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The Possible Importance of Glutamine Supplementation to Mood and Cognition in Hypoxia from High Altitude. Nutrients 2020; 12:nu12123627. [PMID: 33255790 PMCID: PMC7760805 DOI: 10.3390/nu12123627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022] Open
Abstract
Hypoxia induced by low O2 pressure is responsible for several physiological and behavioral alterations. Changes in physiological systems are frequent, including inflammation and psychobiological declines such as mood and cognition worsening, resulting in increased reaction time, difficulty solving problems, reduced memory and concentration. The paper discusses the possible relationship between glutamine supplementation and worsening cognition mediated by inflammation induced by high altitude hypoxia. The paper is a narrative literature review conducted to verify the effects of glutamine supplementation on psychobiological aspects. We searched MEDLINE/PubMed and Web of Science databases and gray literature by Google Scholar for English articles. Mechanistic pathways mediated by glutamine suggest potential positive effects of its supplementation on mood and cognition, mainly its potential effect on inflammation. However, clinical studies are scarce, making any conclusions impossible. Although glutamine plays an important role and seems to mitigate inflammation, clinical studies should test this hypothesis, which will contribute to a better mood and cognition state for several people who suffer from problems mediated by hypoxia.
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Aebi MR, Bourdillon N, Noser P, Millet GP, Bron D. Cognitive Impairment During Combined Normobaric vs. Hypobaric and Normoxic vs. Hypoxic Acute Exposure. Aerosp Med Hum Perform 2020; 91:845-851. [PMID: 33334404 DOI: 10.3357/amhp.5616.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION: Exposure to hypoxia has a deleterious effect on cognitive function; however, the putative effect of hypobaria remains unclear. The present study aimed to evaluate cognitive performance in pilot trainees who were exposed to acute normobaric (NH) and hypobaric hypoxia (HH). Of relevance for military pilots, we also aimed to assess cognitive performance in hypobaric normoxia (HN).METHODS: A total of 16 healthy pilot trainees were exposed to 4 randomized conditions (i.e., normobaric normoxia, NN, altitude level of 440 m; HH at 5500 m; NH, altitude simulation of 5500 m; and HN). Subjects performed a cognitive assessment (KLT-R test). Cerebral oxygen delivery (cDO₂) was estimated based middle cerebral artery blood flow velocity (MCAv) and pulse oxygen saturation (Spo₂) monitored during cognitive assessment.RESULTS: Percentage of errors increased in NH (14.3 9.1%) and HH (12.9 6.4%) when compared to NN (6.5 4.1%) and HN (6.0 4.0%). Number of calculations accomplished was lower only in HH than in NN and HN. When compared to NN, cDO₂ decreased in NH and HH.DISCUSSION: Cognitive performance was decreased similarly in acute NH and HH. The cDO₂ reduction in NH and HH implies insufficient MCAv increase to ensure cognitive performance maintenance. The present study suggests negligible hypobaric influence on cognitive performance in hypoxia and normoxia.Aebi MR, Bourdillon N, Noser P, Millet GP, Bron D. Cognitive impairment during combined normobaric vs. hypobaric and normoxic vs. hypoxic acute exposure. Aerosp Med Hum Perform. 2020; 91(11):845851.
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Jung M, Brizes I, Wages S, Ponce P, Kang M, Loprinzi PD. Combined effects of acute exercise and hypoxia on memory. Physiol Int 2020; 107:337-348. [PMID: 32644939 DOI: 10.1556/2060.2020.00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/27/2020] [Indexed: 11/19/2022]
Abstract
No previous studies have evaluated the potential combined effects of acute exercise and acute hypoxia exposure on memory function, which was the purpose of this study. Twenty-five participants (Mage = 21.2 years) completed two laboratory visits in a counterbalanced order, involving 1) acute exercise (a 20-min bout of moderate-intensity exercise) and then 30 min of exposure to hypoxia (FIO2 = 0.12), and 2) exposure to hypoxia alone (FIO2 = 0.12) for 30 min. Following this, participants completed a cued-recall and memory interference task (AB/AC paradigm), assessing cued-recall memory (recall 1 and recall 2) and memory interference (proactive and retroactive interference). For cued-recall memory, we observed a significant main effect for condition, with Exercise + Hypoxia condition having significantly greater cued-recall performance than Hypoxia alone. Memory interference did not differ as a function of the experimental condition. This experiment demonstrates that engaging in an acute bout of exercise prior to acute hypoxia exposure had an additive effect in enhancing cued-recall memory performance.
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Affiliation(s)
- M Jung
- 1Exercise & Memory Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA.,2Health and Sport Analytics Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - I Brizes
- 1Exercise & Memory Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - S Wages
- 1Exercise & Memory Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - P Ponce
- 1Exercise & Memory Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - M Kang
- 2Health and Sport Analytics Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
| | - P D Loprinzi
- 1Exercise & Memory Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA
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Sharma P, Tulsawani R. Ganoderma lucidum aqueous extract prevents hypobaric hypoxia induced memory deficit by modulating neurotransmission, neuroplasticity and maintaining redox homeostasis. Sci Rep 2020; 10:8944. [PMID: 32488040 PMCID: PMC7265456 DOI: 10.1038/s41598-020-65812-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 05/11/2020] [Indexed: 02/04/2023] Open
Abstract
Oxidative stress due to hypobaric hypoxia at extreme altitudes causes severe neuronal damage and irreversible cognitive loss. Owing to contraindications of current drug therapies, the aim of the study was to investigate memory enhancing potential of aqueous extract of Ganoderma lucidum (GLAQ) and underlying neuroprotective mechanism using rat hypobaric hypoxia test model. Rats exposed to hypobaric hypoxia showed deranged spatial memory in morris water maze test with hippocampal damage and vasogenic cerebral edema. All these changes were prevented with GLAQ treatment. Blood and biochemical analysis revealed activation of hypoxic ventilatory response, red blood cells induction, reversal of electrolyte and redox imbalance, and restoration of cellular bioenergetic losses in GLAQ treated animals. Notably, GLAQ treatment ameliorated levels of neurotransmitters (catecholamines, serotonin, glutamate), prevented glucocorticoid and α-synuclein surge, improved neuroplasticity by upregulating CREB/p-CREB/BDNF expression via ERK1/ERK2 induction. Further, restoration of nuclear factor erythroid 2-related factor with stabilization of hypoxia inducible factors and inflammatory markers were evidenced in GLAQ treated rats which was additionally established in gene reporter array using an alternative HT22 cell test model. Conclusively, our studies provide novel insights into systemic to molecular level protective mechanism by GLAQ in combating hypobaric hypoxia induced oxidative stress and memory impairment.
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Affiliation(s)
- Purva Sharma
- Defence Institute of Physiology and Allied Sciences (DIPAS), Lucknow Road, Timarpur, Delhi, 110054, India
| | - Rajkumar Tulsawani
- Defence Institute of Physiology and Allied Sciences (DIPAS), Lucknow Road, Timarpur, Delhi, 110054, India.
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Walsh JJ, Drouin PJ, King TJ, D'Urzo KA, Tschakovsky ME, Cheung SS, Day TA. Acute aerobic exercise impairs aspects of cognitive function at high altitude. Physiol Behav 2020; 223:112979. [PMID: 32479806 DOI: 10.1016/j.physbeh.2020.112979] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/28/2019] [Accepted: 05/20/2020] [Indexed: 12/24/2022]
Abstract
Hypoxia-mediated cognitive dysfunction can be transiently mitigated by exercise in a laboratory-based setting. Whether this effect holds true in the context of high altitude hypoxia has not been determined. We investigated the effect of acute aerobic exercise on cognitive function (CF) at low (1400m) and high altitude (4240m). Fifteen volunteers (24.1±3.5yrs; 9 females) exercised for 20-min at 40-60% of their heart rate reserve at low and high altitude. CF was assessed before and 10-min after exercise using a tablet-based battery of executive function tests. A sea-level control group (n=13; 24.2±2.4 years; 9 females) performed time-matched CF tests to assess the contribution of a learning effects due to repeated testing. Measures of resting CF were unaffected by ascent to high altitude. Following high altitude exercise, performance significantly worsened on the digit symbol substitution task - a test of processing speed, working memory, and visuospatial attention (z=0.01 vs. -0.59, p=0.02, η2=0.35). No effect was found on other measures of CF following exercise. There was no association between changes in peripheral oxygen saturation and changes in CF following high altitude exercise (r=0.22, p=0.44), but higher hemoglobin concentration at high altitude was associated with a decline in CF following exercise at high altitude (r=-0.65, p=0.02). Acute aerobic exercise performed at high altitude impairs some aspects of CF, whereas other CF tests remain unchanged. The strong ecological validity of this study warrants attention and follow-up investigations are needed to better characterize selective impairment of CF with high altitude exercise.
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Affiliation(s)
- Jeremy J Walsh
- School of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada; School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.
| | - Patrick J Drouin
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Trevor J King
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada; Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Katrina A D'Urzo
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | | | - Stephen S Cheung
- Department of Kinesiology, Brock University, St. Catherines, ON, Canada
| | - Trevor A Day
- Department of Biology, Mount Royal University, Calgary, AB, Canada
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Algaze I, Phillips L, Inglis P, Lathrop G, Gadbois J, Rizzolo K, Harris NS. Incidence of Mild Cognitive Impairment with Ascending Altitude. High Alt Med Biol 2020; 21:184-191. [PMID: 32282276 DOI: 10.1089/ham.2019.0111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: This study aimed to longitudinally quantify the prevalence of mild cognitive impairment (MCI) in individual trekkers at three different ascending altitudes (Site 1: ∼3500 m, Site 2: ∼4400 m, and Site 3: ∼5100 m). We correlated these findings with the presence of acute mountain sickness (AMS). Materials and Methods: We performed serial assays using the environmental quick mild cognitive impairment (eQMCI) score on 103 English-speaking 18- to 65-year-old volunteers trekking to Everest Base Camp in Nepal during spring 2016. We defined MCI as a score less than 67 (lower scores indicating more cognitive impairment). Additional data collected included the Lake Louise Score, demographics, and other possible confounders. Results: eQMCI scores significantly decreased with ascent from Site 1 to 2 (a score of 78.95 [SD = 7.96] to 74.67 [SD = 8.8] [Site 1-2 p = 0.04]), but then increased on ascent to Site 3 to 83.68 (SD = 8.67) (Site 1-3 p = <0.0001, Site 2-3 p = <0.0001). However, subjects who fulfilled eQMCI criteria for MCI increased despite the overall improvement in score: 6.8% (N = 7) at Site 1, 18.7% (N = 14) at Site 2, and 3.3% (N = 2) at Site 3. Incidence of AMS at Sites 1, 2, and 3 was 22.3% (N = 23), 21.3% (N = 16), and 48.3% (N = 29), respectively. Of those with MCI, 1.94% met criteria for AMS at Site 1 (p = 0.0017), 2.67% at Site 2 (p = 0.6949), and 3.33% at Site 3 (p = <0.0001). Conclusions: There is a significant incidence of MCI at high altitude, even in those without subjective findings of AMS. Interestingly, subjects with a decline in cognitive function show an increasing trend for developing AMS at higher altitude. Future research on the clinical impact of MCI on a subject's health, judgment, and performance remains to be elucidated.
