Morphological Brain Changes after Climbing to Extreme Altitudes—A Prospective Cohort Study

摘要: BACKGROUND Findings of cerebral cortical atrophy, white matter lesions and microhemorrhages have been reported in high-altitude climbers. The aim this study was to evaluate structural changes a large cohort climbers after an ascent extreme altitudes correlate these findings with the severity hypoxia neurological signs during climb. METHODS Magnetic resonance imaging (MRI) studies were performed 38 mountaineers before participating high altitude (7126m) climbing expedition. assessed for occurrence new WM hyperintensities microhemorrhages. Changes partial volume estimates cerebrospinal fluid, grey matter, evaluated by voxel-based morphometry. Arterial oxygen saturation acute mountain sickness scores recorded daily climb. RESULTS On post-expedition no observed. Compared baseline testing, we observed significant fluid fraction increase (0.34% [95% CI 0.10-0.58], p = 0.006) reduction (-0.18% -0.32--0.04], 0.012), whereas remained stable (0.16% -0.46-0.13], 0.278). Post-expedition revealed 3 15 reaching over 7000m. Affected had significantly lower values but not higher than without microhemorrhages. CONCLUSIONS A single sojourn is associated development focal atrophy leads decrease brain fraction. Microhemorrhages indicative substantial blood-brain barrier disruption occur number attaining altitudes.