TY - JOUR
T1 - Caudwell xtreme everest
T2 - A prospective study of the effects of environmental hypoxia on cognitive functioning
AU - Griva, Konstadina
AU - Stygall, Jan
AU - Wilson, Mark H.
AU - Martin, Daniel
AU - Levett, Denny
AU - Mitchell, Kay
AU - Mythen, Monty
AU - Montgomery, Hugh E.
AU - Grocott, Mike P.
AU - Aref-Adib, Golnar
AU - Edsell, Mark
AU - Plant, Tracie
AU - Imray, Chris
AU - Cooke, Debbie
AU - Harrington, Jane
AU - Khosravi, Maryam
AU - Newman, Stanton P.
AU - Ahuja, V.
AU - Burnham, R.
AU - Chisholm, A.
AU - Clarke, K.
AU - Coates, D.
AU - Coates, M.
AU - Cook, D.
AU - Cox, M.
AU - Dhillon, S.
AU - Dougall, C.
AU - Doyle, P.
AU - Duncan, P.
AU - Edwards, L.
AU - Evans, L.
AU - Gardiner, P.
AU - Gunning, P.
AU - Hart, N.
AU - Harvey, J.
AU - Holloway, C.
AU - Howard, D.
AU - Hurlbut, D.
AU - Ince, C.
AU - Jonas, M.
AU - Van Der Kaaij, J.
AU - Kolfschoten, N.
AU - Luery, H.
AU - Luks, A.
AU - McMorrow, R.
AU - Meale, P.
AU - Morgan, J.
AU - Richardson, A.
AU - Simpson, J.
AU - Clarke, C.
PY - 2017/3/27
Y1 - 2017/3/27
N2 - Background: The neuropsychological consequences of exposure to environmental hypobaric hypoxia (EHH) remain unclear. We thus investigated them in a large group of healthy volunteers who trekked to Mount Everest base camp (5,300 m). Methods: A neuropsychological (NP) test battery assessing memory, language, attention, and executive function was administered to 198 participants (age 44.5±13.7 years; 60% male). These were studied at baseline (sea level), 3,500 m (Namche Bazaar), 5,300 m (Everest Base Camp) and on return to 1,300 m (Kathmandu) (attrition rate 23.7%). A comparable control group (n = 25; age 44.5±14.1 years; 60% male) for comparison with trekkers was tested at/or near sea level over an equivalent timeframe so as to account for learning effects associated with repeat testing. The Reliable Change Index (RCI) was used to calculate changes in cognition and neuropsychological function during and after exposure to EHH relative to controls. Results: Overall, attention, verbal ability and executive function declined in those exposed to EHH when the performance of the control group was taken into account (RCI .05 to -.95) with decline persisting at descent. Memory and psychomotor function showed decline at highest ascent only (RCI -.08 to -.56). However, there was inter-individual variability in response: whilst NP performance declined in most, this improved in some trekkers. Cognitive decline was greater amongst older people (r = .42; p < .0001), but was otherwise not consistently associated with socio-demographic, mood, or physiological variables. Conclusions: After correcting for learning effects, attention, verbal abilities and executive functioning declined with exposure to EHH. There was considerable individual variability in the response of brain function to sustained hypoxia with some participants not showing any effects of hypoxia. This might have implications for those facing sustained hypoxia as a result of any disease.
AB - Background: The neuropsychological consequences of exposure to environmental hypobaric hypoxia (EHH) remain unclear. We thus investigated them in a large group of healthy volunteers who trekked to Mount Everest base camp (5,300 m). Methods: A neuropsychological (NP) test battery assessing memory, language, attention, and executive function was administered to 198 participants (age 44.5±13.7 years; 60% male). These were studied at baseline (sea level), 3,500 m (Namche Bazaar), 5,300 m (Everest Base Camp) and on return to 1,300 m (Kathmandu) (attrition rate 23.7%). A comparable control group (n = 25; age 44.5±14.1 years; 60% male) for comparison with trekkers was tested at/or near sea level over an equivalent timeframe so as to account for learning effects associated with repeat testing. The Reliable Change Index (RCI) was used to calculate changes in cognition and neuropsychological function during and after exposure to EHH relative to controls. Results: Overall, attention, verbal ability and executive function declined in those exposed to EHH when the performance of the control group was taken into account (RCI .05 to -.95) with decline persisting at descent. Memory and psychomotor function showed decline at highest ascent only (RCI -.08 to -.56). However, there was inter-individual variability in response: whilst NP performance declined in most, this improved in some trekkers. Cognitive decline was greater amongst older people (r = .42; p < .0001), but was otherwise not consistently associated with socio-demographic, mood, or physiological variables. Conclusions: After correcting for learning effects, attention, verbal abilities and executive functioning declined with exposure to EHH. There was considerable individual variability in the response of brain function to sustained hypoxia with some participants not showing any effects of hypoxia. This might have implications for those facing sustained hypoxia as a result of any disease.
UR - http://www.scopus.com/inward/record.url?scp=85016388721&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0174277
DO - 10.1371/journal.pone.0174277
M3 - Article
C2 - 28346535
AN - SCOPUS:85016388721
SN - 1932-6203
VL - 12
JO - PLoS ONE
JF - PLoS ONE
IS - 3
M1 - e0174277
ER -