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Affiliation(s)
- Isabel Algaze
- Department of Emergency Medicine, University of California Irvine Medical Center, Orange, California, USA
| | - Lara Phillips
- Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | | | - Gabriel Lathrop
- Western University of Health Sciences College of Osteopathic Medicine of the Pacific-Northwest, Lebanon, Oregon, USA
| | - Jaclyn Gadbois
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA
| | - Katherine Rizzolo
- Department of Internal Medicine, Maine Medical Center, Portland, Maine, USA
| | - N Stuart Harris
- Division of Wilderness Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Individual chronic mountain sickness symptom is an early warning sign of cognitive impairment. Physiol Behav 2020; 214:112748. [DOI: 10.1016/j.physbeh.2019.112748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/18/2019] [Accepted: 11/22/2019] [Indexed: 12/14/2022]
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Hüfner K, Brugger H, Caramazza F, Stawinoga AE, Brodmann-Maeder M, Gatterer H, Turner R, Tomazin I, Fusar-Poli P, Sperner-Unterweger B. Development of a Self-Administered Questionnaire to Detect Psychosis at High Altitude: The HAPSY Questionnaire. High Alt Med Biol 2019; 20:352-360. [DOI: 10.1089/ham.2019.0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Katharina Hüfner
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Fabio Caramazza
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | | | - Monika Brodmann-Maeder
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, Bern, Switzerland
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Rachel Turner
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Iztok Tomazin
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
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Martin K, McLeod E, Périard J, Rattray B, Keegan R, Pyne DB. The Impact of Environmental Stress on Cognitive Performance: A Systematic Review. HUMAN FACTORS 2019; 61:1205-1246. [PMID: 31002273 DOI: 10.1177/0018720819839817] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE In this review, we detail the impact of environmental stress on cognitive and military task performance and highlight any individual characteristics or interventions which may mitigate any negative effect. BACKGROUND Military personnel are often deployed in regions markedly different from their own, experiencing hot days, cold nights, and trips both above and below sea level. In spite of these stressors, high-level cognitive and operational performance must be maintained. METHOD A systematic review of the electronic databases Medline (PubMed), EMBASE (Scopus), PsycINFO, and Web of Science was conducted from inception up to September 2018. Eligibility criteria included a healthy human cohort, an outcome of cognition or military task performance and assessment of an environmental condition. RESULTS The search returned 113,850 records, of which 124 were included in the systematic review. Thirty-one studies examined the impact of heat stress on cognition; 20 of cold stress; 59 of altitude exposure; and 18 of being below sea level. CONCLUSION The severity and duration of exposure to the environmental stressor affects the degree to which cognitive performance can be impaired, as does the complexity of the cognitive task and the skill or familiarity of the individual performing the task. APPLICATION Strategies to improve cognitive performance in extreme environmental conditions should focus on reducing the magnitude of the physiological and perceptual disturbance caused by the stressor. Strategies may include acclimatization and habituation, being well skilled on the task, and reducing sensations of thermal stress with approaches such as head and neck cooling.
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Affiliation(s)
- Kristy Martin
- University of Canberra, Australian Capital Territory, Australia
| | - Emily McLeod
- University of Canberra, Australian Capital Territory, Australia
| | - Julien Périard
- University of Canberra, Australian Capital Territory, Australia
| | - Ben Rattray
- University of Canberra, Australian Capital Territory, Australia
| | - Richard Keegan
- University of Canberra, Australian Capital Territory, Australia
| | - David B Pyne
- University of Canberra, Australian Capital Territory, Australia
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Loprinzi PD, Matalgah A, Crawford L, Yu JJ, Kong Z, Wang B, Liu S, Zou L. Effects of Acute Normobaric Hypoxia on Memory Interference. Brain Sci 2019; 9:brainsci9110323. [PMID: 31739561 PMCID: PMC6896077 DOI: 10.3390/brainsci9110323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 11/12/2019] [Indexed: 12/29/2022] Open
Abstract
Purpose: Previous research has evaluated the effects of acute hypoxia exposure on cognitive function, notably executive function. No studies, to date, have evaluated the effects of acute hypoxia exposure on memory interference, which was the purpose of this experiment. Methods: A within-subjects, counterbalanced experimental design was employed, with condition (hypoxia vs. normoxia) and time (immediate vs. delayed) being the independent variables. Participants (N = 21; Mage = 21.0 years) completed two laboratory visits, involving 30 min of exposure to either hypoxia (FIO2 = 0.12) or normoxia (FIO2 = 0.21). Following this, they completed a memory interference task (AB/AC paradigm), assessing immediate and delayed proactive and retroactive interference. Results: For retroactive interference, we observed a significant main effect for condition, F(1, 20) = 5.48, p = 0.03, ƞ2 = 0.10, condition by time interaction, F(1, 20) = 4.96, p = 0.03, ƞ2 = 0.01, but no main effect for time, F(1, 20) = 1.75, p = 0.20, ƞ2 = 0.004. Conclusion: Our results demonstrate that acute hypoxia exposure was facilitative in reducing memory interference. We discuss these findings in the context of the potential therapeutic effects of acute hypoxia exposure on synaptic plasticity.
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Affiliation(s)
- Paul D. Loprinzi
- Exercise and Memory Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA; (P.D.L.); (A.M.); (L.C.)
| | - Aala’a Matalgah
- Exercise and Memory Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA; (P.D.L.); (A.M.); (L.C.)
| | - Lindsay Crawford
- Exercise and Memory Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS 38677, USA; (P.D.L.); (A.M.); (L.C.)
| | - Jane J. Yu
- Exercise Psychology and Motor Learning Laboratory, Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Av. da Universidade, Taipa, Macau 999078, China;
| | - Bo Wang
- Department of Psychology, Central University of Finance and Economics, Beijing 100081, China;
| | - Shijie Liu
- Exercise and Mental Health Laboratory, Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen 518060, China;
| | - Liye Zou
- Exercise and Mental Health Laboratory, Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen 518060, China;
- Correspondence: ; Tel.: +86-188-2343-7684; Fax: +86-0755-2653-9584
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61
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Chronic Exposure to High Altitude: Synaptic, Astroglial and Memory Changes. Sci Rep 2019; 9:16406. [PMID: 31712561 PMCID: PMC6848138 DOI: 10.1038/s41598-019-52563-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/11/2019] [Indexed: 11/18/2022] Open
Abstract
Long-term operations carried out at high altitude (HA) by military personnel, pilots, and astronauts may trigger health complications. In particular, chronic exposure to high altitude (CEHA) has been associated with deficits in cognitive function. In this study, we found that mice exposed to chronic HA (5000 m for 12 weeks) exhibited deficits in learning and memory associated with hippocampal function and were linked with changes in the expression of synaptic proteins across various regions of the brain. Specifically, we found decreased levels of synaptophysin (SYP) (p < 0.05) and spinophilin (SPH) (p < 0.05) in the olfactory cortex, post synaptic density−95 (PSD-95) (p < 0.05), growth associated protein 43 (GAP43) (p < 0.05), glial fibrillary acidic protein (GFAP) (p < 0.05) in the cerebellum, and SYP (p < 0.05) and PSD-95 (p < 0.05) in the brainstem. Ultrastructural analyses of synaptic density and morphology in the hippocampus did not reveal any differences in CEHA mice compared to SL mice. Our data are novel and suggest that CEHA exposure leads to cognitive impairment in conjunction with neuroanatomically-based molecular changes in synaptic protein levels and astroglial cell marker in a region specific manner. We hypothesize that these new findings are part of highly complex molecular and neuroplasticity mechanisms underlying neuroadaptation response that occurs in brains when chronically exposed to HA.
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Hobbins L, Girard O, Gaoua N, Hunter S. Acute Psychophysiological Responses to Cyclic Variation of Intermittent Hypoxic Exposure in Adults with Obesity. High Alt Med Biol 2019; 20:262-270. [DOI: 10.1089/ham.2019.0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Liam Hobbins
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, United Kingdom
| | - Olivier Girard
- Murdoch Applied Sports Science (MASS) Laboratory, School of Psychology and Exercise Science, Murdoch University, Perth, Australia
| | - Nadia Gaoua
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, United Kingdom
| | - Steve Hunter
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, United Kingdom
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Li M, Zhu Y, Li J, Chen L, Tao W, Li X, Qiu Y. Effect and mechanism of verbascoside on hypoxic memory injury in plateau. Phytother Res 2019; 33:2692-2701. [PMID: 31364205 DOI: 10.1002/ptr.6443] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 04/23/2019] [Accepted: 06/27/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Maoxing Li
- Department of PharmacyThe 940th Hospital of Joint Logistic Support Force, PLA Lanzhou China
- Key Laboratory of the Prevention and Treatment for Injure in Plateau of PLA Lanzhou China
- Department of PharmacyLanzhou University Lanzhou China
- School of PharmacyGansu University of Chinese Medicine Lanzhou China
| | - Yuting Zhu
- Department of PharmacyThe 940th Hospital of Joint Logistic Support Force, PLA Lanzhou China
- Key Laboratory of the Prevention and Treatment for Injure in Plateau of PLA Lanzhou China
- Department of PharmacyLanzhou University Lanzhou China
| | - Jing Li
- Department of PharmacyThe 940th Hospital of Joint Logistic Support Force, PLA Lanzhou China
- Key Laboratory of the Prevention and Treatment for Injure in Plateau of PLA Lanzhou China
| | - Liping Chen
- Department of PharmacyThe 940th Hospital of Joint Logistic Support Force, PLA Lanzhou China
- Key Laboratory of the Prevention and Treatment for Injure in Plateau of PLA Lanzhou China
| | - Wendi Tao
- Department of PharmacyThe 940th Hospital of Joint Logistic Support Force, PLA Lanzhou China
- Key Laboratory of the Prevention and Treatment for Injure in Plateau of PLA Lanzhou China
- Department of PharmacyLanzhou University Lanzhou China
| | - Xiaoling Li
- Department of PharmacyThe 940th Hospital of Joint Logistic Support Force, PLA Lanzhou China
- Key Laboratory of the Prevention and Treatment for Injure in Plateau of PLA Lanzhou China
- School of PharmacyGansu University of Chinese Medicine Lanzhou China
| | - Yan Qiu
- Department of PharmacyPudong Hospital of Shanghai University of Medicine and Health Science Shanghai China
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Hüfner K, Sperner-Unterweger B, Brugger H. Going to Altitude with a Preexisting Psychiatric Condition. High Alt Med Biol 2019; 20:207-214. [PMID: 31343257 PMCID: PMC6763955 DOI: 10.1089/ham.2019.0020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Psychiatric disorders have a high lifetime prevalence affecting about 30% of the global population. Not much is known about high altitude (HA) sojourns in individuals living with a psychiatric condition. This lack of scientific evidence contrasts with the anticipated increase in numbers of individuals with preexisting psychiatric conditions seeking medical advice on HA exposure. Not only are there risks associated with a HA climb, but physical activity in general is known to improve symptoms of many psychiatric disorder and enhance measures of mental well-being like quality of life and resilience. There are additional positive effects of alpine environments on mental health beyond those of physical activity. All individuals going to HA with a preexisting psychiatric condition should be in a state of stable disease with no recent change in medication. Specific considerations and recommendations apply to individual psychiatric disorders. During the HA sojourn the challenge is to separate altitude-related symptoms such as insomnia from prodromal symptoms of the underlying disorder (e.g., depressive episode) or altitude-related hyperventilation from panic attacks. In case an individual with preexisting anxiety disorder decides to go to HA there might be a predisposition toward acute mountain sickness (AMS), but it should always be considered that many symptoms of anxiety and AMS overlap. Any medication that is anticipated to be taken during ascent or at HA should be tested for compatibility with the psychiatric condition and medication before the trip.
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Affiliation(s)
- Katharina Hüfner
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
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The onset of sleep disturbances and their associations with anxiety after acute high-altitude exposure at 3700 m. Transl Psychiatry 2019; 9:175. [PMID: 31332159 PMCID: PMC6646382 DOI: 10.1038/s41398-019-0510-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/30/2019] [Accepted: 05/31/2019] [Indexed: 11/22/2022] Open
Abstract
Sleep disturbances and psychiatric repercussions pose great challenges at high altitude; however, few studies have investigated sleep disturbance and anxiety profiles and their associations after acute exposure in consecutive patients. Thus, we aimed to study the profiles of sleep disturbances in consecutive patients after high-altitude exposure and the association of such disturbances with anxiety. A total of 668 participants were recruited at sea level and 3700 m. The trials were performed at sea level (1 week prior to a 2-h flight to a high-altitude destination) and at 3700 m (24, 72, and 168 h). Sleep disturbances were assessed by self-reported sleep patterns and scores on the Athens Insomnia Scale (AIS). State anxiety was assessed using the Self-Rating Anxiety Scale (SAS). In our study, the incidence of sleep disturbances increased significantly after acute high-altitude exposure (65.3%, 434/668) and then gradually decreased after 72 h (50%, 141/282) and 168 h (44%, 124/282). The sleep assessments AIS [2.0 (4.0) vs. 4.0 (5.0)] and ESS [4.0 (4.0) vs. 5.0 (5.0)] increased significantly (p < 0.05). Also, the SAS increased significantly from 26.25 (3.75) to 28.75 (7.5). The SAS was significantly high in sleep disturbance group [31.25 (7.5) vs. 27.5 (5), p < 0.001] than in the non-sleep- disturbance group. The baseline SAS and AIS scores were significantly higher in participants with sleep disturbances than in those without (p < 0.01). Age, baseline insomnia, sleepiness, fatigue, and higher SAS were predictors of sleep disturbances in univariate regression (all p values < 0.05). However, only an older age (p = 0.045) and a higher baseline SAS (p = 0.018) remained independent predictors of sleep disturbances. Our findings indicated that acute high-altitude exposure triggers the onset of sleep disturbances, which are closely associated with anxiety. Furthermore, baseline state anxiety and age are independent predictors of sleep disturbances at high altitude.
