Universität zu Köln

Kuehn, Sven, Gerlach, Darius ORCID: 0000-0001-7044-6065, Noble, Hans-Juergen, Weber, Frank, Rittweger, Joern, Jordan, Jens and Limper, Ulrich (2019). An Observational Cerebral Magnetic Resonance Imaging Study Following 7 Days at 4554 m. High Alt. Med. Biol., 20 (4). S. 407 - 417. NEW ROCHELLE: MARY ANN LIEBERT, INC. ISSN 1557-8682

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Abstract

Kuhn, Sven, Darius Gerlach, Hans-Jurgen Noble, Frank Weber, Jorn 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 Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kuehn, Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerlach, Darius UNSPECIFIED orcid.org/0000-0001-7044-6065 UNSPECIFIED Noble, Hans-Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Rittweger, Joern UNSPECIFIED UNSPECIFIED UNSPECIFIED Jordan, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Limper, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-127648
DOI:	10.1089/ham.2019.0056
Journal or Publication Title:	High Alt. Med. Biol.
Volume:	20
Number:	4
Page Range:	S. 407 - 417
Date:	2019
Publisher:	MARY ANN LIEBERT, INC
Place of Publication:	NEW ROCHELLE
ISSN:	1557-8682
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE MOUNTAIN-SICKNESS; ACUTE HYPOBARIC HYPOXIA; BLOOD-FLOW DISTRIBUTION; HIGH-ALTITUDE; BRAIN; EDEMA; MRI; DIFFUSION; EXPOSURE; ATROPHY Multiple languages Biophysics; Public, Environmental & Occupational Health; Sport Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12764