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Abstract Details

Occupational Exposure to Hypobaria Results in Accelerated Cerebral White Matter Aging in Cohort of U-2 pilots and Air Force Physiologists/Chamber Technicians.
General Neurology
S32 - General Neurology: Advances in Neurology: From the Clinic to the Bench (4:47 PM-4:58 PM)
008

Repeated human exposure to extreme hypobaria is associated with increased white matter hyperintensities (WMH) as observed on T2-weighted imaging and decline of axonal integrity measured by fractional anisotropy (FA).  The underlying pathophysiology is thought to be due to occlusion of small vessels and activation of innate immune response but has not been fully elucidated.  Increase in WMH volume and decline in FA values are also observed in normal WM aging. We hypothesize that occupational exposure to hypobaria leads to accelerated aging of cerebral white matter. We tested this by comparing aging trends in U-2 pilots and Air Force physiologists/chamber technicians to age-and-health matched controls.

To assess if occupational exposure to hypobaria may lead to accelerated aging of cerebral white matter.

We collected MRI data in N=106 U-2 pilots; N=74 Air Force physiologists/chamber technicians and N=125 controls ages 28-58 years. The MRI protocol consisted of a 3D T2-weighted FLAIR and diffusion tensor imaging sequences to assess the integrity of cerebral WM.  A general linear model was used to study group by age interaction.  
Significant group by age interactions were observed for whole-brain WMH volume and whole-brain average FA values (p<0.001).  Accelerated aging was also linearly associated with severity of hypobaric exposure (p <0.001).  Regional trend analysis demonstrated accelerated aging was limited to subcortical rather than periventricular WMH volumes. In agreement, accelerated reduction in regional FA values was observed in long-range WM bundles that originated in frontal and parietal lobes.  

The U-2 group accumulated subcortical WMH volume at a faster rate as a function of age compared to age-matched controls.  This group also showed an accelerated decline in whole-brain and regional FA values.  Accumulation of whole brain and subcortical WMH and reduction in FA values were also linearly associated with the degree/severity of hypobaric exposure. 

Authors/Disclosures
Kelsey Cacic, MD
PRESENTER
The institution of Dr. Cacic has received research support from Texas Neurological Society.
No disclosure on file
John H. Sladky, MD, FAAN (San Antonio Military Medical Center/MCHE MDU) Dr. Sladky has nothing to disclose.