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Williams TB, Corbett J, McMorris T, Young JS, Dicks M, Ando S, Thelwell RC, Tipton MJ, Costello JT. Cognitive performance is associated with cerebral oxygenation and peripheral oxygen saturation, but not plasma catecholamines, during graded normobaric hypoxia. Exp Physiol 2019; 104:1384-1397. [DOI: 10.1113/ep087647] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/11/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Thomas B. Williams
- Extreme Environments LaboratoryDepartment of Sport and Exercise SciencesUniversity of Portsmouth Portsmouth UK
| | - Jo Corbett
- Extreme Environments LaboratoryDepartment of Sport and Exercise SciencesUniversity of Portsmouth Portsmouth UK
| | - Terry McMorris
- Extreme Environments LaboratoryDepartment of Sport and Exercise SciencesUniversity of Portsmouth Portsmouth UK
- Department of Sport and Exercise SciencesUniversity of Chichester Chichester UK
| | - John S. Young
- School of Pharmacy and Biomedical ScienceUniversity of Portsmouth Portsmouth UK
| | - Matt Dicks
- Extreme Environments LaboratoryDepartment of Sport and Exercise SciencesUniversity of Portsmouth Portsmouth UK
| | - Soichi Ando
- Graduate School of Informatics and EngineeringThe University of Electro‐Communications Tokyo Japan
| | - Richard C. Thelwell
- Extreme Environments LaboratoryDepartment of Sport and Exercise SciencesUniversity of Portsmouth Portsmouth UK
| | - Michael J. Tipton
- Extreme Environments LaboratoryDepartment of Sport and Exercise SciencesUniversity of Portsmouth Portsmouth UK
| | - Joseph T. Costello
- Extreme Environments LaboratoryDepartment of Sport and Exercise SciencesUniversity of Portsmouth Portsmouth UK
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Ray K, Kishore K, Vats P, Bhattacharyya D, Akunov A, Maripov A, Sarybaev A, Singh SB, Kumar B. A Temporal Study on Learning and Memory at High Altitude in Two Ethnic Groups. High Alt Med Biol 2019; 20:236-244. [PMID: 31210541 DOI: 10.1089/ham.2018.0139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Cognitive function has been compromised during high-altitude (HA) exposure due to slowing of mental processing. Materials and Methods: A total of 20 Indian and 20 Kyrgyz soldiers were studied at 4111 m to assess cognitive function in two different ethnic groups. Paired associate learning, pattern recognition memory, spatial span (SSP), spatial working memory (SWM), choice reaction time (CRT), and simple reaction time (SRT) were evaluated at sea level and on days 3, 7, 14, and 21 of HA stay and on day 3 of deinduction. Results: All the parameters were significantly affected at HA. Indian soldiers were acclimatized by 7 days but Kyrgyz soldiers required 21 days for acclimatization. A slow impairment in SWM, CRT, and SRT was observed in Kyrgyz soldiers than in Indian soldiers and it continues throughout 21 days of HA stay, but for Indian soldiers the deterioration was maximum on day 7 and improvement in SWM, CRT, and SRT was observed on day 14 and close to baseline value on day 21. After deinduction, although Indian soldiers attained the normal value, Kyrgyz soldiers had higher value than baseline in SSP, SWM, CRT, and SRT. Conclusion: Difference in the cognitive performances of Indian and Kyrgyz soldiers may be due to the ethnogenetic diversity of these two groups.
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Affiliation(s)
- Koushik Ray
- Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
| | - Krishna Kishore
- Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
| | - Praveen Vats
- Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
| | - Debojyoti Bhattacharyya
- Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
| | - Almaz Akunov
- Kyrgyz-Indian Mountain Biomedical Research Centre, Bishkek, Kyrgyzstan
| | | | - Akpay Sarybaev
- Kyrgyz-Indian Mountain Biomedical Research Centre, Bishkek, Kyrgyzstan
| | - Shashi Bala Singh
- Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
| | - Bhuvnesh Kumar
- Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
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Heinrich EC, Djokic MA, Gilbertson D, DeYoung PN, Bosompra NO, Wu L, Anza-Ramirez C, Orr JE, Powell FL, Malhotra A, Simonson TS. Cognitive function and mood at high altitude following acclimatization and use of supplemental oxygen and adaptive servoventilation sleep treatments. PLoS One 2019; 14:e0217089. [PMID: 31188839 PMCID: PMC6561544 DOI: 10.1371/journal.pone.0217089] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/03/2019] [Indexed: 11/19/2022] Open
Abstract
Impairments in cognitive function, mood, and sleep quality occur following ascent to high altitude. Low oxygen (hypoxia) and poor sleep quality are both linked to impaired cognitive performance, but their independent contributions at high altitude remain unknown. Adaptive servoventilation (ASV) improves sleep quality by stabilizing breathing and preventing central apneas without supplemental oxygen. We compared the efficacy of ASV and supplemental oxygen sleep treatments for improving daytime cognitive function and mood in high-altitude visitors (N = 18) during acclimatization to 3,800 m. Each night, subjects were randomly provided with ASV, supplemental oxygen (SpO2 > 95%), or no treatment. Each morning subjects completed a series of cognitive function tests and questionnaires to assess mood and multiple aspects of cognitive performance. We found that both ASV and supplemental oxygen (O2) improved daytime feelings of confusion (ASV: p < 0.01; O2: p < 0.05) and fatigue (ASV: p < 0.01; O2: p < 0.01) but did not improve other measures of cognitive performance at high altitude. However, performance improved on the trail making tests (TMT) A and B (p < 0.001), the balloon analog risk test (p < 0.0001), and the psychomotor vigilance test (p < 0.01) over the course of three days at altitude after controlling for effects of sleep treatments. Compared to sea level, subjects reported higher levels of confusion (p < 0.01) and performed worse on the TMT A (p < 0.05) and the emotion recognition test (p < 0.05) on nights when they received no treatment at high altitude. These results suggest that stabilizing breathing (ASV) or increasing oxygenation (supplemental oxygen) during sleep can reduce feelings of fatigue and confusion, but that daytime hypoxia may play a larger role in other cognitive impairments reported at high altitude. Furthermore, this study provides evidence that some aspects of cognition (executive control, risk inhibition, sustained attention) improve with acclimatization.
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Affiliation(s)
- Erica C. Heinrich
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Matea A. Djokic
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Dillon Gilbertson
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Pamela N. DeYoung
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Naa-Oye Bosompra
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Lu Wu
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Cecilia Anza-Ramirez
- Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jeremy E. Orr
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Frank L. Powell
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Atul Malhotra
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Tatum S. Simonson
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, La Jolla, California, United States of America
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Severe Hypoxia Does Not Offset the Benefits of Exercise on Cognitive Function in Sedentary Young Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061003. [PMID: 30897697 PMCID: PMC6466299 DOI: 10.3390/ijerph16061003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/13/2019] [Accepted: 03/18/2019] [Indexed: 12/15/2022]
Abstract
Purpose: To examine the effect of acute moderate-intensity continuous exercise performed under normobaric severe hypoxia on cognition, compared to sea-level normoxia. Methods: Thirty healthy inactive women randomly performed two experimental trials separated by at least three days but at approximately the same time of day. Executive functions were measured during the follicular stage via an interference control task before (rest) and during exercise with 45% peak power output under normobaric normoxia (PIO₂ = 150 mmHg, FIO₂ = 0.21), and (2) hypoxia (PIO₂ = 87 mmHg, FIO₂ = 0.12, simulated at an altitude of 4000 m). Reaction time (RT), accuracy rate (AC), heart rate, ratings of perceived exertion, and peripheral oxygen saturation (SpO₂) were collected before and during exercise. Results: RT (p < 0.05, η²p = 0.203) decreased during moderate exercise when compared at rest, while a short bout of severe hypoxia improved RT (p < 0.05, η²p = 0.134). Exercise and hypoxia had no effects on AC (p > 0.05). No significant associations were found between the changes of RT and SpO₂ under the conditions of normoxia and hypoxia (p > 0.05). Conclusions: At the same phase of the menstrual cycle, a short bout of severe hypoxia simulated at 4000 m altitude caused no impairment at rest. RT during moderate exercise ameliorated in normoxia and severe hypoxia, suggesting that both exercise and short-term severe hypoxia have benefits on cognitive function in sedentary young women.
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Altbäcker A, Takács E, Barkaszi I, Kormos T, Czigler I, Balázs L. Differential impact of acute hypoxia on event related potentials: impaired task-irrelevant, but preserved task-relevant processing and response inhibition. Physiol Behav 2019; 206:28-36. [PMID: 30902633 DOI: 10.1016/j.physbeh.2019.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/21/2019] [Accepted: 03/18/2019] [Indexed: 01/04/2023]
Abstract
The current study investigated how experimentally induced acute normobaric hypoxia affects attentional control functions during easy, monotonous visual sustained attention and response inhibition (modified Continuous Performance Task) and executive control tasks (number-size Stroop task). Along with behavioral efficiency, task-relevant and task-irrelevant information processing were investigated by measuring event related brain potentials (ERP) evoked by target stimuli (Target P3), task-relevant stimuli with no response needed (NoGo P3), and task-irrelevant novel stimuli (Novelty P3) during acute hypoxia exposure. Normobaric hypoxia was induced by adjusting the O2 content of the breathing mixture to obtain 80% peripheral oxygen saturation, equivalent of 5500 m above sea level. Here we report decreased Novelty P3 during acute normobaric hypoxia exposure, while Target P3 and NoGo P3, as well as behavioral efficiency remained intact. Our paper is the first to provide evidence for impaired novelty processing along with intact task-relevant information processing and response inhibition during normobaric hypoxic exposure.
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Affiliation(s)
- Anna Altbäcker
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Endre Takács
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary; Institute of Psychology, Eötvös Loránd University, Budapest, Hungary; Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Irén Barkaszi
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Tamás Kormos
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - István Czigler
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary; Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - László Balázs
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary.
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71
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Zhang F, Niu L, Li S, Le W. Pathological Impacts of Chronic Hypoxia on Alzheimer's Disease. ACS Chem Neurosci 2019; 10:902-909. [PMID: 30412668 DOI: 10.1021/acschemneuro.8b00442] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Chronic hypoxia is considered as one of the important environmental factors contributing to the pathogenesis of Alzheimer's disease (AD). Many chronic hypoxia-causing comorbidities, such as obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD), have been reported to be closely associated with AD. Increasing evidence has documented that chronic hypoxia may affect many pathological aspects of AD including amyloid β (Aβ) metabolism, tau phosphorylation, autophagy, neuroinflammation, oxidative stress, endoplasmic reticulum (ER) stress, and mitochondrial and synaptic dysfunction, which may collectively result in neurodegeneration in the brain. In this Review, we briefly summarize the effects of chronic hypoxia on AD pathogenesis and discuss the underlying mechanisms. Since chronic hypoxia is common in the elderly and may contribute to the pathogenesis of AD, prospective prevention and treatment targeting hypoxia may be helpful to delay or alleviate AD.
