Sopite syndrome

NASA

It has been a very tough week. My wife had a sudden onset of central deterioration in her retina happening over a few weeks. Luckily she was operated on this past Monday so I am home nursing her back to healing health. Losing one eye’s vision as a result of the surgery is no simple operation. The surgeon yesterday was very blunt, “Look it takes 6 weeks for things to heal, this is your retina. You were losing vision capacity fast so the eye will take a hit first before you start to actually see improvement, but it’s not going back to 100%.”

Department of Ophthalmology McGill University

It could be worse it could always be worse the vision could have been lost completely. This morning she pointed at her pyjama leg designs, “Yesterday I couldn’t see the white stars on my PJ’s only the blurry blue of the color. I can see the white outline so I’m getting better.” That’s how we heal in increments of detail especially with something as central as vision. So right now it’s one day at a time, one day at a time.

As you may have noticed I have been writing a lot about vision over the past summer so having things change so close to home forces me to think about vision in a much more intense, appreciative light. I am reading a really great book on BALANCE in Search of the Lost Sense by Scott McCredie. This is a terrific book that gets to the heart that a lot of his observations are very important to how our visual sense interacts coordinates with our balance with our sense of where we are. I wrote a previous essay on Space Eyes how going into Earth orbit could give concussion like symptoms with exposure to micro-gravity for the astronauts going to the space station. I’m going to comment on his chapter nine entitled The Cognitive Connection and think out loud so to speak as I write, especially with my wife’s vision recovery so present on my mind.

McCredie introduces the term Space Stupids to describe what astronauts feel in terms of their vestibular orientation once they are into microgravity Earth orbit. So as I usually do I Google Space Eyes to see what are Space Stupids?   Is there any link with Space Eyes. Here we go, let’s check things out.

In a book entitled: Fundamentals of Space Medicine By Gilles Clément in the chapter The Neuro-Sensory System in Space on page 97 the term Space Stupids is described. Here is the authors descriptions. ” The information from the various sensory organs first reaches the brain stem and cerebellum. We are not consciously aware of what is on our busy body when we sit stand walk or run. However certain sensations eventually reach the cerebral cortex and through them we remain consciously aware of the relative positions of our body parts. Motion sickness may be caused by a conflict among sensory inputs through connections with the autonomic nervous system. ”

Yesterday as I guided my wife to the first day after eye surgery interview with her surgeon. She was very wobbly on her feet. The surgical procedure entailed removing the vitreous liquid within the eye chamber to be replaced with an absorbing gas that would press the retina. So she must spend two weeks with her head down to allow the retina to reconnect. Driving her to the hospital I had to radically change the smoothness of all the motions I was causing. I quickly realized it was helpful to describe what I was doing and going to do. But she still became severely noxious, vestibular speaking.

” Even if someone doesn’t get sick to their stomach, they may feel a less dramatic motion sickness effect known as ‘sopite syndrome’, characterized by lethargy, mental dulness, and disorientation. Many astronauts have noticed this which they call ‘mental viscosity’, ‘space fog,’ or the ‘space stupids.’  ”

I wrote a cerebrovortex essay on Guillaume Latendresse, an NHL hockey player suffering acute post concussion syndrome who was treated earlier this Spring on the GyroStim pitching/spinning/rolling chair who after a couple of these vestibular treatments, spoke to his girlfriend Annie of course in his native Québécois French, ” Annie j’ai sorti de la brume! (Annie I’m out of the fog !)” I find this word prophetic. Using a phrase like, seeing in the fog is a huge distortion of one’s sense of place and position. The fact that astronauts and concussed hockey players use the exact same terminology for me is totally fascinating. I don’t think their word choice is an accident. Let’s look at some basic biology, let’s look at a scene from a NHL hockey player and an astronaut as if they were side by side.

They both perceive either a static or visual stimuli that is sensed through their retina. The retina is positioned by the ocular muscles. The eye pivoting apparatus is a netlinking the oculomotor nuclei in the brainstem with eye movements. Like a cell phone running an elaborate App there is more going on here. The vestibular nuclei coordinate with the grey matter of the cerebral cortex. The vestibular nuclei netlink into the cerebellum with both the otoliths and the middle ear’s semicircular canals coordinating with somatic musculature (neck-torso-hip-legs-ankles-feet) within proprioception sensing plus any angular or liner acceleration sensing of support surface movement. The cerebellum in turn acts to the central autonomic nervous system which is a huge compass of un-sensed activity. The combination of these systems holds the bodies orientation within our 3-D space to link eye movement to body posture within our surroundings.  Microgravity disassembles this visual vestibular netlinking integration.

Sometimes astronauts make mistakes in their missions that they would not normally make on the ground. For example, even though space shuttle commanders and pilots have gone through thousands of hours of landing simulations before their flights, occasionally their real-life landings are too fast, too slow or too hard. They have blown out tires on their landing gear due to hitting the ground too fast, for example.

