{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:31:48Z","timestamp":1791232308515,"version":"4.1.0"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cognit."],"abstract":"<jats:p>Ambient oxygen decreases with increasing altitude, which poses a primary threat to aviators known as hypoxic hypoxia. Decades of research have shown that hypoxia impairs cognition, but the neurophysiological bases for these effects remain poorly understood. Recent advances in neuroscience have permitted non-invasive observation of neural activity under controlled hypoxia exposures and have begun to uncover how the brain responds to hypoxia. Electroencephalography (EEG) in particular has been used to explore how electrical activity produced by networks of cortical neurons changes under hypoxia. Here we review studies that have explored how hypoxia affects prominent EEG brain rhythms as well as responses to specific events or stimuli in the time and frequency domains. Experimental conditions have varied widely, including whether hypoxia exposures were normobaric or hypobaric and the range of equivalent altitudes and durations of exposures. Collectively, these studies have accumulated support for a variety of candidate neural markers of hypoxia impairment spanning sensory and cognitive domains. Continued research will build on these findings to leverage emerging technologies in neuroscience and further our understanding of how hypoxia affects cognition and associated neural activity.<\/jats:p>","DOI":"10.3389\/fcogn.2025.1503028","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T02:11:42Z","timestamp":1738807902000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["EEG as a neural measure of hypoxia-related impairment"],"prefix":"10.3389","volume":"4","author":[{"given":"Stephanie R.","family":"Otto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cammi K.","family":"Borden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel G.","family":"McHail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara J.","family":"Blacker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.physbeh.2019.03.022","article-title":"Differential impact of acute hypoxia on event related potentials: impaired task-irrelevant, but preserved task-relevant processing and response inhibition","volume":"206","author":"Altbacker","year":"2019","journal-title":"Physiol. Behav."},{"key":"B2","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1586\/eop.11.32","article-title":"Effects of hypoxia on color vision with emphasis on the mesopic range","volume":"6","author":"Barbur","year":"2011","journal-title":"Expert Rev. Ophthalmol."},{"key":"B3","first-page":"31","article-title":"\u201cBeyond ERPs: oscillatory neural dynamics,\u201d","volume-title":"The Oxford Handbook of Event-Related Potential Components","author":"Bastiaansen","year":"2013"},{"key":"B4","doi-asserted-by":"publisher","first-page":"353","DOI":"10.3357\/AMHP.6402.2024","article-title":"Assessing the relative severity of altitude effects in rapid versus gradual decompression","volume":"95","author":"Beer","year":"2024","journal-title":"Aerosp. Med. Hum. Perform."},{"key":"B5","doi-asserted-by":"publisher","first-page":"113508","DOI":"10.1016\/j.physbeh.2021.113508","article-title":"Time course of recovery from acute hypoxia exposure as measured by vigilance and event-related potentials","volume":"239","author":"Blacker","year":"2021","journal-title":"Physiol. Behav."},{"key":"B6","doi-asserted-by":"publisher","first-page":"846001","DOI":"10.3389\/fnins.2022.846001","article-title":"Effects of acute hypoxia on early visual and auditory evoked potentials","volume":"16","author":"Blacker","year":"2022","journal-title":"Front. Neurosci."},{"key":"B7","doi-asserted-by":"publisher","first-page":"326","DOI":"10.3357\/AMHP.5735.2021","article-title":"Deficits in visual processing during hypoxia as evidenced by visual mismatch negativity","volume":"92","author":"Blacker","year":"2021","journal-title":"Aerosp. Med. Hum. Perform."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1375919","DOI":"10.3389\/fcogn.2024.1375919","article-title":"The time course of hypoxia effects using an aviation survival trainer","volume":"3","author":"Borden","year":"2024","journal-title":"Front. Cogn."