Neurological Effects of Exposure to Non-Hypoxic Hypobaria.




The objective of this study was to investigate the neurological effects of exposure to non-hypoxic hypobaria following an outbreak of neurological decompression sickness in U-2 pilots. Eighty-three altitude chamber personnel (PHY), 105 U-2 pilots (U2P), and 162 age and medically matched doctorate degree controls (DOC) underwent high-resolution magnetic resonance imaging. Eighty-seven U-2 pilots underwent neurocognitive testing and were compared to 83 USAF pilot controls (AFP). White matter hyperintensities (WMH) are more prevalent in PHY (volume p=0.020/count p=0.040) and U2P volume p<0.001/count p<0.001 when compared to DOC, while PHY is not significantly different than U2P. Lower neurocognitive performance in the domains of reasoning/calculation (p=0.001), memory (p=0.036), information processing accuracy (p=0.032), and general cognitive functioning p=0.004 was demonstrated in U2P compared to AFP. Lower neurocognitive test performance within the U2P shows lower performance in the domains of reasoning/calculation, memory, general cognitive functioning, and general cognitive proficiency in U2P with higher WMH burden compared to U2P with lower WMH burden. This study provides strong evidence that non-hypoxic hypobaric exposure in U2P and potential causes of WMH. This study also demonstrates measurable lower neurocognitive test performance in otherwise highly functioning U2P compared to AFP and furthermore demonstrate higher WMH burden is associated with lower neurocognitive test performance.



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