This fogginess may be attributable to sleep deprivation, motion sickness or even the drugs for motion sickness, which are also used as pre-operative sedatives on Earth. Previous studies on rats also suggest that space radiation could inhibit astronauts’ memory and spatial awareness. “These are high-performance athletes [in terms of] mental performance, and they know they’re not 100%,” says Jon Clark of theNational Space Biomedical Research Institute in Houston, Texas, US. He made the comments at the International Symposium for Personal Spaceflight in Las Cruces, New Mexico, US,” as reported in the New Scientist Space blog October 18, 2006 by Kelly Young.

Permit me to take a stand here from a dying man’s plea for provoking what Paul Bach-y-Rita wrote three years ago after his stellar career pushing our understanding of the nature of plastic healing repair within our brains. Bach-y-Rita condemned the legions of scientists who savagely attack fellow scientists with ridicule even to ostracization who dare to think differently from their herd mentality championing the preferred dogma of understanding especially insisting before any novel concept must be always proven to be rigorous fact. Bach-y-Rita advocated the approach of Theoretical Neurology. The opportunity to challenges not scientists massive egos but rather concepts antiquated in their common acceptances. I write then in the spirit of Bach-y-Rita, which is a faster way to resolve ideas toward changes that will eventually pan out for improved healing of ‘being in the fog’ for both astronauts and hockey players. What is wrong with that desire to happen as quickly as possible ?

Latendresse spoke of losing the fogginess in his mind. Yet things appear to start with the eyes first. I’ll repeat the message from previous essays that the eye is the first sense network, the first brain structure that happened to develop interactively in evolution over 800 million years ago. Life on our planet needs to see around whether it’s in the primal ocean or a husband looking worried into the healing eye of his wife. The eye is such a marvellous structure that determines our entire orientation, our complete interaction within our immediate surroundings. Concussions disturb the eye integration within the brain networks of sensing Earth’s gravitational field. We don’t have the language for this vague difference so like all things we try to describe as best we can. We call it being in the fog. Astronauts’ talk about the Space Stupids. Both groups of people are groping for this sopite syndrome. It’s time to sharpen the language of concussions, it’s time to add great detail. That’s why I write this blog. Every day things heal a little better, every day gets more detail. It’s the miracle of seeing life around us.

When you do a Google on Astronaut eyes this is what shows up:

NASA

“Space flight may be bad for your eyesight. Changes found in astronauts’ eye tissue may cause vision problems, and possibly even blindness. As well as threatening the health of astronauts, this could jeopardise long-haul missions into space.

Larry Kramer of Texas Medical School in Houston and colleagues carried out MRI scans on 27 NASA astronauts after they had spent an average of 108 days in space. Four had bulging of the optic nerve, three had kinks in the nerve sheath, and six had flattening of the eyeball.

The changes match those seen in people with idiopathic intracranial hypertension, a rare condition in which the pressure of blood and other fluids is abnormally high in the brain. People with the condition experience headaches, nausea, vomiting and visual problems including blindness.

In space, the alterations are probably caused by living in free-fall. “One potential mechanism is that blood which normally pools in the legs is shifted toward the skull, raising pressure,” says Kramer.

The findings tally with the results of a survey of 300 astronauts carried out last year. Deteriorations in vision were reported by 29 per cent of astronauts on short-term missions, and 60 per cent on long-term missions.

“If astronauts are exhibiting these changes after only 100 days in space, what will happen on a three-year flight to Mars?” asks Jason Kring, who studies human performance in extreme conditions at the Embry-Riddle Aeronautical University in Daytona Beach, Florida.

Deteriorating vision could seriously impair astronauts’ ability to carry out routine mission tasks, including monitoring displays and navigating the rocky landscape of Mars, says Kring. “This possibility, combined with what we already know about how microgravity affects muscles and bones, paints a very bleak future for human space flight unless we start to develop effective countermeasures.”

Kramer says that NASA has the matter in hand. In the wake of the study, all astronauts now have regular brain scans. This includes those yet to travel into space, providing a baseline from which any changes would be obvious. He also believes it might be possible to identify astronauts’ risk of eyesight damage from medical data before sending them into space.” reported from NewScientist Space written by Andy Coghlan, March 14, 2012  Space is bad for astronauts’ eyes

Sagittal oblique T2-weighted MR images show a left eye (a) before long-term exposure to microgravity. Convexity of posterior globe is noted (arrows). Another left eye image (b) shows long-term exposure to microgravity, with the loss of convexity of the posterior scleral margin (arrows). The right eye (c) of a different astronaut notes two abruptly angulated foci (long arrows) in optic nerve sheath and posterior globe flattening (short arrows). Images courtesy of Radiology.

Journal reference: Neuroradiology DOI: 10.1148/radiol.12111986

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About cerebrovortex

Montreal Grandmother, Agnes Kent was saved by Raul Wallenberg from certain death, when he provided papers for her and her Mom to escape away from the Nazis. Today when asked what that escape meant, she replied,"Remind people, that while statesmen and whole countries remained silent and did nothing, a single individual chose to act, with ramifications that proved enormous. Similar choices confront us today. Write that simple truth she said, it can never be repeated often enough because the world keeps forgetting it."
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