},{"key":"B9","first-page":"699","article-title":"Effects of altitude hypoxia on middle latency auditory evoked potentials in humans","volume":"68","author":"Bouchet","year":"1997","journal-title":"Aviat. Space Environ. Med."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780195301069.001.0001","author":"Buzsaki","year":"2006","journal-title":"Rhythms of the Brain"},{"key":"B11","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.bbr.2018.02.038","article-title":"Adenosine A2A receptor involves in neuroinflammation-mediated cognitive decline through activating microglia under acute hypobaric hypoxia","volume":"347","author":"Chen","year":"2018","journal-title":"Behav. Brain Res."},{"key":"B12","doi-asserted-by":"publisher","first-page":"54","DOI":"10.3357\/AMHP.6338.2023","article-title":"Personal hypoxia symptoms vary widely within individuals","volume":"95","author":"Cox","year":"2024","journal-title":"Aerosp. Med. Hum. Perform."},{"key":"B13","first-page":"14","volume":"2","author":"DeNicola","year":"2023","journal-title":"Approach"},{"key":"B14","first-page":"15","article-title":"Unexplained physiological episodes. A pilot's perspective","author":"Elliott","year":"2019","journal-title":"Air Space Power J."},{"key":"B15","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1056\/NEJMra0910283","article-title":"Hypoxia and inflammation","volume":"364","author":"Eltzschig","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"B16","first-page":"49","article-title":"\u201cChapter 4: Hypoxia and hyperventilation,\u201d","volume-title":"Ernsting's Aviation and Space Medicine","author":"Gradwell","year":"2016"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1016\/j.clinph.2005.02.020","article-title":"Effects of simulated high altitude on event-related potential (P300) and auditory brain-stem responses","volume":"116","author":"Hayashi","year":"2005","journal-title":"Clin. Neurophysiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1109\/RBME.2020.2969915","article-title":"A review on machine learning for EEG signal processing in bioengineering","volume":"14","author":"Hosseini","year":"2020","journal-title":"IEEE Rev. Biomed. Eng."},{"key":"B19","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/S0160-2896(99)80049-X","article-title":"Intelligence and the effects of perceptual processing demands, task difficulty and processing speed on P300, reaction time and movement time","volume":"26","author":"Houlihan","year":"1998","journal-title":"Intelligence"},{"key":"B20","doi-asserted-by":"publisher","first-page":"2345","DOI":"10.1002\/hbm.26214","article-title":"Associations between spontaneous electroencephalogram oscillations and oxygen saturation across normobaric and hypobaric hypoxia","volume":"44","author":"Hutcheon","year":"","journal-title":"Hum. Brain Mapp."},{"key":"B21","doi-asserted-by":"publisher","first-page":"18021","DOI":"10.1038\/s41598-023-45308-8","article-title":"Comparing neuronal oscillations during visual spatial attention orienting between normobaric and hypobaric hypoxia","volume":"13","author":"Hutcheon","year":"","journal-title":"Sci. Rep."},{"key":"B22","unstructured":"Hypoxico Altitude to Oxygen Chart"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-022-10881-x","article-title":"High altitude is associated with pTau deposition, neuroinflammation, and myelin loss","volume":"12","author":"Iacono","year":"2022","journal-title":"Sci. Rep."},{"key":"B24","doi-asserted-by":"publisher","first-page":"186","DOI":"10.3389\/fnhum.2010.00186","article-title":"Shaping functional architecture by oscillatory alpha activity: gating by inhibition","volume":"4","author":"Jensen","year":"2010","journal-title":"Front. Hum. Neurosci."},{"key":"B25","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.neuroimage.2018.09.012","article-title":"Systematic comparison between a wireless EEG system with dry electrodes and a wired EEG system with wet electrodes","volume":"1","author":"Kam","year":"2019","journal-title":"NeuroImage"},{"key":"B26","doi-asserted-by":"publisher","first-page":"3844","DOI":"10.1152\/jn.01234.2005","article-title":"Increases in alpha oscillatory power reflect an active retinotopic mechanism for distracter suppression during sustained visuospatial attention","volume":"95","author":"Kelly","year":"2006","journal-title":"J. Neurophysiol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.1152\/jappl.1993.74.4.1735","article-title":"Cognitive