Hypoxia's Impact on Hippocampal Functional Connectivity: Insights from Resting-State fMRI Studies

The hippocampus is one of the brain's most vulnerable structures to hypoxia, playing a crucial role in memory and spatial navigation. This sensitivity makes it a key region for understanding the effects of hypoxia on brain connectivity. This review examines the effects of both acute and chronic hypoxia on resting-state networks (RSNs) that contribute to hippocampal functional connectivity (FC). Hypoxia, characterized by a reduced oxygen supply to the brain, can result from environmental factors (such as high-altitude exposure) or hypoxia-induced pathological conditions (including obstructive sleep apnea and hypoxic-ischemic encephalopathy). The hippocampus's susceptibility to hypoxic damage significantly impairs brain connectivity. This review examines through rs-fMRI studies how hypoxia alters hippocampal FC, focusing on its effects on RSNs involved in hippocampal functions, and compares acute and chronic hypoxic states. We seek to determine whether distinct or shared patterns of FC changes exist between acute and chronic hypoxia, and how hypoxia indirectly changes hippocampal FC, given the challenges of studying it in isolation. By addressing these questions, this review aims to deepen our understanding of hypoxia-induced changes in hippocampal FC and provide insights into potential therapeutic strategies to mitigate its effects on cognitive functions.