• Cephalalgia · Apr 2015

    Randomized Controlled Trial

    Space headache on Earth: head-down-tilted bed rest studies simulating outer-space microgravity.

    • W P J van Oosterhout, G M Terwindt, A A Vein, and M D Ferrari.
    • Department of Neurology, Leiden University Medical Center, the Netherlands w.p.j.van_oosterhout@lumc.nl.
    • Cephalalgia. 2015 Apr 1; 35 (4): 335-43.

    BackgroundHeadache is a common symptom during space travel, both isolated and as part of space motion syndrome. Head-down-tilted bed rest (HDTBR) studies are used to simulate outer space microgravity on Earth, and allow countermeasure interventions such as artificial gravity and training protocols, aimed at restoring microgravity-induced physiological changes.ObjectivesThe objectives of this article are to assess headache incidence and characteristics during HDTBR, and to evaluate the effects of countermeasures.MethodsIn a randomized cross-over design by the European Space Agency (ESA), 22 healthy male subjects, without primary headache history, underwent three periods of -6-degree HDTBR. In two of these episodes countermeasure protocols were added, with either centrifugation or aerobic exercise training protocols. Headache occurrence and characteristics were daily assessed using a specially designed questionnaire.ResultsIn total 14/22 (63.6%) subjects reported a headache during ≥1 of the three HDTBR periods, in 12/14 (85.7%) non-specific, and two of 14 (14.4%) migraine. The occurrence of headache did not differ between HDTBR with and without countermeasures: 12/22 (54.5%) subjects vs. eight of 22 (36.4%) subjects; p = 0.20; 13/109 (11.9%) headache days vs. 36/213 (16.9%) headache days; p = 0.24). During countermeasures headaches were, however, more often mild (p = 0.03) and had fewer associated symptoms (p = 0.008).ConclusionsSimulated microgravity during HDTBR induces headache episodes, mostly on the first day. Countermeasures are useful in reducing headache severity and associated symptoms. Reversible, microgravity-induced cephalic fluid shift may cause headache, also on Earth. HDTBR can be used to study space headache on Earth.© International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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