Sage Journals: Discover world-class research

Abstract

Background

The correlation between brain injury and high-altitude (HA) exposure duration (Dur_HA) as well as peripheral oxygen saturation (SpO₂) remains unclear.

Purpose

To evaluate the global and regional brain volume differences between HA immigrants and sea-level residents, and the relationship between brain volume with Dur_HA and SpO₂.

Material and Methods

Structural magnetic resonance imaging (MRI) scans were acquired in 33 healthy male HA immigrants (HA group) and 33 matched sea-level male residents (SL group). Differences in global gray matter volume (GMV), white matter volume (WMV), brain parenchyma volume (BV), total intracranial volume (TIV), and the volume-fraction (the ratio of GMV/TIV, WMV/TIV, BV/TIV) were assessed. Regional gray matter differences were investigated using voxel-based morphology analysis. The volume of clusters with GM loss were calculated as the volume of volume of interest (V_VOI). Student’s t-test and partial correlation were adopted for statistic calculation.

Results

Compared to the SL group, the HA immigrants had larger WMV (P = 0.015), smaller ratio of GMV/WMV (P = 0.022), and regional gray matter loss in bilateral basal ganglion, limbic system, midbrain, and vermis (cluster size >100 voxels, family-wise error corrected at P = 0.01). The global GMV, BV, and V_VOI confined to vermis had negative correlations with the Dur_HA (r = -0.369, P = 0.049; r = -0.380, P = 0.042; and r = −0.471, P = 0.010. Neither global nor regional brain volume correlated with SpO₂.

Conclusion

Global and regional brain are affected by long-term HA exposure, and global and regional gray matter have a time-dependent volume loss.

Keywords

Brain gray matter hypoxia magnetic resonance imaging

Get full access to this article

View all access options for this article.

References

Jiang

Chen

Liu

, et al. Chronic mountain sickness in Chinese Han males who migrated to the Qinghai-Tibetan plateau: application and evaluation of diagnostic criteria for chronic mountain sickness. BMC Public Health 2014;14:701.

Pei

Tao

, et al. Burden of disease resulting from chronic mountain sickness among young Chinese male immigrants in Tibet. BMC Public Health 2012;12:401.

Chen

Zhang

Wang

, et al. Cognitive and neuroimaging changes in healthy immigrants upon relocation to a high altitude: a panel study. Hum Brain Mapp 2017;38:3865–3877.

Bhattarai

Paudel

Thakur

, et al. Effect of long term high altitude exposure on cardiovascular autonomic adjustment during rest and post-exercise recovery. Ann Occup Environ Med 2018;30:34.

Zhang

, et al. Long-term exposure to high altitude attenuates verbal and spatial working memory: evidence from an event-related potential study. Brain Behav 2019;9:e01256.

Cavaletti

Moroni

Garavaglia

, et al. Brain damage after high-altitude climbs without oxygen. Lancet 1987;329:101.

Chen

Zhang

, et al. Combined fractional anisotropy and subcortical volumetric abnormalities in healthy immigrants to high altitude: a longitudinal study. Hum Brain Mapp 2019;40:4202–4212.

Kühn

Gerlach

Noblé

, et al. An observational cerebral magnetic resonance imaging study following 7 days at 4554 m. High Alt Med Biol 2019;20:407–416.

Maiti

Singh

Muthuraju

, et al. Hypobaric hypoxia damages the hippocampal pyramidal neurons in the rat brain. Brain Res 2007;1175:1–9.

10.

Nakajima

Ishida

Lange

, et al. Apoptosis has a prolonged role in the neurodegeneration after hypoxic ischemia in the newborn rat. J Neurosci 2000;20:7994–8004.

11.

Kabakuş

Ozcan

Aysun

, et al. Evaluation of neuronal damage following hypoxic-ischaemic brain injury in acute and early chronic periods in neonatal rats. Cell Biochem Funct 2006;24:257–260.

12.

Kumar

Farahvar

Ogren

, et al. Brain putamen volume changes in newly-diagnosed patients with obstructive sleep apnea. Neuroimage Clin 2014;4:383–391.

13.

George

Kalaivani

Sudhakar

. A non-iterative multi-scale approach for intensity inhomogeneity correction in MRI. Magn Reson Imaging 2017;42:43–59.

14.

Ashburner

. A fast diffeomorphic image registration algorithm. Neuroimage 2007;38:95–113.

15.

Ashburner

Friston

. Voxel-based morphometry–the methods. Neuroimage 2000;11:805–821.

