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Morphological Brain Changes after Climbing to Extreme Altitudes--A Prospective Cohort Study
Raimund Kottke1, Jacqueline Pichler Hefti2, Christian Rummel3
1Institute for Diagnostic and Interventional Neuroradiology, University Hospital and University of Bern, 3010, Bern, Switzerland.
Plos One
|October 29, 2015
Summary
High-altitude climbing causes brain white matter reduction and potential microhemorrhages, indicating blood-brain barrier disruption. No significant grey matter atrophy or new white matter lesions were observed after the expedition.
Area of Science:
- Neurology
- High-altitude physiology
- Neuroimaging
Background:
- Previous studies reported cerebral atrophy, white matter lesions, and microhemorrhages in high-altitude climbers.
- Understanding structural brain changes and their correlation with hypoxia is crucial for climber safety.
Purpose of the Study:
- To evaluate structural cerebral changes in mountaineers after ascending to extreme altitudes (7126 m).
- To correlate these brain changes with hypoxia severity and neurological signs during the climb.
Main Methods:
- Magnetic resonance imaging (MRI) was used to assess 38 mountaineers before and after the expedition.
- Voxel-based morphometry evaluated changes in cerebrospinal fluid, grey matter, and white matter.
- Arterial oxygen saturation and acute mountain sickness scores were recorded daily.
Main Results:
- A significant increase in cerebrospinal fluid fraction (0.34%) and a reduction in white matter fraction (-0.18%) were observed post-expedition.
- Grey matter fraction remained stable.
- New microhemorrhages were found in 3 of 15 climbers above 7000 m, associated with lower oxygen saturation.
Conclusions:
- Extreme altitude exposure leads to white matter fraction decrease but not focal white matter hyperintensities or grey matter atrophy.
- Microhemorrhages, suggesting blood-brain barrier disruption, occur in a notable proportion of climbers at extreme altitudes.