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Affiliation(s)
- Feng Zhang
- Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian 116021, China
- Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian 116021, China
| | - Long Niu
- Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian 116021, China
- Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian 116021, China
| | - Song Li
- Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian 116021, China
- Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian 116021, China
| | - Weidong Le
- Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian 116021, China
- Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian 116021, China
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Steinberg F, Doppelmayr M. Neurocognitive Markers During Prolonged Breath-Holding in Freedivers: An Event-Related EEG Study. Front Physiol 2019; 10:69. [PMID: 30792665 PMCID: PMC6374628 DOI: 10.3389/fphys.2019.00069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 01/21/2019] [Indexed: 01/16/2023] Open
Abstract
Since little is known concerning the psychological, cognitive, and neurophysiological factors that are involved in and important for phases of prolonged breath-holding (pBH) in freedivers, the present study uses electroencephalography (EEG) to investigate event-related neurocognitive markers during pBH of experienced freedivers that regularly train pBH. The purpose was to determine whether the well-known neurophysiological modulations elicited by hypoxic and hypercapnic conditions can also be detected during pBH induced hypoxic hypercapnia. Ten experienced free-divers (all male, aged 35.10 ± 7.89 years) were asked to hold their breath twice for 4 min per instance. During the first pBH, a checker board reversal task was presented and in the second four-min pBH phase a classical visual oddball paradigm was performed. A visual evoked potential (VEP) as an index of early visual processing (i.e., latencies and amplitudes of N75, P100, and N145) and the latency and amplitude of a P300 component (visual oddball paradigm) as an index of cognitive processing were investigated. In a counter-balanced cross-over design, all tasks were once performed during normal breathing (B), and once during pBH. All components were then compared between an early pBH (0–2 min) and a later pBH stage (2–4 min) and with the same time phases without pBH (i.e., during normal breathing). Statistical analyses using analyses of variance (ANOVA) revealed that comparisons between B and pBH yielded no significant changes either in the amplitude and latency of the VEP or in the P300. This indicates that neurocognitive markers, whether in an early visual processing stream or at a later cognitive processing stage, were not affected by pBH in experienced free-divers.
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Affiliation(s)
- Fabian Steinberg
- Department of Sport Psychology, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michael Doppelmayr
- Department of Sport Psychology, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany.,Centre of Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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Giampá SQDC, Souza JFTD, Mello MTD, Tufik S, Santos RVTD, Antunes HKM. MAXIMUM EFFORT TRAINING PERFORMED IN HYPOXIA ALTERS THE MOOD PROFILE. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182406133712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Physical exercise at high altitude has become constant. However, the risks associated with this type of exercise represent a major concern, considering the influence of important stressors such as hypoxia and physical exercise on psychobiological and physiological responses. Objective: Analyze the mood state and behavior of physiological variables of volunteers subjected to a progressive loading protocol until they reached maximum volitional exhaustion, both at sea level and at a simulated altitude of 4500 meters. Method: For both conditions studied, the volunteers responded to two instruments that assess mood responses: The Brunel Mood Scale and the Visual Analogue Mood Scale. They also underwent blood sampling to measure blood lactate levels and to evaluate oxygen-hemoglobin saturation. These procedures were performed before, immediately after, and 30 and 60 minutes after the end of the protocol. Results: Hypoxia triggered negative effects on mood responses, especially when compared to sea level conditions. An increase in fatigue level (p=0.02) and mental confusion (p=0.04) was observed immediately after the exercise session, and reduction of vigor (p=0.03) was noted at 30 minutes, accompanied by a reduction in oxygen-hemoglobin saturation immediately after the session and at 30 minutes. There was also an increase in blood lactate levels immediately after the session (p=0.006). Conclusion: The particularities of the hypoxic environment associated with maximum exercise are able to cause a deterioration of mood and physiological responses, which can negatively modulate physical performance. This is a cross-sectional clinical study.
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Affiliation(s)
| | | | | | | | - Ronaldo Vagner Thomatieli dos Santos
- Universidade Federal de São Paulo, Brazil; Laboratório Interdisciplinar em Fisiologia e Exercício, Brazil; Universidade Federal de São Paulo, Brazil
| | - Hanna Karen Moreira Antunes
- Universidade Federal de São Paulo, Brazil; Laboratório Interdisciplinar em Fisiologia e Exercício, Brazil; Universidade Federal de São Paulo, Brazil
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Kammerer T, Faihs V, Hulde N, Bayer A, Hübner M, Brettner F, Karlen W, Kröpfl JM, Rehm M, Spengler C, Schäfer ST. Changes of hemodynamic and cerebral oxygenation after exercise in normobaric and hypobaric hypoxia: associations with acute mountain sickness. Ann Occup Environ Med 2018; 30:66. [PMID: 30479778 PMCID: PMC6245893 DOI: 10.1186/s40557-018-0276-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/31/2018] [Indexed: 12/14/2022] Open
Abstract
Objective Normobaric (NH) and hypobaric hypoxia (HH) are associated with acute mountain sickness (AMS) and cognitive dysfunction. Only few variables, like heart-rate-variability, are correlated with AMS. However, prediction of AMS remains difficult. We therefore designed an expedition-study with healthy volunteers in NH/HH to investigate additional non-invasive hemodynamic variables associated with AMS. Methods Eleven healthy subjects were examined in NH (FiO2 13.1%; equivalent of 3.883 m a.s.l; duration 4 h) and HH (3.883 m a.s.l.; duration 24 h) before and after an exercise of 120 min. Changes in parameters of electrical cardiometry (cardiac index (CI), left-ventricular ejection time (LVET), stroke volume (SV), index of contractility (ICON)), near-infrared spectroscopy (cerebral oxygenation, rScO2), Lake-Louise-Score (LLS) and cognitive function tests were assessed. One-Way-ANOVA, Wilcoxon matched-pairs test, Spearman's-correlation-analysis and Student's t-test were performed. Results HH increased heart rate (HR), mean arterial pressure (MAP) and CI and decreased LVET, SV and ICON, whereas NH increased HR and decreased LVET. In both NH and HH cerebral oxygenation decreased and LLS increased significantly. After 24 h in HH, 6 of 11 subjects (54.6%) developed AMS. LLS remained increased until 24 h in HH, whereas cognitive function remained unaltered. In HH, HR and LLS were inversely correlated (r = - 0.692; p < 0.05). More importantly, the rScO2-decrease after exercise in NH significantly correlated with LLS after 24 h in HH (r = - 0.971; p < 0.01) and rScO2 correlated significantly with HR (r = 0.802; p < 0.01), CI (r = 0.682; p < 0.05) and SV (r = 0.709; p < 0.05) after exercise in HH. Conclusions Both acute NH and HH altered hemodynamic and cerebral oxygenation and induced AMS. Subjects, who adapted their CI had higher rScO2 and lower LLS. Furthermore, rScO2 after exercise under normobaric conditions was associated with AMS at high altitudes.
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Affiliation(s)
- Tobias Kammerer
- Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.,2Walter Brendel Centre of Experimental Medicine, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.,5Institute of Anesthesiology, Heart and Diabetes Center NRW, Ruhr University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany
| | - Valentina Faihs
- Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Nikolai Hulde
- 5Institute of Anesthesiology, Heart and Diabetes Center NRW, Ruhr University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany
| | - Andreas Bayer
- Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Max Hübner
- Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.,2Walter Brendel Centre of Experimental Medicine, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Florian Brettner
- Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.,2Walter Brendel Centre of Experimental Medicine, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Walter Karlen
- 4Mobile Health Systems Lab, Institute of Robotics and Intelligent Systems, ETH Zurich, Lengghalde 5, 8092 Zurich, Switzerland
| | - Julia Maria Kröpfl
- 3Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Winterthurerstr. 190, 8057 Zurich, Switzerland
| | - Markus Rehm
- Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Christina Spengler
- 3Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Winterthurerstr. 190, 8057 Zurich, Switzerland
| | - Simon Thomas Schäfer
- Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.,2Walter Brendel Centre of Experimental Medicine, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
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Gibson OR, Taylor L, Watt PW, Maxwell NS. Cross-Adaptation: Heat and Cold Adaptation to Improve Physiological and Cellular Responses to Hypoxia. Sports Med 2018; 47:1751-1768. [PMID: 28389828 PMCID: PMC5554481 DOI: 10.1007/s40279-017-0717-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
To prepare for extremes of heat, cold or low partial pressures of oxygen (O2), humans can undertake a period of acclimation or acclimatization to induce environment-specific adaptations, e.g. heat acclimation (HA), cold acclimation (CA), or altitude training. While these strategies are effective, they are not always feasible due to logistical impracticalities. Cross-adaptation is a term used to describe the phenomenon whereby alternative environmental interventions, e.g. HA or CA, may be a beneficial alternative to altitude interventions, providing physiological stress and inducing adaptations observable at altitude. HA can attenuate physiological strain at rest and during moderate-intensity exercise at altitude via adaptations allied to improved O2 delivery to metabolically active tissue, likely following increases in plasma volume and reductions in body temperature. CA appears to improve physiological responses to altitude by attenuating the autonomic response to altitude. While no cross-acclimation-derived exercise performance/capacity data have been measured following CA, post-HA improvements in performance underpinned by aerobic metabolism, and therefore dependent on O2 delivery at altitude, are likely. At a cellular level, heat shock protein responses to altitude are attenuated by prior HA, suggesting that an attenuation of the cellular stress response and therefore a reduced disruption to homeostasis at altitude has occurred. This process is known as cross-tolerance. The effects of CA on markers of cross-tolerance is an area requiring further investigation. Because much of the evidence relating to cross-adaptation to altitude has examined the benefits at moderate to high altitudes, future research examining responses at lower altitudes should be conducted, given that these environments are more frequently visited by athletes and workers. Mechanistic work to identify the specific physiological and cellular pathways responsible for cross-adaptation between heat and altitude, and between cold and altitude, is warranted, as is exploration of benefits across different populations and physical activity profiles.
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Affiliation(s)
- Oliver R Gibson
- Centre for Human Performance, Exercise and Rehabilitation (CHPER), Brunel University London, Uxbridge, UK. .,Welkin Human Performance Laboratories, Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Denton Road, Eastbourne, UK.
| | - Lee Taylor
- Athlete Health and Performance Research Centre, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Peter W Watt
- Welkin Human Performance Laboratories, Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Denton Road, Eastbourne, UK
| | - Neil S Maxwell
- Welkin Human Performance Laboratories, Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Denton Road, Eastbourne, UK
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Ochi G, Kanazawa Y, Hyodo K, Suwabe K, Shimizu T, Fukuie T, Byun K, Soya H. Hypoxia-induced lowered executive function depends on arterial oxygen desaturation. J Physiol Sci 2018; 68:847-853. [PMID: 29536370 PMCID: PMC10717617 DOI: 10.1007/s12576-018-0603-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/04/2018] [Indexed: 01/20/2023]
Abstract
Although it has been traditionally thought that decreasing SpO2 with ascent to high altitudes not only induces acute mountain sickness but also can decrease executive function, the relationship between decreased SpO2 levels and hypoxia-induced lowered executive function is still unclear. Here we aimed to clarify whether hypoxia-induced lowered executive function was associated with arterial oxygen desaturation, using 21 participants performing the color-word Stroop task under normoxic and three hypoxic conditions (FIO2 = 0.165, 0.135, 0.105; corresponding to altitudes of 2000, 3500, and 5000 m, respectively). Stroop interference significantly increased under severe hypoxic condition (FIO2 = 0.105) compared with the other conditions. Moreover, there was a negative correlation between Stroop interference and SpO2. In conclusion, acute exposure to severe hypoxic condition decreased executive function and this negative effect was associated with decreased SpO2. We initially implicated an arterial oxygen desaturation as a potential physiological factor resulting in hypoxia-induced lowered executive function.
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Affiliation(s)
- Genta Ochi
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
- Sports Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
| | - Yusuke Kanazawa
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
| | - Kazuki Hyodo
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Kazuya Suwabe
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
- Sports Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
| | - Takeshi Shimizu
- Sports Research and Development Core, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
| | - Takemune Fukuie
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
- Sports Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
| | - Kyeongho Byun
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
- Sports Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan
| | - Hideaki Soya
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan.
