White matter hyperintensities on MRI in high-altitude U-2 pilots

Abstract

Pilots with occupational exposure to hypobaria showed a significant increase in WMH lesion volume and number. Unlike the healthy controls with predominantly WMH in the frontal white matter, WMH in pilots were more uniformly distributed throughout the brain. This is consistent with our hypothesized pattern of damage produced by interaction between microemboli and cerebral tissue, leading to thrombosis, coagulation, inflammation, and/or activation of innate immune response, although further studies will be necessary to clarify the pathologic mechanisms responsible.

Cortical Thickness of Native Tibetans in the Qinghai-Tibetan Plateau

“…Acute mountain sickness scores were higher, 34 and visual sensitivities were lower 35 in hypobaric than in normobaric hypoxia. Studies on U-2 pilots showed that hypobaria was associated with a change of white matter hyperintensity 14,36 and with the reduction of cortical thickness. 15 Moreover, exposure to hypobaria after traumatic brain injury worsened brain function.…”

Lower neurocognitive function in U-2 pilots

“…6 Follow-up research reported significant elevation of WMH in high-altitude pilots without clinical symptoms of NDCS. 7 WMH are important markers of cerebral integrity in aging and brain disorders 8 linked to executive functioning, 9 processing speed, and general neurocognitive status, [9][10][11] and are an important predictor of increased neurocognitive decline.…”

“…7 All DOCs were healthy at the time of study, without present or past history of any medical conditions associated with WMH or disqualifying for Flying Class II certification.…”

“…6,7 AFPs only participated in the neurocognitive assessment and did not undergo MRI. Neurocognitive assessment data were collected on U2Ps before imaging.…”

White matter hyperintensities on MRI in high-altitude U-2 pilots

“…Julian Hellmann-Regen, Kim Hinkelmann, Francesca Regen, Berlin, Germany: McGuire et al 1 presented interesting data on the prevalence and location of white matter hyperintensities (WMHs) in MRI scans of highaltitude pilots. The authors demonstrated that WMHs differ between the pilot group and a matched group of healthy controls.…”