, at a time when there is serious consideration to make " land "a ship on Mars.
Previous studies suggest that brain vessel adaptation may contribute to spatial post-flight
orthostatic intolerance. The question remains controversial because not all studies are
consistent. These studies are all based on the measurement of blood flow in a single artery
of the brain (the average cerebral, see cerebral circulation diagram) easily accessible with
a Doppler ultrasound machine. Our team has good reason to believe that the adaptation of the
cerebral vessels is not carried out in the same way in all the arteries of the brain and that
in particular the arteries that irrigate the posterior and inferior parts of the brain are a
major determinant. from cerebrovascular adaptation to orthostatism and that orthostatic
intolerance is more specifically related to a decrease in blood flow in these arteries. On
the other hand our team has shown that the external carotid artery plays, under certain
conditions, a buffer role of the sudden variations of perfusion pressure of the brain.
During the weightless phase of parabolic flight, part of the blood from the legs and abdomen
"rises" to the thorax and this transfer of fluid induces changes in blood pressure and
cardiac output that affect the cerebral circulation. From a cardiovascular point of view, it
is the same thing for a seated subject to lie down, but the parabolic flight offers the
unique possibility of achieving this transfer in a fraction of a second and thus allowing to
study the immediate response of the cerebral circulation. .
Investigators goal is therefore to quantify the changes in blood flow in the posterior and
anterior territories of the brain (transcranial ultrasound) as well as in the internal
carotid and vertebral (Doppler ultrasound) during changes in blood pressure and cardiac
output induced by transfers. liquid resources associated with the transition to
weightlessness.
The oxidative stress generated by weightlessness has been identified as a determining factor
in cerebrovascular deconditioning associated with orthostatic intolerance. In order to
quantify the biochemical markers of this stress, a venous sample will be taken before and
just after the parabolic flight.
Parabolic flights make it possible to produce a reduced gravity environment on Earth. With
the specially adapted A310 Zero-G, each parable produces a period of zero gravity ("0g"). The
duration of the periods of reduced gravity is about 21 seconds. Each parable begins and ends
with a resource (hyper-gravity) at 1.8 g; each resource lasts about 20 seconds. A typical
flight lasts from two to three hours and includes 30 parabolic maneuvers, usually all in
weightlessness.
Participants will arrive at Novespace, at Bordeaux-Mérignac Airport, no later than 2 pm the
day before the first flight of the campaign in order to participate in the security briefing.
A delay of at least 2 hours will be granted before collection of their written consent.
Before the flight, the participants will necessarily participate in the safety briefing (2h,
organized by the Flight Manager (Novespace) and will meet the research team to become
familiar with the procedures and devices that will be used during the experiment.
On the day of the flight, the participants will have to arrive at the premises of Novespace
before 7.30am.
Before the flight, they will be prepared for flight recordings. Seven self-adhesive
electrodes will be placed on the chest to measure the electrical activity of the heart and
the blood volume in the chest.
A venous blood test to measure blood markers of oxidative stress will be performed by a
doctor or a registered nurse.
Doppler and ultrasound operators will make blood flow measurements in the vertebral, internal
carotid, posterior cerebral and anterior cerebral arteries) using an echo-doppler device.
These measures are strictly non-invasive and painless. Participants can take medication
against motion sickness under the supervision of the flight doctor. The duration of the study
is a little less than 6 hours (2 hours before the flight, 3 hours flight, 30 minutes after
the flight).
Preparation before parables, in the plane. In addition to the participant, two other subjects
will be the participants of the flight, one will also be a subject, and the third will be a
rescue participant who will be tested in case the subject or his partner falls ill during the
flight. The flight includes 31 parables, but the first participant will be subject only for
16 parables and the second for 15.
When it is not subject, the participant is rid of equipment and can join the so-called "free
floating" area to enjoy the sensations of weightlessness.
After takeoff, but before the first parable the subject (or the other participant) will sit
on a chair built for the flight. His pelvis will be immobilized by restraints to prevent him
from floating freely during the weightlessness.
It will be connected to different measuring equipment, all non-invasive:
An arterial pressure sensor on the finger. Electrotrocardiogram (connected to 3 self-adhesive
electrodes) Thoracic impedance meter (connected to 4 self-adhesive electrodes) An oxygen
scope (for measuring the expired CO2).
During the flight During each phase of weightlessness, an operator will apply on the neck or
skull of the subject an ultrasound measurement probe (as on the ground). We recommend that
participants do not move their head, especially during periods of hypergravity, to prevent
motion sickness.
Except in exceptional circumstances, the aircraft normally completes the mission, but it must
be clear that the subject is free to withdraw his consent and participation in the experiment
at any time, without prejudice to him or to any other reason, without justification,
including during the flight.
After the flight Following the flight, a second venous sample will be made to determine the
effects of weightlessness on the markers of oxidative stress.
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