ArticleNeurology2014
Lower neurocognitive function in U-2 pilots: Relationship to white matter hyperintensities.
Article in Neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Morphological brain changes in high-altitude careers and spaceflights: a systematic review and meta-analysis.BMC neurology · 2026Pooled it
- Cognitive Framework for Aircraft Piloting: A Core Cognition Set.Behavioral sciences (Basel, Switzerland) · 2026Review
- Human limits in next-generation fighter aviation: psychophysiological stressors, readiness, health, performance, and countermeasures.Frontiers in physiology · 2026Review
- The impact of occupational nonhypoxic hypobaria on cerebral function and integrity.Scientific reports · 2025Observational
- Acute Changes in Rat Tissue Gene Expression Following Exposure to Flight Relevant Hypobaria.Scientific data · 2025Article
- Neurological Biomarker Profiles in Royal Canadian Air Force (RCAF) Pilots and Aircrew.Brain sciences · 2024Article
- High altitude is associated with pTau deposition, neuroinflammation, and myelin loss.Scientific reports · 2022Article
- European position paper on the management of patients with patent foramen ovale. Part II - Decompression sickness, migraine, arterial deoxygenation syndromes and select high-risk clinical conditions.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021Article
- Chronic Exposure to High Altitude: Synaptic, Astroglial and Memory Changes.Scientific reports · 2019Article
- White matter and hypoxic hypobaria in humans.Human brain mapping · 2019Article
- Reproducibility of quantitative structural and physiological MRI measurements.Brain and behavior · 2017Article
- Cognitive and neuroimaging changes in healthy immigrants upon relocation to a high altitude: A panel study.Human brain mapping · 2017Article
- Utilization of MRI for Cerebral White Matter Injury in a Hypobaric Swine Model-Validation of Technique.Military medicine · 2017Article
- White Matter Integrity in High-Altitude Pilots Exposed to Hypobaria.Aerospace medicine and human performance · 2016Article
- White matter hyperintensities and hypobaric exposure.Annals of neurology · 2014Article
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDetermine whether United States Air Force (USAF) U-2 pilots (U2Ps) with occupational exposure to repeated hypobaria had lower neurocognitive performance compared to pilots without repeated hypobaric exposure and whether U2P neurocognitive performance correlated with white matter hyperintensity (WMH) burden.
methodsWe collected Multidimensional Aptitude Battery-II (MAB-II) and MicroCog: Assessment of Cognitive Functioning (MicroCog) neurocognitive data on USAF U2Ps with a history of repeated occupational exposure to hypobaria and compared these with control data collected from USAF pilots (AFPs) without repeated hypobaric exposure (U2Ps/AFPs MAB-II 87/83; MicroCog 93/80). Additional comparisons were performed between U2Ps with high vs low WMH burden.
resultsU2Ps with repeated hypobaric exposure had significantly lower scores than control pilots on reasoning/calculation (U2Ps/AFPs 99.4/106.5), memory (105.5/110.9), information processing accuracy (102.1/105.8), and general cognitive functioning (103.5/108.5). In addition, U2Ps with high whole-brain WMH count showed significantly lower scores on reasoning/calculation (high/low 96.8/104.1), memory (102.9/110.2), general cognitive functioning (101.5/107.2), and general cognitive proficiency (103.6/108.8) than U2Ps with low WMH burden (high/low WMH mean volume 0.213/0.003 cm(3) and mean count 14.2/0.4).
conclusionIn these otherwise healthy, highly functioning individuals, pilots with occupational exposure to repeated hypobaria demonstrated lower neurocognitive performance, albeit demonstrable on only some tests, than pilots without repeated exposure. Furthermore, within the U2P population, higher WMH burden was associated with lower neurocognitive test performance. Hypobaric exposure may be a risk factor for subtle changes in neurocognition.
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