{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:21:10Z","timestamp":1790018470446,"version":"4.0.1"},"reference-count":12,"publisher":"Aerospace Medical Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["aerosp med hum perform"],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:p><jats:bold>INTRODUCTION:<\/jats:bold> Hypobaric decompression has been associated with brain white matter injury. Relevant exposure limits are unknown, raising ethical concerns over safety of volunteers for altitude chamber research. To inform this, a prospective study of white matter status using brain\n Magnetic Resonance Imaging (MRI) was conducted before and after a 9-mo program of hypobaric research.<jats:bold>METHODS:<\/jats:bold> Volunteers underwent 3-D, volumetric, fluid attenuated inversion recovery (FLAIR) MRI at the University of Nottingham, UK, on study entry and again after their final exposure.\n MRI data were analyzed and reported independently at the University of Maryland, Baltimore, MD, USA. Entry criteria were 5 subcortical white matter hyperintensities (WMH) of total volume 0.08 mL.<jats:bold>RESULTS:<\/jats:bold> One volunteer failed screening with 63 WMH (total volume 2.38 mL). Eleven individuals\n completed 160 short-duration (&lt; 1h) exposures (range 3 to 26) to 18,000 ft pressure altitude (maximum 40,000 ft), no more often than twice weekly. The cohort exhibited eight total WMH on study entry (total volume 0.166 mL) and five (mostly different) total WMH on exit (0.184 mL). Just one\n WMH (frontal lobe) was present on both entry and exit scans. Excess background WMH on MRI screening were associated with past mild traumatic brain injury (MTBI).<jats:bold>CONCLUSIONS:<\/jats:bold> One hypoxia familiarization plus multiple, brief, infrequent, nonhypoxic hypobaric exposures (with denitrogenation)\n have not promoted WMH in this small cohort. Less intensive programs of decompression stress do not warrant MRI screening. A negative past history of MTBI has strong negative predictive value for excess WMH in young healthy subjects (<jats:italic>N<\/jats:italic> 33).<jats:bold>Connolly DM, Lupa HT. <jats:italic>Prospective\n study of white matter health for an altitude chamber research program.<\/jats:italic> Aerosp Med Hum Perform. 2021; 92(4):215222.<\/jats:bold><\/jats:p>","DOI":"10.3357\/amhp.5730.2021","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T04:58:55Z","timestamp":1616475535000},"page":"215-222","source":"Crossref","is-referenced-by-count":4,"title":["Prospective Study of White Matter Health for an Altitude Chamber Research Program"],"prefix":"10.3357","volume":"92","author":[{"given":"Desmond M.","family":"Connolly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry T.","family":"Lupa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"issue":"8","key":"bib1","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s002340050342","article-title":"Incidental white-matter foci on MRI in \u201chealthy\u201d subjects: evidence of subtle cognitive dysfunction","volume":"38","author":"Baum","year":"1996","journal-title":"Neuroradiology."},{"issue":"4","key":"bib2","doi-asserted-by":"crossref","first-page":"e94734","DOI":"10.1371\/journal.pone.0094734","article-title":"Persistent, long-term cerebral white matter changes after sports-related repetitive head impacts","volume":"9","author":"Bazarian","year":"2014","journal-title":"PLoS One."},{"issue":"11","key":"bib3","doi-asserted-by":"crossref","first-page":"928","DOI":"10.3357\/AMHP.4392.2015","article-title":"Odds ratio meta-analysis and increased prevalence of white matter injury in healthy divers","volume":"86","author":"Connolly","year":"2015","journal-title":"Aerosp Med Hum Perform."},{"issue":"9","key":"bib4","doi-asserted-by":"crossref","first-page":"777","DOI":"10.3357\/AMHP.5090.2018","article-title":"White matter status of participants in altitude chamber research and training","volume":"89","author":"Connolly","year":"2018","journal-title":"Aerosp Med Hum Perform."},{"key":"bib5","doi-asserted-by":"crossref","first-page":"c3666","DOI":"10.1136\/bmj.c3666","article-title":"The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis","volume":"341","author":"Debette","year":"2010","journal-title":"BMJ."},{"issue":"13","key":"bib6","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1001\/jama.1983.03330370053031","article-title":"If nothing goes wrong, is everything all right? Interpreting zero numerators","volume":"249","author":"Hanley","year":"1983","journal-title":"JAMA."},{"issue":"3","key":"bib7","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1148\/radiol.13130545","article-title":"Soccer heading is associated with white matter microstructural and cognitive abnormalities","volume":"268","author":"Lipton","year":"2013","journal-title":"Radiology."},{"issue":"12","key":"bib8","doi-asserted-by":"crossref","first-page":"983","DOI":"10.3357\/AMHP.4585.2016","article-title":"White matter integrity in high-altitude pilots exposed to hypobaria","volume":"87","author":"McGuire","year":"2016","journal-title":"Aerosp Med Hum Perform."},{"issue":"12","key":"bib9","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.3357\/ASEM.3395.2012","article-title":"Hyperintense white matter lesions in 50 high-altitude pilots with neurologic decompression sickness","volume":"83","author":"McGuire","year":"2012","journal-title":"Aviat Space Environ Med."},{"issue":"8","key":"bib10","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1212\/WNL.0b013e3182a1ab12","article-title":"White matter hyperintensities on MRI in high-altitude U-2 pilots","volume":"81","author":"McGuire","year":"2013","journal-title":"Neurology."},{"issue":"5","key":"bib11","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1002\/ana.24264","article-title":"White matter hyperintensities and hypobaric exposure","volume":"76","author":"McGuire","year":"2014","journal-title":"Ann Neurol."},{"issue":"7","key":"bib12","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1212\/WNL.0000000000000694","article-title":"Lower neurocognitive function in U-2 pilots: Relationship to white matter hyperintensities","volume":"83","author":"McGuire","year":"2014","journal-title":"Neurology."}],"container-title":["Aerospace Medicine and Human Performance"],"original-title":[],"link":[{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/92\/4\/article-p215.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/92\/4\/article-p215.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/92\/4\/article-p215.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:23:31Z","timestamp":1728303811000},"score":1,"resource":{"primary":{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/92\/4\/article-p215.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,1]]},"references-count":12,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3357\/amhp.5730.2021","relation":{},"ISSN":["2375-6314","2375-6322"],"issn-type":[{"value":"2375-6314","type":"print"},{"value":"2375-6322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,1]]}}}