Acute and Chronic Altitude-Induced Cognitive Dysfunction in Children and Adolescents

Rimoldi, Stefano F.; Rexhaj, Emrush; Duplain, Hervé; Urben, Sébastien; Billieux, Joël; Allemann, Yves; Romero, Catherine; Ayaviri, Alejandro; Salinas, Carlos; Villena, Mercedes; Scherrer, Urs; Sartori, Cláudio

doi:10.1016/j.jpeds.2015.10.009

Cited by 42 publications

(29 citation statements)

References 44 publications

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“…Verbal and spatial WM are both reportedly impaired in HA residents (Yan et al, , ); however, the impact of HA on the executive system has not been elucidated. Previous study using the Go/NoGo and the Trail Making Test (part B) tasks showed that inhibition and shifting processes were affected in HA residents (Ma, Wang, Wu, Luo, & Han, ; Rimoldi et al, ). It remains unclear whether the updating process is involved in WM impairment.…”

Section: Introductionmentioning

confidence: 98%

Long‐term exposure to high altitude attenuates verbal and spatial working memory: Evidence from an event‐related potential study

Zhang

et al. 2019

Brain and Behavior

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Introduction This study aimed to determine the neurocognitive basis underlying the effects of long‐term high‐altitude (HA) exposure on working memory (WM). Methods Using event‐related potentials (ERPs), we compared the performance of an HA group (individuals who had lived at HA for 3 years but were born and raised at low altitude [LA]) to that of an LA group (individuals who had only lived at LA) on verbal and spatial n‐back tasks (i.e., 1‐ and 2‐back memory load). Results Response accuracy of the HA group was significantly decreased in comparison to the LA group in both the verbal and spatial 2‐back tasks. The P2 amplitude was larger in the HA than in the LA group in the spatial, but not the verbal 2‐back task. A smaller late‐positive potential (LPP) amplitude was found in the HA group in both the verbal and spatial 2‐back tasks. Conclusions These results suggest that HA impairs the matching (P2) process in spatial WM tasks and the maintenance (LPP) process in both verbal and spatial WM tasks, indicating that HA had a different effect on verbal and spatial 2‐back task performance.

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Section: Introductionmentioning

confidence: 98%

Long‐term exposure to high altitude attenuates verbal and spatial working memory: Evidence from an event‐related potential study

Zhang

et al. 2019

Brain and Behavior

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“…; Rimoldi et al . ; McMorris et al . ), including lasting damage to white and grey matter motor architecture (Di Paola et al .…”

Section: Introductionmentioning

confidence: 99%

“…The requirement to process large amounts of O 2 over a relatively small tissue mass supports the high rate of ATP formation to fuel the maintenance of ionic equilibria and uptake of neurotransmitters for synaptic transmission (Alle et al 2009). That cognitive function is impaired by acute hypoxia is thus not surprising and an extensive literature has since documented proportional deficits in executive function, attention, mental speed, language and memory (Virues-Ortega et al 2004;Rimoldi et al 2016;McMorris et al 2017), including lasting damage to white and grey matter motor architecture (Di Paola et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Exaggerated systemic oxidative‐inflammatory‐nitrosative stress in chronic mountain sickness is associated with cognitive decline and depression