- Sports Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Ibaraki, Japan.
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77
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The influence of hypoxia and prolonged exercise on attentional performance at high and extreme altitudes: A pilot study. PLoS One 2018; 13:e0205285. [PMID: 30281651 PMCID: PMC6169942 DOI: 10.1371/journal.pone.0205285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/21/2018] [Indexed: 12/13/2022] Open
Abstract
Introduction Exposure to hypoxic conditions is reported to impair cognitive performance. Further, moderate physical exercise improves cognitive function, but little is known about the influence of exercise on cognitive function in hypoxia. Therefore, the current study aimed to examine the influence of hypoxia (HYP) and prolonged exercise (EX) on attentional performance. Methods A total of 80 participants (female: n = 29; male: n = 51) were assigned to four groups: HYP + EX (n = 15), HYP (n = 25), EX (n = 21) and normoxia (NOR) (n = 21). The Frankfurt Attention Inventory—2 (FAIR-2) was performed at four testing points (day 1, 14, 16 and 18) to assess attentional performance. All groups completed a pretest (D1) and a follow-up test (D18). In HYP + EX conditions, the cognitive task was performed in a hypoxic state after prolonged exercise (D14: 3950 m, D16: 5739 m) during a mountain climb on Mt. Kilimanjaro. Participants in HYP were tested under intermittent hypoxia at rest in a hypoxic chamber (D14: 3500 m, D16: 5800 m), and those in EX were tested under normoxia after prolonged exercise during a 7-day backcountry ski hiking tour. NOR was a control group, and participants completed all tests under normoxia and at rest. Results Hypoxia impaired the attentional functions performance value (PV) and continuity value (CV) for the HYP + EX (p = 0.000) and HYP (L: p = 0.025; K: p = 0.043) groups at 5739 m and 5800 m, respectively, but not the function quality value (QV). In contrast, the EX group did not exhibit changes in attentional function. Conclusion The current results suggest that attentional performance is impaired during extreme normobaric and hypobaric hypoxic exposure. We further conclude that greater cognitive impairment under hypobaric hypoxia during a mountain climb compared with normobaric hypoxia at rest is not caused by prolonged exercise, but may be influenced by other factors (e.g. low temperatures, dehydration, or sleep deprivation) that remain to be verified.
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Roy K, Chauhan G, Kumari P, Wadhwa M, Alam S, Ray K, Panjwani U, Kishore K. Phosphorylated delta sleep inducing peptide restores spatial memory and p-CREB expression by improving sleep architecture at high altitude. Life Sci 2018; 209:282-290. [PMID: 30107169 DOI: 10.1016/j.lfs.2018.08.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/07/2018] [Accepted: 08/10/2018] [Indexed: 12/27/2022]
Abstract
AIMS Sleep loss at high altitude (HA) play major role in worsening of neuropsychological functions, such as attention, memory and decision making. This study investigates the role of phosphorylated delta sleep inducing peptide (p-DSIP) in improving sleep architecture during chronic hypobaric hypoxia (HH) exposure and restoration of spatial navigational memory. METHODS Morris water maze (MWM) trained rats were exposed to HH at 7620 m. p-DSIP was injected intra-peritoneally (10 μg/Kg bw) during HH exposure as an intervention against sleep alteration. Sleep architecture was recorded telemetrically before and during HH exposure. Monoamines were estimated by high performance liquid chromatography from brain stem (BS) and hypothalamus. CREB and p-CREB level in hippocampus was studied by western blotting and expression of different monoamine regulatory enzymes in BS was measured by flow cytometry. Naloxone (1 mg/kg bw), a μ opioid receptor antagonist of sleep inducing effect of DSIP was also studied. KEY FINDINGS p-DSIP injection daily in circadian active period (18.30 h) during chronic HH enhanced non rapid eye movement sleep, rapid eye movement sleep as well as improved MWM performance of rats. p-DSIP treatment showed lower monoamine level and tyrosine hydroxylase (TH) expression and increased monoamine oxidase A (MAO A), glutamic acid decarboxylase (GAD) and Choline acetyltransferase (ChAT) expression. Further, naloxone altered navigational memory by decreasing the CREB and p-CREB level in hippocampus suggesting suppression of sleep inducing effect of p-DSIP. SIGNIFICANCE Our study demonstrates that improvement of sleep quality by p-DSIP restores spatial memory by up regulating CREB phosphorylation during simulated high altitude hypoxia.
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Affiliation(s)
- Koustav Roy
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organization (DRDO), Lucknow Road, Timarpur, Delhi 110 054, India
| | - Garima Chauhan
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organization (DRDO), Lucknow Road, Timarpur, Delhi 110 054, India
| | - Punita Kumari
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organization (DRDO), Lucknow Road, Timarpur, Delhi 110 054, India
| | - Meetu Wadhwa
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organization (DRDO), Lucknow Road, Timarpur, Delhi 110 054, India
| | - Shahnawaz Alam
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organization (DRDO), Lucknow Road, Timarpur, Delhi 110 054, India
| | - Koushik Ray
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organization (DRDO), Lucknow Road, Timarpur, Delhi 110 054, India
| | - Usha Panjwani
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organization (DRDO), Lucknow Road, Timarpur, Delhi 110 054, India
| | - Krishna Kishore
- Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organization (DRDO), Lucknow Road, Timarpur, Delhi 110 054, India.
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Hüfner K, Brugger H, Kuster E, Dünsser F, Stawinoga AE, Turner R, Tomazin I, Sperner-Unterweger B. Isolated psychosis during exposure to very high and extreme altitude - characterisation of a new medical entity. Psychol Med 2018; 48:1872-1879. [PMID: 29202898 PMCID: PMC6088769 DOI: 10.1017/s0033291717003397] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Psychotic episodes during exposure to very high or extreme altitude have been frequently reported in mountain literature, but not systematically analysed and acknowledged as a distinct clinical entity. METHODS Episodes reported above 3500 m altitude with possible psychosis were collected from the lay literature and provide the basis for this observational study. Dimensional criteria of the Diagnostic and Statistical Manual of Mental Disorders were used for psychosis, and the Lake Louise Scoring criteria for acute mountain sickness and high-altitude cerebral oedema (HACE). Eighty-three of the episodes collected underwent a cluster analysis to identify similar groups. Ratings were done by two independent, trained researchers (κ values 0.6-1).FindingsCluster 1 included 51% (42/83) episodes without psychosis; cluster 2 22% (18/83) cases with psychosis, plus symptoms of HACE or mental status change from other origins; and cluster 3 28% (23/83) episodes with isolated psychosis. Possible risk factors of psychosis and associated somatic symptoms were analysed between the three clusters and revealed differences regarding the factors 'starvation' (χ2 test, p = 0.002), 'frostbite' (p = 0.024) and 'supplemental oxygen' (p = 0.046). Episodes with psychosis were reversible but associated with near accidents and accidents (p = 0.007, odds ratio 4.44). CONCLUSIONS Episodes of psychosis during exposure to high altitude are frequently reported, but have not been specifically examined or assigned to medical diagnoses. In addition to the risk of suffering from somatic mountain illnesses, climbers and workers at high altitude should be aware of the potential occurrence of psychotic episodes, the associated risks and respective coping strategies.
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Affiliation(s)
- Katharina Hüfner
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University Innsbruck, Innsbruck, Austria
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, EURAC research, Bolzano, Italy
- Medical University Innsbruck, Innsbruck, Austria
| | - Eva Kuster
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University Innsbruck, Innsbruck, Austria
| | - Franziska Dünsser
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University Innsbruck, Innsbruck, Austria
| | | | - Rachel Turner
- Institute of Mountain Emergency Medicine, EURAC research, Bolzano, Italy
- Medical University Innsbruck, Innsbruck, Austria
| | - Iztok Tomazin
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Slovenia
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University Innsbruck, Innsbruck, Austria
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Chen PZ, He WJ, Zhu ZR, E GJ, Xu G, Chen DW, Gao YQ. Adenosine A 2A receptor involves in neuroinflammation-mediated cognitive decline through activating microglia under acute hypobaric hypoxia. Behav Brain Res 2018; 347:99-107. [PMID: 29501623 DOI: 10.1016/j.bbr.2018.02.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/26/2018] [Accepted: 02/26/2018] [Indexed: 01/05/2023]
Abstract
Hypobaric hypoxia (HH) at high altitudes leads to a wide range of cognitive impairments which can handicap human normal activities and performances. However, the underlying mechanism is still unclear. Adenosine A2A receptors (A2ARs) of the brain are pivotal to synaptic plasticity and cognition. Besides, insult-induced up-regulation of A2AR regulates neuroinflammation and therefore induces brain damages in various neuropathological processes. The present study was designed to determine whether A2AR-mediate neuroinflammation involves in cognitive impairments under acute HH. A2AR knock-out and wild-type male mice were exposed to a simulated altitude of 8000 m for 7 consecutive days in a hypobaric chamber and simultaneously received behavioral tests including Morris water maze test and open filed test. A2AR expression, the activation of microglia and the production of TNF-α were evaluated in the hippocampus by immunohistochemistry and ELISA, respectively. Behavioral tests showed that acute HH exposure caused the dysfunction of spatial memory and mood, while genetic inactivation of A2AR attenuated the impairment of spatial memory but not that of mood. Double-labeled immunofluorescence showed that A2ARs were mainly expressed on microglia and up-regulated in the hippocampus of acute HH model mice. Acute HH also induced the accumulation of microglia and increased production of TNF-α in the hippocampus, which could be markedly inhibited by A2AR inactivation. These findings indicate that microglia-mediated neuroinflammation triggered by A2AR activation involves in acute HH-induced spatial memory impairment and that A2AR could be a new target for the pharmacotherapy of cognitive dysfunction at high altitudes.
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Affiliation(s)
- Peng-Zhi Chen
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of Education, Chongqing, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, China
| | - Wen-Juan He
- Department of Pathophysiology and High Altitude Pathology, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, China
| | - Zhi-Ru Zhu
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Guo-Ji E
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of Education, Chongqing, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, China
| | - Gang Xu
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of Education, Chongqing, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, China
| | - De-Wei Chen
- Department of Pathophysiology and High Altitude Pathology, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, China
| | - Yu-Qi Gao
- Institute of Medicine and Hygienic Equipment for High Altitude Region, College of High Altitude Military Medicine, Third Military Medical University, Chongqing, China; Key Laboratory of High Altitude Environmental Medicine, Third Military Medical University, Ministry of Education, Chongqing, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, China.
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Abstract
The term ‘Cerebral hypoxia’ refers to reduced supply of oxygen to the brain tissues. If a brain cell becomes completely deprived of oxygen, the condition is referred to as cerebral anoxia. Since brain needs constant supply of oxygen for its vital functioning, cerebral hypoxia can have major impact of cerebral hemispheres, leading to cognitive, behavioural as well as personality changes including anxiety, depression and memory loss.
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Ortiz-Prado E, Simbaña K, Gómez L, Henriquez-Trujillo AR, Cornejo-Leon F, Vasconez E, Castillo D, Viscor G. The disease burden of suicide in Ecuador, a 15 years' geodemographic cross-sectional study (2001-2015). BMC Psychiatry 2017; 17:342. [PMID: 29017474 PMCID: PMC5634887 DOI: 10.1186/s12888-017-1502-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/02/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Suicide affects people from different backgrounds, ethnical groups, socio-economic status and geographical locations. In Latin America, suicide reports arescarce, specially in Andean countries. In Ecuador, very few reports have partially described this phenomenon, nonetheless, estimation of the burden of disease (BoD) hasnever been reported in the country. METHODS A country-wide comparison was performed using the Ministry of Public Health's national databases of overall mortality, Hospital Discharges Database, and the Population Census of the National Institute of Census and Statistics (INEC). The study variables analyzed were age, geographical distribution to provincial level, sex, means of suicide, educational attainment, marital status and mortality. Linear Regression and relative Risk analysis were used to predict outcome and the likelihood that suicide occur among study variables. RESULTS In the last 15 years, 13,024 suicides were officially reported. Men were 3 times more likely than women to die by suicide. The overall age-adjusted suicide ratio in Ecuador corresponds to 7.1 per 100,000 per year. The sex-specific rates were 5.3 in women and 13.2 in men. The primary mean of suicide was hanging X70 (51.1%), followed by self-poisoning X68-X69 (35.2%) and firearms X72-X74 (7.6%). Provinces located at higher altitude reported higher rates than those located at sea level (9 per 100,000 vs 4.5 per 100.000). The total economic loss due to suicide was estimated to be $852.6 million during the 15 years' analysis. CONCLUSIONS This is the first geodemographic study exploring the complete burden of suicide in Ecuador and one of the very few in Latin-America. In the last 15 years of available data, Ecuador ranks above the regional average with an adjusted suicide rate of 7.1 per 100,000 inhabitants. An important finding is that Suicide affects rather younger populations, adding more than 10,000 years of premature years of life lost (YYL) between 2001 and 2015, becoming the first and fourth leading cause of death among adolescent women and men respectively. Suicide affects people from different backgrounds, socioeconomic status and educational attainment. The mean of suicide changed over time showing that gun and pesticides related deaths decreased significantly since 2001, while hanging and suffocation increased in more than 50%.
