LOWER-BODY NEGATIVE PRESSURE DECREASES NON-INVASIVELY MEASURED INTRACRANIAL PRESSURE AND INTERNAL JUGULAR VEIN CROSS-SECTIONAL AREA DURING HEAD-DOWN TILT

Introduction: Long-term space flight induces a near visual acuity change in approximately 50% of astronauts. In some crew members, postflight cerebrospinal fluid (CSF) opening pressures by lumbar puncture are as high as 20.9 mmHg who demonstrated optic disc edema. CSF communicates through the cochlear aqueduct to affect perilymphatic pressure and tympanic membrane motion. We hypothesized that 50 mmHg of lower-body negative pressure (LBNP) during 15° head-down tilt (HDT) would mitigate elevations in internal jugular vein cross-sectional area (IJV CSA) and intracranial pressure (ICP). Methods: Fifteen healthy adult volunteers were positioned in sitting (5 min), supine (5 min), 15° HDT (5 min), and 15° HDT with LBNP (10 min) postures for data collection. Evoked tympanic membrane displacements (TMD) quantified ICP noninvasively. IJV CSA was measured using standard ultrasound techniques. Results: ICP and IJV CSA increased significantly from the seated-upright to the 15° HDT posture (P < 0.05), and LBNP mitigated these increases. LBNP at 25 mmHg reduced ICP during HDT (TMD of 322.13 ± 419.17 nL) to 232.38 ± 445.85 nL, and at 50 mmHg ICP was reduced further to TMD of 199.76 ± 429.69 nL. In addition, 50 mmHg LBNP significantly reduced IJV CSA (1.50 ± 0.33 cm²) during 15° HDT to 0.83 ± 0.42 cm². Discussion: LBNP counteracts the headward fluid shift elevation of ICP and IJV CSA experienced during microgravity as simulated by 15° HDT . These data provide quantitative evidence that LBNP shifts cephalic fluid to the lower body, reducing IJV CSA and ICP.

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