Bailey

Brugniaux

Filipponi

et al. 2018

The Journal of Physiology

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Key points Chronic mountain sickness (CMS) is a maladaptation syndrome encountered at high altitude (HA) characterised by severe hypoxaemia that carries a higher risk of stroke and migraine and is associated with increased morbidity and mortality. We examined if exaggerated oxidative‐inflammatory‐nitrosative stress (OXINOS) and corresponding decrease in vascular nitric oxide bioavailability in patients with CMS (CMS+) is associated with impaired cerebrovascular function and adverse neurological outcome. Systemic OXINOS was markedly elevated in CMS+ compared to healthy HA (CMS−) and low‐altitude controls. OXINOS was associated with blunted cerebral perfusion and vasoreactivity to hypercapnia, impaired cognition and, in CMS+, symptoms of depression. These findings are the first to suggest that a physiological continuum exists for hypoxaemia‐induced systemic OXINOS in HA dwellers that when excessive is associated with accelerated cognitive decline and depression, helping identify those in need of more specialist neurological assessment and targeted support. Abstract Chronic mountain sickness (CMS) is a maladaptation syndrome encountered at high altitude (HA) characterised by severe hypoxaemia that carries a higher risk of stroke and migraine and is associated with increased morbidity and mortality. The present cross‐sectional study examined to what extent exaggerated systemic oxidative‐inflammatory‐nitrosative stress (OXINOS), defined by an increase in free radical formation and corresponding decrease in vascular nitric oxide (NO) bioavailability, is associated with impaired cerebrovascular function, accelerated cognitive decline and depression in CMS. Venous blood was obtained from healthy male lowlanders (80 m, n = 17), and age‐ and gender‐matched HA dwellers born and bred in La Paz, Bolivia (3600 m) with (CMS+, n = 23) and without (CMS−, n = 14) CMS. We sampled blood for oxidative (electron paramagnetic resonance spectroscopy, HPLC), nitrosative (ozone‐based chemiluminescence) and inflammatory (fluorescence) biomarkers. We employed transcranial Doppler ultrasound to measure cerebral blood flow (CBF) and reactivity. We utilised psychometric tests and validated questionnaires to assess cognition and depression. Highlanders exhibited elevated systemic OXINOS (P < 0.05 vs. lowlanders) that was especially exaggerated in the more hypoxaemic CMS+ patients (P < 0.05 vs. CMS−). OXINOS was associated with blunted cerebral perfusion and vasoreactivity to hypercapnia, impaired cognition and, in CMS+, symptoms of depression. Collectively, these findings are the first to suggest that a physiological continuum exists for hypoxaemia‐induced OXINOS in HA dwellers that when excessive is associated with accelerated cognitive decline and depression, helping identify those in need of specialist neurological assessment and support.

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“…In air conditioning is the refrigerant gas in chiller, in oxygen-conditioning is zeolite to absorb nitrogen from atmospheric air [77]. Possible more general applications may be schools because the learning is compromised at high altitudes [78], hospitals (since, for example, wound healing is compromised at great heights and neonatal mortality is higher [79][80][81], boardrooms, courts, banks and embassies [62].…”

Section: Non-conventional Indicationsmentioning

confidence: 99%

Domiciliary Oxygen: Facts and fallacies

Alvarado¹

2017

Clin Res Trial

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Molecular oxygen is vital for energy which is essential for life. The fact that we all need oxygen to live might make us think that the use of supplemental oxygen in every hypoxemic patient seems obvious. This is a fallacy. The survival of all metazoan organisms is dependent on the regulation of the delivery and use of oxygen to maintain a balance between the generation of energy and the production of oxygen radicals, potentially toxic. HIF (hypoxia inducible factor) is a transcription factor or nuclear messenger that should be conceptualized as a master regulator of oxygen homeostasis. Therefore, it is proceeded to discuss how its action in hypoxia conditions the activation of diverse genes that codify the synthesis of proteins that explain some of the clinical manifestations and the events of hypoxia. We also discuss how inflammatory diseases of the respiratory system can perpetuate, in the presence of oxygen at inappropriately high doses, the oxidative stress that in turn amplifies the inflammatory phenomenon. Subsequently, the doses of ambulatory oxygen are defined in conventional indications and in some unconventional indications such as air travel and high altitude. Finally, some research avenues are mentioned in this topic.

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Acute and Chronic Altitude-Induced Cognitive Dysfunction in Children and Adolescents

Cited by 42 publications

References 44 publications

Long‐term exposure to high altitude attenuates verbal and spatial working memory: Evidence from an event‐related potential study

Long‐term exposure to high altitude attenuates verbal and spatial working memory: Evidence from an event‐related potential study

Exaggerated systemic oxidative‐inflammatory‐nitrosative stress in chronic mountain sickness is associated with cognitive decline and depression

Domiciliary Oxygen: Facts and fallacies

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