ArticlePloS one2015
Morphological Brain Changes after Climbing to Extreme Altitudes--A Prospective Cohort Study.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effects of long-term exposure to high altitude on brain structure in healthy people: an MRI-based systematic review and meta-analysis.Frontiers in psychiatry · 2023Pooled it
- Impact of Exposure Duration to High-Altitude Hypoxia on Oxidative Homeostasis in Rat Brain Regions.International journal of molecular sciences · 2025Article
- Mechanism, prevention and treatment of cognitive impairment caused by high altitude exposure.Frontiers in physiology · 2023Review
- The human brain in a high altitude natural environment: A review.Frontiers in human neuroscience · 2022Review
- Humans at extreme altitudes.BJA education · 2021Review
- High-altitude illnesses: Old stories and new insights into the pathophysiology, treatment and prevention.Sports medicine and health science · 2021Review
- Recommendations for traveling to altitude with neurological disorders.Journal of central nervous system disease · 2021Review
- Combined fractional anisotropy and subcortical volumetric abnormalities in healthy immigrants to high altitude: A longitudinal study.Human brain mapping · 2019Article
- Recruitment of non-perfused sublingual capillaries increases microcirculatory oxygen extraction capacity throughout ascent to 7126 m.The Journal of physiology · 2019Article
- Acute and Evolving MRI of High-Altitude Cerebral Edema: Microbleeds, Edema, and Pathophysiology.AJNR. American journal of neuroradiology · 2019Article
- Emergence of AnnexinVpos CD31neg CD42blow/neg extracellular vesicles in plasma of humans at extreme altitude.PloS one · 2019Observational
- Utilization of MRI for Cerebral White Matter Injury in a Hypobaric Swine Model-Validation of Technique.Military medicine · 2017Article
- Reversible Brain Abnormalities in People Without Signs of Mountain Sickness During High-Altitude Exposure.Scientific reports · 2016Article
- Multiparametric Magnetic Resonance Investigation of Brain Adaptations to 6 Days at 4350 m.Frontiers in physiology · 2016Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFindings of cerebral cortical atrophy, white matter lesions and microhemorrhages have been reported in high-altitude climbers. The aim of this study was to evaluate structural cerebral changes in a large cohort of climbers after an ascent to extreme altitudes and to correlate these findings with the severity of hypoxia and neurological signs during the climb.
methodsMagnetic resonance imaging (MRI) studies were performed in 38 mountaineers before and after participating in a high altitude (7126 m) climbing expedition. The imaging studies were assessed for occurrence of new WM hyperintensities and microhemorrhages. Changes of partial volume estimates of cerebrospinal fluid, grey matter, and white matter were evaluated by voxel-based morphometry. Arterial oxygen saturation and acute mountain sickness scores were recorded daily during the climb.
resultsOn post-expedition imaging no new white matter hyperintensities were observed. Compared to baseline testing, we observed a significant cerebrospinal fluid fraction increase (0.34% [95% CI 0.10-0.58], p = 0.006) and a white matter fraction reduction (-0.18% [95% CI -0.32--0.04], p = 0.012), whereas the grey matter fraction remained stable (0.16% [95% CI -0.46-0.13], p = 0.278). Post-expedition imaging revealed new microhemorrhages in 3 of 15 climbers reaching an altitude of over 7000 m. Affected climbers had significantly lower oxygen saturation values but not higher acute mountain sickness scores than climbers without microhemorrhages.
conclusionsA single sojourn to extreme altitudes is not associated with development of focal white matter hyperintensities and grey matter atrophy but leads to a decrease in brain white matter fraction. Microhemorrhages indicative of substantial blood-brain barrier disruption occur in a significant number of climbers attaining extreme altitudes.
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