According to a study comparing the changes in the brain experienced during long term missions on ISS, it appears that the Russians have developed better protocols for preparing themselves for return to Earth that prevents the enlargement in one part of the brain seen in American astronauts.
From the link:
The study focused on 24 Americans, 13 Russians, and a small, unspecified number of astronauts from the ESA. The researchers collected MRI scans of the astronauts’ brains before and after they spent six months on the ISS (only 256 individuals have visited the space station).
After being in space, all the space travelers exhibited similar brain changes: cerebrospinal fluid buildup and reduced space between the brain and the surrounding membrane at the top of the head. The Americans, however, also had more enlargement in the regions of the brain that serve as a cleaning system during sleep, e.g. the perivascular space (PVS).
…The Russian astronauts did not exhibit enlarged PVS, suggesting there might be differences in protocol that are neuro-protective.
From the paper itself:
[Russian C]osmonauts undergo six lower body negative pressure (LBNP) sessions starting two weeks prior to landing, while NASA and ESA astronauts do not typically do it. LBNP induces caudal displacement of fluids from the upper body by placing the legs and pelvis in a semiairtight chamber with negative pressure.
An advanced resistive exercise device (ARED) is regularly used by space flyers to perform free weight exercises on the ISS, but the load and frequency of use are lower for [Russian] cosmonauts compared with NASA and ESA astronauts. Lifting heavy loads during resistive exercise is often accompanied by a brief Valsalva maneuver, inducing increased ICP and decreased cerebral blood flow and cerebrovascular transmural pressure, which can result in PVS fluid accumulation. Although the effects of LBNP and ARED on the brain during spaceflight are unknown, they could partly explain the different WM-PVS changes detected in astronauts and cosmonauts. We cannot exclude that other factors (e.g., diet) might play a role in this difference. Further studies are required to confirm these hypotheses.
Apparently two protocols are different that seem to help the Russians. First, the LBNP, developed by the Russians on their earlier space stations, is essentially a pair of pants that sucks fluids down to the legs, simulating the situation normally found on Earth, and thus reduces the fluids in the upper body sooner than landing. Second, doing exercises simulating lower weight loads apparently helps the Russians as well.
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