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Affiliation(s)
- Esteban Ortiz-Prado
- OneHealth Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador
- Department of Cell Biology, Physiology and Immunology, Universitat de Barcelona, Barcelona, Spain
- One Health Research Group, Universidad de las Américas, Quito, Ecuador Calle de los Colimes y Avenida De los Granados, 170137 Quito, Ecuador
| | - Katherine Simbaña
- Faculty of Medicine, Universidad Central del Ecuador, Quito, Ecuador
| | - Lenin Gómez
- Faculty of Medicine, Universidad Central del Ecuador, Quito, Ecuador
| | | | | | - Eduardo Vasconez
- OneHealth Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador
| | - Diana Castillo
- OneHealth Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador
| | - Ginés Viscor
- Department of Cell Biology, Physiology and Immunology, Universitat de Barcelona, Barcelona, Spain
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Phillips L, Basnyat B, Chang Y, Swenson ER, Harris NS. Findings of Cognitive Impairment at High Altitude: Relationships to Acetazolamide Use and Acute Mountain Sickness. High Alt Med Biol 2017; 18:121-127. [PMID: 28509579 DOI: 10.1089/ham.2016.0001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Phillips, Lara, Buddha Basnyat, Yuchiao Chang, Erik R. Swenson, and N. Stuart Harris. Findings of cognitive impairment at high altitude: relationships to acetazolamide use and acute mountain sickness. High Alt Med Biol. 18:121-127, 2017. OBJECTIVE Acute mountain sickness (AMS) is defined by patient-reported symptoms using the Lake Louise Score (LLS), which provides limited insight into any possible underlying central nervous system (CNS) dysfunction. Some evidence suggests AMS might coexist with altered neural functioning. Cognitive impairment (CI) may go undetected unless a sensitive test is applied. Our hypothesis was that a standardized test for mild CI would provide an objective measure of CNS dysfunction, which may correlate with the symptoms of AMS and so provide a potential new tool to better characterize altitude-related CNS dysfunction. We compared a cognitive screening tool with the LLS to see if it correlated with CNS dysfunction. METHODS Adult native English-speaking subjects visiting Himalayan Rescue Association aid stations in Nepal at 3520 m (11,548 ft) and 4550 m (14,927 ft) were recruited. Subjects were administered the LLS and a slightly modified version of the environmental Quick mild cognitive impairment screen (eQmci). Medication use for altitude illness was recorded. Scores were compared using the Spearman's correlation coefficient. Data also included medication use. RESULTS Seventy-nine subjects were enrolled. A cut-off of three or greater was used for the LLS to diagnose AMS and 67 or less for the eQmci to diagnose CI. There were 22 (28%) subjects who met criteria for AMS and 17 (22%) subjects who met criteria for CI. There was a weak correlation (r2 = 0.06, p = 0.04) between eQmci score and LLS. In matched subjects with identical LLS, recent acetazolamide use was associated with significantly more CI. CONCLUSION Field assessment of CI using a rapid standardized tool demonstrated that a substantial number of subjects were found to have mild CI following rapid ascent to 3520-4550 m (11,548-14,927 ft). The weak correlation between the LLS and eQmci suggests that AMS does not result in CI. Use of acetazolamide appears to be associated with CI at all levels of AMS severity.
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Affiliation(s)
- Lara Phillips
- 1 Division of Wilderness Medicine, Department of Emergency Medicine, Massachusetts General Hospital , Harvard Medical School, Boston, Massachusetts
| | - Buddha Basnyat
- 2 Oxford University Clinical Research Unit - Nepal , Himalayan Rescue Association, Kathmandu, Nepal
| | - Yuchiao Chang
- 1 Division of Wilderness Medicine, Department of Emergency Medicine, Massachusetts General Hospital , Harvard Medical School, Boston, Massachusetts
| | - Erik R Swenson
- 3 Medical Service, Veterans Affairs Puget Sound Health Care System, University of Washington , Seattle, Washington
| | - N Stuart Harris
- 1 Division of Wilderness Medicine, Department of Emergency Medicine, Massachusetts General Hospital , Harvard Medical School, Boston, Massachusetts
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Pramsohler S, Wimmer S, Kopp M, Gatterer H, Faulhaber M, Burtscher M, Netzer NC. Normobaric hypoxia overnight impairs cognitive reaction time. BMC Neurosci 2017; 18:43. [PMID: 28506292 PMCID: PMC5433012 DOI: 10.1186/s12868-017-0362-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 05/10/2017] [Indexed: 01/04/2023] Open
Abstract
Background Impaired reaction time in patients suffering from hypoxia during sleep, caused by sleep breathing disorders, is a well-described phenomenon. High altitude sleep is known to induce periodic breathing with central apneas and oxygen desaturations, even in perfectly healthy subjects. However, deficits in reaction time in mountaineers or workers after just some nights of hypoxia exposure are not sufficiently explored. Therefore, we aimed to investigate the impact of sleep in a normobaric hypoxic environment on reaction time divided by its cognitive and motoric components. Eleven healthy non acclimatized students (5f, 6m, 21 ± 2.1 years) slept one night at a simulated altitude of 3500 m in a normobaric hypoxic room, followed by a night with polysomnography at simulated 5500 m. Preexisting sleep disorders were excluded via BERLIN questionnaire. All subjects performed a choice reaction test (SCHUHFRIED RT, S3) at 450 m and directly after the nights at simulated 3500 and 5500 m. Results We found a significant increase of cognitive reaction time with higher altitude (p = 0.026). No changes were detected in movement time (p = n.s.). Reaction time, the combined parameter of cognitive- and motoric reaction time, didn’t change either (p = n.s.). Lower SpO2 surprisingly correlated significantly with shorter cognitive reaction time (r = 0.78, p = 0.004). Sleep stage distribution and arousals at 5500 m didn’t correlate with reaction time, cognitive reaction time or movement time. Conclusion Sleep in hypoxia does not seem to affect reaction time to simple tasks. The component of cognitive reaction time is increasingly delayed whereas motoric reaction time seems not to be affected. Low SpO2 and arousals are not related to increased cognitive reaction time therefore the causality remains unclear. The fact of increased cognitive reaction time after sleep in hypoxia, considering high altitude workers and mountaineering operations with overnight stays, should be further investigated.
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Affiliation(s)
- Stephan Pramsohler
- Hermann Buhl Institute for Hypoxia and Sleep Medicine Research, Ghersburgstr. 9, 83043, Bad Aibling, Germany.
| | - Stefan Wimmer
- Hermann Buhl Institute for Hypoxia and Sleep Medicine Research, Ghersburgstr. 9, 83043, Bad Aibling, Germany.,Department of Sport Science, University Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - Hannes Gatterer
- Department of Sport Science, University Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - Martin Faulhaber
- Department of Sport Science, University Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - Martin Burtscher
- Department of Sport Science, University Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - Nikolaus Cristoph Netzer
- Hermann Buhl Institute for Hypoxia and Sleep Medicine Research, Ghersburgstr. 9, 83043, Bad Aibling, Germany.,Department of Sport Science, University Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria.,Division of Sports Medicine and Rehabilitation, Department of Medicine, University Ulm, Fürstenweg 185, Ulm, Germany
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85
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Ogoh S. Relationship between cognitive function and regulation of cerebral blood flow. J Physiol Sci 2017; 67:345-351. [PMID: 28155036 PMCID: PMC10717011 DOI: 10.1007/s12576-017-0525-0] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/23/2017] [Indexed: 12/11/2022]
Abstract
Ageing is the primary risk factor for cognitive deterioration. Given that the cerebral blood flow (CBF) or regulation of cerebral circulation is attenuated in the elderly, it could be expected that ageing-induced cognitive deterioration may be affected by a decrease in CBF as a result of brain ischemia and energy depletion. CBF regulation associated with cerebral metabolism thus likely plays an important role in the preservation of cognitive function. However, in some specific conditions (e.g. during exercise), change in CBF does not synchronize with that of cerebral metabolism. Our recent study demonstrated that cognitive function was more strongly affected by changes in cerebral metabolism than by changes in CBF during exercise. Therefore, it remains unclear how an alteration in CBF or its regulation affects cognitive function. In this review, I summarize current knowledge on previous investigations providing the possibility of an interaction between regulation of CBF or cerebral metabolism and cognitive function.
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Affiliation(s)
- Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-Shi, Saitama, 350-8585, Japan.
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86
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Strewe C, Zeller R, Feuerecker M, Hoerl M, Kumprej I, Crispin A, Johannes B, Debevec T, Mekjavic I, Schelling G, Choukèr A. PlanHab study: assessment of psycho-neuroendocrine function in male subjects during 21 d of normobaric hypoxia and bed rest. Stress 2017; 20:131-139. [PMID: 28166699 DOI: 10.1080/10253890.2017.1292246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Immobilization and hypoxemia are conditions often seen in patients suffering from severe heart insufficiency or primary pulmonary diseases (e.g. fibrosis, emphysema). In future planned long-duration and exploration class space missions (including habitats on the moon and Mars), healthy individuals will encounter such a combination of reduced physical activity and oxygen tension by way of technical reasons and the reduced gravitational forces. These overall unconventional extraterrestrial conditions can result in yet unknown consequences for the regulation of stress-permissive, psycho-neuroendocrine responses, which warrant appropriate measures in order to mitigate foreseeable risks. The Planetary Habitat Simulation Study (PlanHab) investigated these two space-related conditions: bed rest as model of reduced gravity and normobaric hypoxia, with the aim of examining their influence on psycho-neuroendocrine responses. We hypothesized that both conditions independently increase measures of psychological stress and enhance neuroendocrine markers of stress, and that these effects would be exacerbated by combined treatment. The cross-over study composed of three interventions (NBR, normobaric normoxic horizontal bed rest; HBR, normobaric hypoxic horizontal bed rest; HAMB, normobaric hypoxic ambulatory confinement) with 14 male subjects during three sequential campaigns separated by 4 months. The psychological state was determined through three questionnaires and principal neuroendocrine responses were evaluated by measuring cortisol in saliva, catecholamine in urine, and endocannabinoids in blood. The results revealed no effects after 3 weeks of normobaric hypoxia on psycho-neuroendocrine responses. Conversely, bed rest induced neuroendocrine alterations that were not influenced by hypoxia.
