Cognitive Effects of Repeated Acute Exposure to Very High Altitude Among Altitude-Experienced Workers at 5050 m

Pun, Matiram; Guadagni, Veronica; Drogos, Lauren L.; Pon, Charlotte; Hartmann, Sara E.; Furian, Michael; Lichtblau, Mona; Muralt, Lara; Bader, Patrick R.; Moraga, Fernando A.; Soza, Daniel; López, Iván; Rawling, Jean M.; Ulrich, Silvia; Bloch, Konrad E.; Giesbrecht, Barry; Poulin, Marc J.

doi:10.1089/ham.2019.0012

Cited by 15 publications

(5 citation statements)

References 27 publications

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“…material) and QoL questionnaires (QUALMS and PROMIS) were used. We selected the robust, validated RVP task to assess the cognitive domain of sustained attention as this has been shown to be impaired at high altitude [ 20 ]. The QUALMS (Quality of Life in Myelodysplasia Scale) was created and validated to measure quality of life in myelodysplastic syndrome patients specifically [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

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Remote Monitoring of Vital and Activity Parameters in Chronic Transfusion-Dependent Patients: A Feasibility Pilot Using Wearable Biosensors

Tonino

Tweardy²,

Wegerich³

et al. 2022

Digit Biomark

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Introduction: Little is known if, and to what extent, outpatient red blood cell (RBC) transfusions benefit chronic transfusion-dependent patients. Costs, labour, and potential side effects of RBC transfusions cause a restrictive transfusion strategy to be the standard of care. However, effects on the actual performance and quality of life of patients who require RBCs on a regular basis are hardly studied. The aim of this study was to assess if new technologies and techniques like wearable biosensor devices and web-based testing can be used to measure physiological changes, functional activity, and hence eventually better assess quality of life in a cohort of transfusion-dependent patients. Methods: We monitored 5 patients who regularly receive transfusions during one transfusion cycle with the accelerateIQ biosensor platform, the Withings Steel HR, and web-based cognitive and quality of life testing. Results: Data collection by the deployed devices was shown to be feasible; the AccelerateIQ platform rendered data of which 97.8% was of high quality and usable; of the data the Withings Steel HR rendered, 98.9% was of high quality and usable. Furthermore, heart rate decreased and cognition improved significantly following RBC transfusions. Activity and quality of life measures did not show transfusion-induced changes. Conclusion: In a 5-patient cohort of transfusion-dependent patients, we found that the accelerateIQ, Withings Steel HR, and CANTAB platforms enable acquisition of high-quality data. The collected data suggest that RBC transfusions significantly and reversibly decrease heart rate and increase sustained attention in this cohort. This feasibility study justifies larger validation trials to confirm that these wearables can indeed help to determine personalized RBC transfusion strategies and thus optimization of each patient’s quality of life.

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Section: Methodsmentioning

confidence: 99%

“…This may subsequentially lead to an increase in quality of life (QoL) and activity parameters. Furthermore, since correlations between altitude and cognition, through altitude-induced hypoxia, have been established [ 19 , 20 , 21 ], patients with chronic anaemia might endure similar hypoxia-induced cognitive changes.…”

Section: Introductionmentioning

confidence: 99%

Remote Monitoring of Vital and Activity Parameters in Chronic Transfusion-Dependent Patients: A Feasibility Pilot Using Wearable Biosensors

Tonino

Tweardy²,

Wegerich³

et al. 2022

Digit Biomark

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“…A decline of cognition has been described after high altitude exposure, which depends on the altitude and duration. It may be less affected after acclimatization, and can recover to the baseline after a short-time exposure of mild hypoxia (Pun et al 2019). Researchers found that just a 15 min high altitude exposure (20,000 ft., equal to 6096 m) could rapidly impair learning and memory functions, predominantly memory encoding, retrieval and retention abilities (Nation et al 2017).…”

Section: Acute High Altitude Hypoxiamentioning

confidence: 99%

Cognitive impairment caused by hypoxia: from clinical evidences to molecular mechanisms