16.

Gozal

Daniel

Dohanich

. Behavioral and anatomical correlates of chronic episodic hypoxia during sleep in the rat. J Neurosci 2001;21:2442–2450.

17.

Aviles-Reyes

Angelo

Villarreal

, et al. Intermittent hypoxia during sleep induces reactive gliosis and limited neuronal death in rats: implications for sleep apnea. J Neurochem 2010;112:854–869.

18.

Zatorre

Fields

Johansen-Berg

. Plasticity in gray and white: neuroimaging changes in brain structure during learning. Nat Neurosci 2012;15:528–536.

19.

Huang

Castillo

. Hypoxic-ischemic brain injury: imaging findings from birth to adulthood. Radiographics 2008;28:417–439; quiz 617.

20.

Suominen

Vähätalo

. Neurologic long term outcome after drowning in children. Scand J Trauma Resusc Emerg Med 2012;20:55.

21.

Beppu

. The role of MR imaging in assessment of brain damage from carbon monoxide poisoning: a review of the literature. AJNR Am J Neuroradiol 2014;35:625–631.

22.

Metter

Rittenberger

Guyette

, et al.

Association between a quantitative CT scan measure of brain edema and outcome after cardiac arrest

Resuscitation 2011;82:1180–1185.

23.

Ishaque

Manning

Woolsey

, et al. Lenticulostriate arterial distribution pathology may underlie pediatric anoxic brain injury in drowning. Neuroimage Clin 2016;11:167–172.

24.

von Leupoldt

Sommer

Kegat

, et al. The unpleasantness of perceived dyspnea is processed in the anterior insula and amygdala. Am J Respir Crit Care Med 2008;177:1026–1032.

25.

Zhang

Wang

Lin

, et al. Reduced regional gray matter volume in patients with chronic obstructive pulmonary disease: a voxel-based morphometry study. AJNR Am J Neuroradiol 2013;34:334–339.

26.

Morrell

Jackson

Twigg

, et al. Changes in brain morphology in patients with obstructive sleep apnoea. Thorax 2010;65:908–914.

27.

Welsh

Yuen

Placantonakis

, et al. Why do Purkinje cells die so easily after global brain ischemia? Aldolase C, EAAT4, and the cerebellar contribution to posthypoxic myoclonus. Adv Neurol 2002;89:331–359.

28.

Hochachka

Clark

Brown

, et al.

The brain at high altitude: hypometabolism as a defense against chronic hypoxia?

J Cereb Blood Flow Metab 1994;14:671–679.

29.

Binks

Cunningham

Adams

, et al. Gray matter blood flow change is unevenly distributed during moderate isocapnic hypoxia in humans. J Appl Physiol (1985) 2008;104:212–217.

30.

Wardlaw

. What causes lacunar stroke? J Neurol Neurosurg Psychiatry 2005;76:617–619.

31.

Fan

Zhao

, et al. Reversible brain abnormalities in people without signs of mountain sickness during high-altitude exposure. Sci Rep 2016;6:33596.

32.

Bao

Wang

Zhao

, et al. Cerebral edema in chronic mountain sickness: a new finding. Sci Rep 2017;7:43224.

33.

Wang

Young

. White matter plasticity in adulthood. Neuroscience 2014;276:148–160.

34.

Fleischer

Gröger

Koirala

, et al. Increased structural white and grey matter network connectivity compensates for functional decline in early multiple sclerosis. Mult Scler 2017;23:432–441.

35.

Chorghay

Káradóttir

Ruthazer

. White matter plasticity keeps the brain in tune: axons conduct while Glia wrap. Front Cell Neurosci 2018;12:428.

36.

Zhang

Yan

Shi

, et al. Structural modifications of the brain in acclimatization to high-altitude. PLoS One 2010;5:e11449.

37.

Macey

Henderson

Macey

, et al. Brain morphology associated with obstructive sleep apnea. Am J Respir Crit Care Med 2002;166:1382–1387.

38.

Zhang

Wang

Lin

, et al. Grey and white matter abnormalities in chronic obstructive pulmonary disease: a case-control study. BMJ Open 2012;2:e000844.

39.

Balaban

Duffin

Preiss

, et al. The in-vivo oxyhaemoglobin dissociation curve at sea level and high altitude. Respir Physiol Neurobiol 2013;186:45–52.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.02 MB

High-altitude exposure duration dependent global and regional gray matter volume decrease in healthy immigrants: a cross-sectional study

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Keywords

Get full access to this article

References

Supplementary Material