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A Proposed Mechanism of Neuronal Injury in Pilots and Aircrew Personnel with Hypobaric Exposure

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Conference Paper

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59th Medical Wing San Antonio United States

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Background U-2 pilots display an increased incidence of white-matter hyperintensities WMH on MRI compared to healthy age-matched controls non-pilots. U-2 pilots demonstrate reduced neurocognitive performance associated with burden of WMH. WMH are a marker of cerebral integrity and associated with cognitive decline. Similar findings of increased WMH have been replicated in aircrew personnel with non-hypoxic hypobaric exposure via altitude chamber training. Aircrew personnel undergo training per standard USAF procedure in altitude chambers that simulate conditions at 25,000 feet. Sessions are 30 minutes long and 100o oxygen is provided continuously via chamber masks. Goals of Ongoing Studies. What is the mechanism of WMH formation in non-hypoxic hypobaria Microemboli, breakdown of BBB, neuroinflammation Is there a specific pattern of cellular injury Cyto-architectural changes, metabolic changes Glial cells, neuronal cells, axonsAre there measurable changes in the brain prior to WMH formation How early after exposure can changes be detected

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  • Stress Physiology

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