Title:  A case report: Autogenic-Feedback Training (AFTE) As A Potential Treatment For Dysautonomia
Authors:  H. Rashed, P.S. Cowings, W.B. Toscano, E. Rebello, T. Abell, and S. Cardoso
Reference:  Paper accepted for the Eighth International Symposium on the Autonomic Nervous System, American Autonomic Association, Hawaii, 1997

AFTE is a physiological conditioning procedure developed by NASA as a treatment for space motion sickness. It provides individuals with the ability to recognize bodily sensations associated with modulation in their physiological response levels. Individuals eventually learn how to maintain their physiological response levels at or near their own resting baseline levels and improve the threshold of their tolerance to symptoms. A case report on a preliminary trial of AFTE with a 20 year old female with nausea and vomiting quantified by standardized gastrointestinal (GI) symptom (SX) scores for 6 months. Patient had a history of mild cerebral palsy, but had no known anatomical cause for her symptoms. The esophagogastroduodenoscopy, abdominal ultrasound, and upper GI small bowel were within normal limits. Autonomic nervous system evaluation indicated an abnormal enteric nervous system function. In AFTE training sessions conducted over a 2 week period the patient utilized heart rate as a guide for alternating relaxation (Relax) and stimulation (Stim.) AFTE was administered in four sessions, 30 minutes each divided into five cycles, subdivided into three minute intervals of Relax. followed by three minutes of Stim. preceded by 6 minutes of baseline at the beginning and at the end of each session. Blood pressure (BP), heart rate (HR), cutaneous blood flow, respiration, and skin temperature were measured as previously reported (H. Rashed, Clin. Auton. Res.: 7,93-96, 1997) and was analyzed by t-test and expressed as mean +/- SEM.

Results: Data collected from 2 sessions as summarized in the table for sessions 1 and 4: each for 6 minutes of baseline, Stim., and Relax.

1) Within sessions 1 and 4, a significant increases in BP and HR with Stim. compared with baseline. 2) In sessions 2, 3, & 4, BP was decreased significantly during the Relax. 3) The patient reported a decrease in SX score (40%).

Session SBP/mmHg DBP/mmHg MAP/mmHg HR/BPM
#1        
Baseline 121 3.4 60 0.8 781.2 661.4
Stimulation 1392.8 671.8 972.5 772.2
Rest 1411.7 741.9 941.7 650.8
#4        
Baseline 1152.9 571.4 751.7 673.0
Stimulation 1293.0* 682.0* 872.5* 741.6*
Rest* 1162.6* 621.4* 071.6* 641.9*

*p0.02

In conclusion: In this patient, we have demonstrated by using AFTE not only to moderate cardiovascular responses, but also as a powerful method in treating patients with dysautonomia with both gastrointestinal symptoms and cardiovascular abnormalities.


Title:  An Evaluation of The Frequency and Severity of Motion Sickness Incidences in Personnel Within the Command and Control Vehicle (C2V)
Authors:  P.S. Cowings, W.B. Toscano, C. DeRoshia

The purpose of this study was to assess the frequency and severity of motion sickness in personnel during a field exercise in the Command and Control Vehicle (C2V). This vehicle contains 4 workstations where military personnel are expected to perform command decisions in the field during combat conditions. Eight active duty military men (U.S. Army) at the Yuma Proving Grounds in Arizona participated in this study. All subjects were given baseline performance tests while their physiological responses were monitored on the first day. On the second day of their participation subjects rode in the C2V while their physiological responses and performance measures were recorded. Self-reports of motion sickness were also recorded. Results showed that only one subject experienced two incidences of emesis. However, seven out of the eight subjects reported other motion sickness symptoms; most predominant was the report of drowsiness which occurred a total of 19 times. Changes in physiological responses were observed relative to motion sickness symptoms reported and the different environmental conditions (i.e., level, hills, gravel) during the field exercise. Performance data showed an overall decrement during the C2V exercise. These findings suggest that malaise and severe drowsiness can potentially impact the operational efficiency of C2V crew. However, a number of variables (e.g., individual’s sleep quantity prior to the mission, prior experience in the C2V, etc.) were not controlled for in this study and may have influenced the results. Most notably was the fact that subjects with previous experience in the C2V all occupied seat 4 which was anecdotally reported to be the least provocative position. Nonetheless, it was possible to determine which factors most likely contributed to the results observed. It was concluded that conflicting sensory information from the subject’s visual displays and movements of the vehicle during the field exercise significantly contributed to motion sickness symptoms observed in both this study and the earlier study at Camp Roberts. The objectives of this study were successfully met. The use of three converging indicators, (1) physiological monitoring, (2) subject self-reports of symptoms and (3) performance metrics, was an effective means of evaluating the incidence of motion sickness and the impact on overall crew operational capacity within the C2V. It was recommended that a second study be conducted to further evaluate the impact of seat position or orientation and C2V experience on motion sickness susceptibility. Further, it was recommended that an investigation be performed on behavioral methods for improving crew alertness, motivation, performance and for reducing malaise.

AltaGenics has been granted an exclusive license to commercialize AFT (Autogenic Feedback Training) technology from NASA. Access to this patented technology requires the initiation of a Space Act Agreement (SAA) with NASA.

For information on SAA’s concerning this technolgy please contact:

Rick Ballard
Commercial Technology Office
Mail Stop 202A-3
NASA Ames Research Center
Moffett Field, CA 94035-1000
Phone: (650) 604-1853
Fax: (650) 604-1592
Email: rballard@mail.arc.nasa.gov

The Psychophysiological Facility at NASA Ames will be host to the IBMP (Institute of Biomedical Problems) during the last two weeks of November, 1997. During this time, two of their engineers will learn how to set up the Ames Clinical Laboratory within the IBMP facility in Moscow, Russia. This will allow Lyudmilla Kornilova to train MIR 25 Cosmonauts (Talgot Mustabyev and Nicoli Budarin) in the use of AFTE to reduce the effects of motion sickness in space. The MIR 25 cosmonauts are scheduled to launch January 1998.

At the annual meeting of the American Autonomic Society being held in Hawaii the first week of November 1997, Dr Cowings and Dr. Toscano in conjunction with Dr. Rashid of the University of Tennessee Medical Center will be presenting A case report: Autogenic-Feedback Training (AFTE) As A Potential Treatment For Dysautonomia. It documents the success that has been observed with patients at the university using AFTE methods developed by Dr. Cowings.