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Lower neurocognitive function in U-2 pilots: Relationship to white matter hyperintensities
Stephen A McGuire1, David F Tate2, Joe Wood2
1From the US Air Force School of Aerospace Medicine (S.A.M., J.W., K.M., E.S.K.), Aerospace Medicine Consultation Division, Wright-Patterson AFB, OH; Department of Neurology (S.A.M., J.R.), University of Texas Health Sciences Center, San Antonio; Departments of Neuroradiology (P.M.S.) and Neurology (S.A.M., J.H.S., A.M.W.), 59th Medical Wing, Lackland AFB; Henry Jackson Foundation for the Advancement of Military Medicine (D.F.T.), San Antonio, TX; and Maryland Psychiatric Research Center (L.M.R., B.P., S.N.W., E.H., P.V.K.), University of Maryland School of Medicine, Baltimore. smcguire@satx.rr.com.
United States Air Force (USAF) U-2 pilots (U2Ps) exposed to repeated hypobaria showed lower neurocognitive performance. Higher white matter hyperintensity (WMH) burden in U2Ps was linked to poorer cognitive test results, suggesting hypobaric exposure may impact cognition.
Area of Science:
- Aerospace Medicine
- Neuroscience
- Occupational Health
Background:
- Occupational exposure to repeated hypobaria is experienced by United States Air Force (USAF) U-2 pilots (U2Ps).
- The potential impact of hypobaric exposure on neurocognitive function and its correlation with white matter hyperintensity (WMH) burden remains an area of investigation.
Purpose of the Study:
- To determine if USAF U-2 pilots with occupational exposure to repeated hypobaria exhibit lower neurocognitive performance compared to pilots without such exposure.
- To investigate the correlation between U2P neurocognitive performance and their white matter hyperintensity (WMH) burden.
Main Methods:
- Neurocognitive data were collected using the Multidimensional Aptitude Battery-II (MAB-II) and MicroCog: Assessment of Cognitive Functioning (MicroCog).
- Data from USAF U-2 pilots (U2Ps) with repeated hypobaric exposure were compared to control data from USAF pilots (AFPs) without this exposure.
- Comparisons were also made between U2Ps with high versus low WMH burden.
Main Results:
- U2Ps demonstrated significantly lower scores in reasoning/calculation, memory, information processing accuracy, and general cognitive functioning compared to control AFPs.
- U2Ps with a high whole-brain WMH count exhibited significantly lower scores in reasoning/calculation, memory, general cognitive functioning, and general cognitive proficiency compared to U2Ps with low WMH burden.
- WMH burden was quantified by mean volume and count, with high WMH groups showing substantially greater volumes and counts.
Conclusions:
- Pilots with occupational exposure to repeated hypobaria showed reduced neurocognitive performance on specific tests compared to those without exposure.
- Within the U2P group, increased WMH burden was associated with diminished neurocognitive test performance.
- Repeated hypobaric exposure may represent a risk factor for subtle neurocognitive alterations in otherwise healthy, high-functioning individuals.
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