Wang

Cui

2021

Metab Brain Dis

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Hypoxia is a state of reduced oxygen supply and excessive oxygen consumption. According to the duration of hypoxic period, it can be classified as acute and chronic hypoxia. Both acute and chronic hypoxia could induce abundant neurological deficits. Although there have been significant advances in the pathophysiological injuries, few studies have focused on the cognitive dysfunction. In this review, we focused on the clinical evidences and molecular mechanisms of cognitive impairment under acute and chronic hypoxia. Hypoxia can impair several cognitive domains such as attention, learning and memory, procession speed and executive function, which are similar in acute and chronic hypoxia. The severity of cognitive deficit correlates with the duration and degree of hypoxia. Recovery can be achieved after acute hypoxia, while sequelae or even dementia can be observed after chronic hypoxia, perhaps due to the different molecular mechanisms. Cardiopulmonary compensatory response, glycolysis, oxidative stress, calcium overload, adenosine, mitochondrial disruption, inflammation and excitotoxicity contribute to the molecular mechanisms of cognitive deficit after acute hypoxia. During the chronic stage of hypoxia, different adaptive responses, impaired neurovascular coupling, apoptosis, transcription factors-mediated inflammation, as well as Aβ accumulation and tau phosphorylation account for the neurocognitive deficit. Moreover, brain structural changes with hippocampus and cortex atrophy, ventricle enlargement, senile plaque and neurofibrillary tangle deposition can be observed under chronic hypoxia rather than acute hypoxia.

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“…After a weeklong break at 520 m, an identical sequence of altitude exposure was repeated (cycle 2). During the same expedition, comprehensive evaluations on AMS symptoms, cognitive and psychomotor performance were obtained and have been published previously [22,23]. Apart from baseline characteristics of participants, the data presented here have not been yet published.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Extravascular lung water and cardiac function assessed by echocardiography in healthy lowlanders during repeated very high-altitude exposure

Lichtblau

Bader

Carta

et al. 2021

International Journal of Cardiology

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Background: High-altitude pulmonary edema is associated with elevated systolic pulmonary artery pressure (sPAP) and increased extravascular lung water (EVLW). We investigated sPAP and EVLW during repeated exposures to high altitude (HA). Methods: Healthy lowlanders underwent two identical 7-day HA-cycles, where subjects slept at 2900 m and spent 4-8 h daily at 5050 m, separated by a weeklong break at low altitude (LA). Echocardiography and EVLW by B-lines were measured at 520 m (baseline, LA 1 ), on day one, two and six at 5050 m (HA 1-3 ) and after descent (LA 2 ). Results: We included 21 subjects (median 25 years, body mass index 22 kg/m 2 , SpO 2 98%). SPAP rose from 21 mmHg at LA 1 to 38 mmHg at HA 1 , decreased to 30 mmHg at HA 3 (both p < 0.05 vs LA 1 ) and normalized at 20 mmHg at LA 2 (p = ns vs LA 1 ). B-lines increased from 0 at LA 1 to 6 at HA 2 and 7 at HA 3 (both p < 0.05 vs LA 1 ) and receded to 1 at LA 2 (p = ns vs LA 1 ). Overall, in cycle two, sPAP did not differ (mean difference (95% confidence interval) −0.2(−2.3 to 1.9) mmHg, p = 0.864) but B-lines were more prevalent (+2.3 (1.4-3.1), p < 0.001) compared to cycle 1. Right ventricular systolic function decreased significantly but minimally at 5050 m. Conclusions: Exposure to 5050 m induced a rapid increase in sPAP. B-lines rose during prolonged exposures to 5050 m, despite gradual decrease in sPAP, indicating excessive hydrostatic pressure might not be solely responsible for EVLW-development. Repeated HA-exposure had no acclimatization effect on EVLW. This may affect workers needing repetitive ascents to altitude and could indicate greater B-line development upon repeated exposure.

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Cognitive Effects of Repeated Acute Exposure to Very High Altitude Among Altitude-Experienced Workers at 5050 m

Cited by 15 publications

References 27 publications

Remote Monitoring of Vital and Activity Parameters in Chronic Transfusion-Dependent Patients: A Feasibility Pilot Using Wearable Biosensors

Remote Monitoring of Vital and Activity Parameters in Chronic Transfusion-Dependent Patients: A Feasibility Pilot Using Wearable Biosensors

Cognitive impairment caused by hypoxia: from clinical evidences to molecular mechanisms

Extravascular lung water and cardiac function assessed by echocardiography in healthy lowlanders during repeated very high-altitude exposure

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