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Affiliation(s)
- C Strewe
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - R Zeller
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - M Feuerecker
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - M Hoerl
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - I Kumprej
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
- b Department of Automation, Biocybernetics and Robotics , Jozef Stefan Institute , Ljubljana , Slovenia
| | - A Crispin
- c Department of Biometry and Epidemiology, Klinikum Großhadern , University of Munich , Munich , Germany
| | - B Johannes
- d Department of Space Physiology , Institute of Aerospace Medicine, German Aerospace Center (DLR) , Cologne , Germany
| | - T Debevec
- b Department of Automation, Biocybernetics and Robotics , Jozef Stefan Institute , Ljubljana , Slovenia
| | - I Mekjavic
- b Department of Automation, Biocybernetics and Robotics , Jozef Stefan Institute , Ljubljana , Slovenia
| | - G Schelling
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - A Choukèr
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
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87
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Abstract
Objective: To screen out psychiatric ‘cases’ and find the frequency of anxiety and depression symptoms in military volunteers performing duties at very high altitudes in the Karakoram ranges of Pakistan. Methods: This was a descriptive study lasting from Jan 2015 to June 2015, on volunteers serving at very high altitude, using General Health Questionnaire-12 (GHQ-12) and Hospital Anxiety and Depression Scale (HADS), Urdu versions. Analysis involved descriptive, inferential techniques and Bonferroni test. Demographic variables were compared to the scores. Results: A high percentage of the military volunteers screened positive for psychiatric ‘caseness’ and symptoms of anxiety and depression; mostly in the mild to moderate range, while very few of them reported severe symptoms. Demographic variables such as marital status, number of children, positive family psychiatric history, past medical history, duration at high altitude and educational levels were found to be significant risk factors for developing symptoms of anxiety and depression. Conclusions: Individuals performing duties at very high altitude, experience symptoms of anxiety and depression, their demographics are important in understanding their emotional problems.
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Affiliation(s)
- Sabih Ahmad
- Dr. Sabih Ahmad, FCPS. Department of Psychiatry, Consultant Psychiatrist, Combined Military Hospital, Gilgit, Pakistan
| | - Sadiq Hussain
- Dr. Sadiq Hussain, PhD. Department of Behavioral Sciences, Head of Department, Karakorum International University, Gilgit, Pakistan
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88
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Bickler PE, Feiner JR, Lipnick MS, Batchelder P, MacLeod DB, Severinghaus JW. Effects of Acute, Profound Hypoxia on Healthy Humans. Anesth Analg 2017; 124:146-153. [DOI: 10.1213/ane.0000000000001421] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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89
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Abstract
This study aims to evaluate the effect of the duration of high-altitude (HA) pre-exposure on human neurobehavioral parameters including mood states and cognitive performance at HA. One hundred and eleven healthy individuals (ranging in age from 18 to 35 years) were recruited to participate in this study. They were divided into two groups: a 4-day short-term HA pre-exposure group (n=57) and a 3-month long-term HA pre-exposure group (n=54). All participants lived in the area at 400 m altitude above sea level before pre-exposure to HA. They were then transported to 3700 m plateau for either a 4-day or a 3-month HA pre-exposure, and finally delivered to 4400 m plateau. On the last day of pre-exposure at 3700 m and on the 10th day at 4400 m, neurobehavioral parameters of the participants in the two groups were evaluated. At the end of pre-exposure and on the 10th day of HA exposure, participants in the short-term group had significantly lower negative mood states, better cognitive performance with higher sensorimotor, attention, and psychomotor abilities, and less acute mountain sickness in comparison with the participants in the long-term pre-exposure group. Our field study with large samples showed that in comparison with 3-month long-term pre-exposure, 4-day short-term HA pre-exposure at 3700 m has a better effect in improving human neurobehavioral parameters including mood states and cognitive performance and reducing acute mountain sickness when exposed to a HA at 4400 m.
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90
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Shi Q, Liu X, Wang N, Zheng X, Ran J, Liu Z, Fu J, Zheng J. 1400W ameliorates acute hypobaric hypoxia/reoxygenation-induced cognitive deficits by suppressing the induction of inducible nitric oxide synthase in rat cerebral cortex microglia. Behav Brain Res 2016; 319:188-199. [PMID: 27888018 DOI: 10.1016/j.bbr.2016.11.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/18/2016] [Accepted: 11/21/2016] [Indexed: 01/04/2023]
Abstract
Nitric oxide (NO) is involved in neuronal modifications, and overproduction of NO contributes to memory deficits after acute hypobaric hypoxia-reoxygenation. This study investigated the ability of the iNOS inhibitor 1400W to counteract spatial memory deficits following acute hypobaric hypoxia-reoxygenation, and to affect expression of NOS, NO, 3-NT and MDA production, and apoptosis in rat cerebral cortex. We also used primary rat microglia to investigate the effect of 1400W on expression of NOS, NO, 3-NT and MDA production, and apoptosis. Acute hypobaric hypoxia-reoxygenation impaired spatial memory, and was accompanied by activated microglia, increased iNOS expression, NO, 3-NT and MDA production, and neuronal cell apoptosis in rat cerebral cortex one day post-reoxygenation. 1400W treatment inhibited iNOS expression without affecting nNOS or eNOS. 1400W also reduced NO, 3-NT and MDA production, and prevented neuronal cell apoptosis in cerebral cortex, in addition to reversing spatial memory impairment after acute hypobaric hypoxia-reoxygenation. Hypoxia-reoxygenation activated primary microglia, and increased iNOS and nNOS expression, NO, 3-NT, and MDA production, and apoptosis. Treatment with 1400W inhibited iNOS expression without affecting nNOS, reduced NO, 3-NT and MDA production, and prevented apoptosis in primary microglia. Based on the above findings, we concluded that the highly selective iNOS inhibitor 1400W inhibited iNOS induction in microglial cells, and reduced generation of NO, thereby mitigating oxidative stress and neuronal cell apoptosis in the rat cerebral cortex, and improving the spatial memory dysfunction caused by acute hypobaric hypoxia-reoxygenation.
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Affiliation(s)
- Qinghai Shi
- Medical Research Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China; Clinical Laboratory Diagnostic Center, General Hospital of Xinjiang Military Region, Urumqi 830000, Xinjiang, China
| | - Xin Liu
- Medical Research Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Ning Wang
- Medical Research Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Xinchuan Zheng
- Medical Research Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jihua Ran
- Clinical Laboratory Diagnostic Center, General Hospital of Xinjiang Military Region, Urumqi 830000, Xinjiang, China
| | - Zhengxiang Liu
- Clinical Laboratory Diagnostic Center, General Hospital of Xinjiang Military Region, Urumqi 830000, Xinjiang, China
| | - Jianfeng Fu
- Clinical Laboratory Diagnostic Center, General Hospital of Xinjiang Military Region, Urumqi 830000, Xinjiang, China
| | - Jiang Zheng
- Medical Research Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
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91
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Negative Association of Hospital Efficiency Under Increasing Geographic Elevation on Acute Myocardial Infarction In-Patient Mortality. J Healthc Qual 2016; 40:9-18. [PMID: 27631707 DOI: 10.1097/jhq.0000000000000061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although variation in-patient outcomes based on hospitals' geographic location has been studied, altitude of hospitals above sea level may also affect patient outcomes. Possibly, because of negative physical and psychological effects of altitude on hospital employees, hospital efficiency may decline at higher altitudes. Greater focus on hospital efficiency, despite decreasing efficiency at higher altitudes, could increase demands on hospital employees and further deteriorate patient outcomes. Using data envelopment analysis on a sample of 840 hospital-year observations representing 95,504 patients with acute myocardial infarction (AMI) in the United States, and controlling for patient, hospital, and county characteristics and controlling for hospital, state, and year fixed effects, we find support for the negative association between hospital altitude and efficiency; for 1 percentage point increase in efficiency and every 1,000 feet increase in altitude above the sea level, the mortality of patients with AMI increases by 0.66 percentage points. The findings have implications for hospital performance at increasing geographic elevation and introduces to the literature the notion of "health economics of elevation," to suggest that elevation of a hospital may be an important criterion for consideration for policy makers and insurance firms.
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92
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Chen J, Li J, Han Q, Lin J, Yang T, Chen Z, Zhang J. Long-term acclimatization to high-altitude hypoxia modifies interhemispheric functional and structural connectivity in the adult brain. Brain Behav 2016; 6:e00512. [PMID: 27688941 PMCID: PMC5036434 DOI: 10.1002/brb3.512] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 05/09/2016] [Accepted: 05/11/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Structural and functional networks can be reorganized to adjust to environmental pressures and physiologic changes in the adult brain, but such processes remain unclear in prolonged adaptation to high-altitude (HA) hypoxia. This study aimed to characterize the interhemispheric functionally and structurally coupled modifications in the brains of adult HA immigrants. METHODS We performed resting-state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) in 16 adults who had immigrated to the Qinghai-Tibet Plateau (2300-4400 m) for 2 years and in 16 age-matched sea-level (SL) controls. A recently validated approach of voxel-mirrored homotopic connectivity (VMHC) was employed to examine the interhemispheric resting-state functional connectivity. Areas showing changed VMHC in HA immigrants were selected as regions of interest for follow-up DTI tractography analysis. The fiber parameters of fractional anisotropy and fiber length were obtained. Cognitive and physiological assessments were made and correlated with the resulting image metrics. RESULTS Compared with SL controls, VMHC in the bilateral visual cortex was significantly increased in HA immigrants. The mean VMHC value extracted within the visual cortex was positively correlated with hemoglobin concentration. Moreover, the path length of the commissural fibers connecting homotopic visual areas was increased in HA immigrants, covarying positively with VMHC. CONCLUSIONS These observations are the first to demonstrate interhemispheric functional and structural connectivity resilience in the adult brain after prolonged HA acclimatization independent of inherited and developmental effects, and the coupled modifications in the bilateral visual cortex indicate important neural compensatory mechanisms underlying visual dysfunction in physiologically well-acclimatized HA immigrants. The study of human central adaptation to extreme environments promotes the understanding of our brain's capacity for survival.
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Affiliation(s)
- Ji Chen
- Department of Medical ImagingFuzhou Dongfang HospitalXiamen UniversityFuzhouFujianChina
- Department of Physiology and NeurobiologyMedical College of Xiamen UniversityXiamenFujianChina
| | - Jinqiang Li
- Department of Clinical PsychologyGulangyu Sanatorium of PLAXiamenFujianChina
| | - Qiaoqing Han
- Department of Clinical PsychologyGulangyu Sanatorium of PLAXiamenFujianChina
| | - Jianzhong Lin
- Magnetic Resonance CenterThe Affiliated Zhongshan Hospital of Xiamen UniversityXiamenFujianChina
| | - Tianhe Yang
- Magnetic Resonance CenterThe Affiliated Zhongshan Hospital of Xiamen UniversityXiamenFujianChina
| | - Ziqian Chen
- Department of Medical ImagingFuzhou Dongfang HospitalXiamen UniversityFuzhouFujianChina
| | - Jiaxing Zhang
- Department of Physiology and NeurobiologyMedical College of Xiamen UniversityXiamenFujianChina
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93
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Dobashi S, Horiuchi M, Endo J, Kiuchi M, Koyama K. Cognitive Function and Cerebral Oxygenation During Prolonged Exercise Under Hypoxia in Healthy Young Males. High Alt Med Biol 2016; 17:214-221. [PMID: 27584683 DOI: 10.1089/ham.2016.0036] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Dobashi, Shohei, Masahiro Horiuchi, Junko Endo, Masataka Kiuchi, and Katsuhiro Koyama. Cognitive function and cerebral oxygenation during prolonged exercise under hypoxia in healthy young males. High Alt Med Biol. 17:214-221, 2016.-The present study examined the effect of prolonged hypoxic exercise on cognitive function. Eight healthy male volunteers were required to complete exercise trials (four 30-minute cycling sessions with a 15-minute rest interval) at an intensity corresponding to 50% of their altitude-adjusted peak oxygen uptake under two different conditions: normoxia (room air at 400 m) and hypoxia (fraction of inspired oxygen: 0.141). Cognitive function was evaluated before, during, and 60 minutes after completion of the exercise trial. The color-word Stroop task (CWST) was used to assess cognitive function, with regard to the number of achievements, accuracy rate, and the number of correct responses made within 60 seconds. Cerebral oxygenation was monitored throughout the experimental period using near-infrared spectroscopy. The accuracy rate did not significantly differ between the two trials. A significant reduction in the number of correct responses during simple CWST tasks was detected in the hypoxic condition 60 minutes after exercise (p < 0.05), wherein a significant correlation was identified between reduced task performance on simple CWST and cerebral oxygenation (p < 0.01). These results demonstrate that prolonged exercise under hypoxic conditions induces a reduction in cerebral oxygenation partly associated with impairment of cognitive function.
