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An observational cerebral magnetic resonance imaging study following 7 days at 4554 m. High Altitude Medicine and Biology

Kühn, S. and Gerlach, D.A. and Noble, H.J. and Weber, F. and Rittweger, J. and Jordan, J. and Limper, U. (2019) An observational cerebral magnetic resonance imaging study following 7 days at 4554 m. High Altitude Medicine and Biology. High Altitude Medicine and Biology. Mary Ann Liebert. DOI: 10.1089/ham.2019.0056 ISSN 1527-0297

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Abstract

Kühn, Sven, Darius Gerlach, Hans-Jürgen Noblé, Frank Weber, Jörn Rittweger, Jens Jordan, and Ulrich Limper. An observational cerebral magnetic resonance imaging study following 7 days at 4554 m. Background: In human beings exposed to high altitude, cerebral magnetic resonance imaging (cMRI) revealed alterations ranging from subclinical cerebral edema formation to subtle brain abnormalities. Yet, brain structure after adaptation to high altitude and their recovery after return to lowlands have been rarely investigated. We, therefore, examined 10 healthy individuals by cMRI before, 12 hours after descent (R + 12h), and again 3.5 months (R + 3.5m) after a 7-day high altitude exposure at 4554 m. Results: After their 3-day lasting, stepwise ascent to 4554 m, all subjects suffered acute mountain sickness with a mean Lake Louise score of 5.8 ± 1.7 after the first night at that altitude. Acute mountain sickness completely resolved after 4 days at 4554 m. While 12 hours after descent mean white and gray matter volumes were increased compared with before altitude exposure (p = 0.045 and p = 0.002), these volumes were normalized on R + 3.5m. Moreover, we observed significant focal volume alterations likely attributed to either vasogenic or cytotoxic edema formation. Two subjects presented new brain findings after altitude exposure. In one individual the number of preexisting white matter hyperintensities (WMHI) transiently increased, in the other individual a reversible splenial lesion syndrome (RESLES) emerged. Both findings had resolved 15 and 8 days after descent, respectively. None developed structural lesions like brain atrophy, cerebral infarcts, microbleeds, or high-altitude cerebral edema. Discussion: Three days after complete recovery from acute mountain sickness and after return to low altitude, subclinical vasogenic and cytotoxic edema, RESLES and WMHI are present in high-altitude acclimatized individuals. However, these cerebral alterations are reversible within months at lowland.

Item URL in elib:https://elib.dlr.de/133062/
Document Type:Article
Title:An observational cerebral magnetic resonance imaging study following 7 days at 4554 m. High Altitude Medicine and Biology
Authors:
AuthorsInstitution or Email of AuthorsAuthors ORCID iD
Kühn, S.German Air Force Center of Aerospace Medicine, Fürstenfeldbruck, GermanyUNSPECIFIED
Gerlach, D.A.German Aerospace Center (DLR)https://orcid.org/0000-0001-7044-6065
Noble, H.J.German Air Force Center of Aerospace Medicine, Fürstenfeldbruck, GermanyUNSPECIFIED
Weber, F.German Air Force Center of Aerospace Medicine, Fürstenfeldbruck, GermanyUNSPECIFIED
Rittweger, J.Joern.Rittweger (at) dlr.dehttps://orcid.org/0000-0002-2223-8963
Jordan, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; Jens.Jordan (at) dlr.dehttps://orcid.org/0000-0003-4518-0706
Limper, U.Ulrich.Limper (at) dlr.dehttps://orcid.org/0000-0001-9927-4180
Date:14 November 2019
Journal or Publication Title:High Altitude Medicine and Biology
Refereed publication:Yes
Open Access:No
Gold Open Access:No
In SCOPUS:Yes
In ISI Web of Science:Yes
DOI :10.1089/ham.2019.0056
Publisher:Mary Ann Liebert
ISSN:1527-0297
Status:Published
Keywords:RESLES; acclimatization; cytotoxic edema; vasogenic edema; white matter lesion
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Forschung unter Weltraumbedingungen
DLR - Research theme (Project):R - Vorhaben Systemphysiologie
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Deposited By: Schrage, Larissa
Deposited On:07 Jan 2020 12:09
Last Modified:07 Jan 2020 12:09

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