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Affiliation(s)
- Shohei Dobashi
- 1 Integrated Graduate School Department of Medicine, Engineering, and Agricultural Sciences, University of Yamanashi , Kofu, Japan
| | - Masahiro Horiuchi
- 2 Division of Human Environmental Science, Mt. Fuji Research Institute , Fujiyoshida, Japan
| | - Junko Endo
- 2 Division of Human Environmental Science, Mt. Fuji Research Institute , Fujiyoshida, Japan
| | - Masataka Kiuchi
- 3 Graduate School Department of Education, University of Yamanashi , Kofu, Japan
| | - Katsuhiro Koyama
- 4 Graduate School Department of Interdisciplinary Research, University of Yamanashi , Kofu, Japan
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94
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Association of Cognitive Performance with Time at Altitude, Sleep Quality, and Acute Mountain Sickness Symptoms. Wilderness Environ Med 2016; 27:371-8. [PMID: 27460198 DOI: 10.1016/j.wem.2016.04.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 04/25/2016] [Accepted: 04/25/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE It is well documented that cognitive performance may be altered with ascent to altitude, but the association of various cognitive performance tests with symptoms of acute mountain sickness (AMS) is not well understood. Our objective was to assess and compare cognitive performance during a high-altitude expedition using several tests and to report the association of each test with AMS, headache, and quality of sleep. METHODS During an expedition to Mount Everest, 3 cognitive tests (Stroop, Trail Making, and the real-time cognitive assessment tool, an in-house developed motor accuracy test) were used along with a questionnaire to assess health and AMS. Eight team members were assessed pre-expedition, postexpedition, and at several time points during the expedition. RESULTS There were no significant differences (P >.05) found among scores taken at 3 time points at base camp and the postexpedition scores for all 3 tests. Changes in the Stroop test scores were significantly associated with the odds of AMS (P <.05). The logistic regression results show that the percent change from baseline for Stroop score (β = -5.637; P = .032) and Stroop attempts (β = -5.269; P = .049) are significantly associated with the odds of meeting the criteria for AMS. CONCLUSIONS No significant changes were found in overall cognitive performance at altitude, but a significant relationship was found between symptoms of AMS and performance in certain cognitive tests. This research shows the need for more investigation of objective physiologic assessments to associate with self-perceived metrics of AMS to gauge effect on cognitive performance.
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95
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Davranche K, Casini L, Arnal PJ, Rupp T, Perrey S, Verges S. Cognitive functions and cerebral oxygenation changes during acute and prolonged hypoxic exposure. Physiol Behav 2016; 164:189-97. [PMID: 27262217 DOI: 10.1016/j.physbeh.2016.06.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 11/26/2022]
Abstract
The present study aimed to assess specific cognitive processes (cognitive control and time perception) and hemodynamic correlates using functional near-infrared spectroscopy (fNIRS) during acute and prolonged high-altitude exposure. Eleven male subjects were transported via helicopter and dropped at 14 272 ft (4 350 meters) of altitude where they stayed for 4 days. Cognitive tasks, involving a conflict task and temporal bisection task, were performed at sea level the week before ascending to high altitude, the day of arrival (D0), the second (D2) and fourth (D4) day at high altitude. Cortical hemodynamic changes in the prefrontal cortex (PFC) area were monitored with fNIRS at rest and during the conflict task. Results showed that high altitude impacts information processing in terms of speed and accuracy. In the early hours of exposure (D0), participants displayed slower reaction times (RT) and decision errors were twice as high. While error rate for simple spontaneous responses remained twice that at sea level, the slow-down of RT was not detectable after 2 days at high-altitude. The larger fNIRS responses from D0 to D2 suggest that higher prefrontal activity partially counteracted cognitive performance decrements. Cognitive control, assessed through the build-up of a top-down response suppression mechanism, the early automatic response activation and the post-error adjustment were not impacted by hypoxia. However, during prolonged hypoxic exposure the temporal judgments were underestimated suggesting a slowdown of the internal clock. A decrease in cortical arousal level induced by hypoxia could consistently explain both the slowdown of the internal clock and the persistence of a higher number of errors after several days of exposure.
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Affiliation(s)
- Karen Davranche
- Laboratoire de Psychologie Cognitive (LPC), UMR 7290, CNRS, Aix-Marseille Université, FR, 3C FR, 3512, Marseille, France.
| | - Laurence Casini
- Laboratoire de Neurosciences Cognitives (LNC), UMR 7291, CNRS, Aix Marseille Université, FR, 3C FR, 3512, Marseille, France.
| | - Pierrick J Arnal
- Université de Lyon, Laboratoire de Physiologie de l'Exercice, EA4338, Saint-Étienne, France.
| | - Thomas Rupp
- HP2 Laboratory, Grenoble Alpes Université, Grenoble, France; U1042, INSERM, Grenoble, France.
| | | | - Samuel Verges
- HP2 Laboratory, Grenoble Alpes Université, Grenoble, France; U1042, INSERM, Grenoble, France.
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96
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Ma Q, Hu L, Li J, Hu Y, Xia L, Chen X, Hu W. Different Effects of Hypoxia on Mental Rotation of Normal and Mirrored Letters: Evidence from the Rotation-Related Negativity. PLoS One 2016; 11:e0154479. [PMID: 27144444 PMCID: PMC4856360 DOI: 10.1371/journal.pone.0154479] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/21/2016] [Indexed: 11/19/2022] Open
Abstract
The present study explored the neural mechanism underlying the effect of moderate and transient hypoxic exposure on mental rotation of two-dimensional letters in both normal and mirror versions. Event-related potential data and behavioral data were acquired in the task of discrimination between normal and mirrored versions separately in conditions of normoxia (simulated sea level) and hypoxia conditions (simulated 5000 meter altitude). The behavioral results revealed no significant difference between the normoxia and hypoxia conditions both in response time and error rate. However, obvious differences between these two conditions in ERP were found. First, enlarged P300 and Rotation-related Negativity (RRN) were observed in the hypoxia condition compared to the normoxia condition only with normal letters. Second, the angle effect on the amplitude of RRN was more evident with normal letters in the hypoxia condition than that in the normoxia condition. However, this angle effect nearly disappeared with the mirrored letters in the hypoxia condition. Third, more bilateral parietal activation was observed in the hypoxia condition than the normoxia condition. These results suggested that the compensation mechanism existed in the hypoxia condition and was effective with normal letters but had little effect on the mirrored letters. This study extends the research about the hypoxic effect on spatial ability of humans by employing a mental rotation task and further provides neural evidence for this effect.
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Affiliation(s)
- Qingguo Ma
- Institute of Neural Management Sciences, Zhejiang University of Technology, Hangzhou, China
- Neuromanagement Lab, Zhejiang University, Hangzhou, China
- * E-mail:
| | - Linfeng Hu
- School of Management, Zhejiang University, Hangzhou, China
- Neuromanagement Lab, Zhejiang University, Hangzhou, China
| | - Jiaojie Li
- Hangzhou Aviation Medicine Assessment and Training Center of Air Force, Hangzhou, China
| | - Yue Hu
- School of Management, Zhejiang University, Hangzhou, China
- Neuromanagement Lab, Zhejiang University, Hangzhou, China
| | - Ling Xia
- Hangzhou Aviation Medicine Assessment and Training Center of Air Force, Hangzhou, China
| | - Xiaojian Chen
- Hangzhou Aviation Medicine Assessment and Training Center of Air Force, Hangzhou, China
| | - Wendong Hu
- Faculty of Aerospace Medicine, The Fourth Military Medical University, Xi’an, China
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Phenylethanoid glycosides of Pedicularis muscicola Maxim ameliorate high altitude-induced memory impairment. Physiol Behav 2016; 157:39-46. [DOI: 10.1016/j.physbeh.2016.01.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/23/2016] [Accepted: 01/25/2016] [Indexed: 01/20/2023]
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98
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Flaherty G, O'Connor R, Johnston N. Altitude training for elite endurance athletes: A review for the travel medicine practitioner. Travel Med Infect Dis 2016; 14:200-11. [PMID: 27040934 DOI: 10.1016/j.tmaid.2016.03.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 11/30/2022]
Abstract
High altitude training is regarded as an integral component of modern athletic preparation, especially for endurance sports such as middle and long distance running. It has rapidly achieved popularity among elite endurance athletes and their coaches. Increased hypoxic stress at altitude facilitates key physiological adaptations within the athlete, which in turn may lead to improvements in sea-level athletic performance. Despite much research in this area to date, the exact mechanisms which underlie such improvements remain to be fully elucidated. This review describes the current understanding of physiological adaptation to high altitude training and its implications for athletic performance. It also discusses the rationale and main effects of different training models currently employed to maximise performance. Athletes who travel to altitude for training purposes are at risk of suffering the detrimental effects of altitude. Altitude illness, weight loss, immune suppression and sleep disturbance may serve to limit athletic performance. This review provides an overview of potential problems which an athlete may experience at altitude, and offers specific training recommendations so that these detrimental effects are minimised.
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Affiliation(s)
- Gerard Flaherty
- School of Medicine, National University of Ireland, Galway, Ireland; School of Medicine, International Medical University, Kuala Lumpur, Malaysia.
| | - Rory O'Connor
- School of Biomedical Science, National University of Ireland, Galway, Ireland.
| | - Niall Johnston
- School of Medicine, National University of Ireland, Galway, Ireland.
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de Aquino-Lemos V, Santos RVT, Antunes HKM, Lira FS, Luz Bittar IG, Caris AV, Tufik S, de Mello MT. Acute physical exercise under hypoxia improves sleep, mood and reaction time. Physiol Behav 2016; 154:90-9. [DOI: 10.1016/j.physbeh.2015.10.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/15/2015] [Accepted: 10/27/2015] [Indexed: 01/20/2023]
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100
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Rimoldi SF, Rexhaj E, Duplain H, Urben S, Billieux J, Allemann Y, Romero C, Ayaviri A, Salinas C, Villena M, Scherrer U, Sartori C. Acute and Chronic Altitude-Induced Cognitive Dysfunction in Children and Adolescents. J Pediatr 2016; 169:238-43. [PMID: 26541425 DOI: 10.1016/j.jpeds.2015.10.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/31/2015] [Accepted: 10/02/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess whether exposure to high altitude induces cognitive dysfunction in young healthy European children and adolescents during acute, short-term exposure to an altitude of 3450 m and in an age-matched European population permanently living at this altitude. STUDY DESIGN We tested executive function (inhibition, shifting, and working memory), memory (verbal, short-term visuospatial, and verbal episodic memory), and speed processing ability in: (1) 48 healthy nonacclimatized European children and adolescents, 24 hours after arrival at high altitude and 3 months after return to low altitude; (2) 21 matched European subjects permanently living at high altitude; and (3) a matched control group tested twice at low altitude. RESULTS Short-term hypoxia significantly impaired all but 2 (visuospatial memory and processing speed) of the neuropsychological abilities that were tested. These impairments were even more severe in the children permanently living at high altitude. Three months after return to low altitude, the neuropsychological performances significantly improved and were comparable with those observed in the control group tested only at low altitude. CONCLUSIONS Acute short-term exposure to an altitude at which major tourist destinations are located induces marked executive and memory deficits in healthy children. These deficits are equally marked or more severe in children permanently living at high altitude and are expected to impair their learning abilities.
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Affiliation(s)
- Stefano F Rimoldi
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland
| | - Emrush Rexhaj
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland
| | - Hervé Duplain
- Department of Internal Medicine, University Hospital, Lausanne, Switzerland
| | - Sébastien Urben
- Research Unit, Child and Adolescent Psychiatric Service, University Hospital, Lausanne, Switzerland
| | - Joël Billieux
- Psychological Sciences Research Institute, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Yves Allemann
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland
| | | | | | - Carlos Salinas
- Bolivian Institute of Altitude Biology (IBBA), La Paz, Bolivia
| | | | - Urs Scherrer
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland; Department of Biology, University of Tarapacá, Arica, Chile
| | - Claudio Sartori
- Department of Internal Medicine, University Hospital, Lausanne, Switzerland.
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