performance and event-related brain potentials under simulated high altitudes","volume":"74","author":"Kida","year":"1993","journal-title":"J. Appl. Physiol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/0013-4694(88)90002-8","article-title":"Quantitative EEG changes due to hypobaric hypoxia in normal subjects","volume":"69","author":"Kraaier","year":"1988","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"356","DOI":"10.3109\/00206099309071866","article-title":"Effects of hypobaric hypoxia on the middle-latency and steady-state auditory evoked potentials","volume":"32","author":"Lucertini","year":"1993","journal-title":"Int. J. Audiol."},{"key":"B30","volume-title":"An Introduction to the Event-Related Potential Technique","author":"Luck","year":"2014"},{"key":"B31","volume-title":"The Oxford Handbook of Event-Related Potential Components","author":"Luck","year":"2013"},{"key":"B32","doi-asserted-by":"publisher","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"},{"key":"B33","doi-asserted-by":"publisher","first-page":"438","DOI":"10.3389\/fnins.2015.00438","article-title":"EEG recorded from the ear: characterizing the ear-EEG method","volume":"9","author":"Mikkelsen","year":"2015","journal-title":"Front. Neurosci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/0001-6918(78)90006-9","article-title":"Early selective-attention effect on evoked potential reinterpreted","volume":"42","author":"Naatanen","year":"1978","journal-title":"Acta Psychol."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780198705079.001.0001","author":"Naatanen","year":"2019","journal-title":"The Mismatch Negativity (MMN): A Window to the Brain"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2544","DOI":"10.1016\/j.clinph.2007.04.026","article-title":"The mismatch negativity (MMN) in basic research of central auditory processing: a review","volume":"118","author":"Naatanen","year":"2007","journal-title":"Clin. Neurophysiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1152\/japplphysiol.00348.2017","article-title":"Effects of acute hypoxia on human cognitive processing: a study using ERPs and SEPs","volume":"123","author":"Nakata","year":"2017","journal-title":"J. Appl. Physiol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/0013-4694(94)00311-8","article-title":"Topographic EEG changes due to hypobaric hypoxia at simulated high altitude","volume":"94","author":"Ozaki","year":"1995","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.clinph.2006.09.008","article-title":"The effect of hypobaric hypoxia on multichannel EEG signal complexity","volume":"118","author":"Papadelis","year":"2007","journal-title":"Clin. Neurophysiol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/0168-5597(92)90040-I","article-title":"Event-related potential (ERP) correlates of performance of intelligence tests","volume":"84","author":"Pelosi","year":"1992","journal-title":"Electroencephalogr. Clin. Neurophysiol. Evok. Poten. Sect."},{"key":"B41","first-page":"89","article-title":"\u201cSensory ERP components,\u201d","volume-title":"Oxford Handbook of Event-Related Potential Components","author":"Pratt","year":"2011"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15252\/embr.202051696","article-title":"SFRP1 modulates astrocyte-to-microglia crosstalk in acute and chronic neuroinflammation","volume":"22","author":"Rueda-Carrasco","year":"2021","journal-title":"EMBO Rep."},{"key":"B43","first-page":"462","article-title":"Transient and maintained changes of the spontaneous occipital EEG during acute systemic hypoxia","volume":"72","author":"Schellart","year":"2001","journal-title":"Aviat. Space Environ. Med."},{"key":"B44","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/j.bbr.2008.10.020","article-title":"Monitoring effects of acute hypoxia on brain cortical activity by using electromagnetic tomography","volume":"197","author":"Schneider","year":"2009","journal-title":"Behav. Brain Res."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1857","DOI":"10.1002\/hbm.20745","article-title":"Source connectivity analysis with MEG and EEG","volume":"30","author":"Schoffelen","year":"2009","journal-title":"Hum. Brain Mapp."},{"key":"B46","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3389\/fpsyt.2020.00012","article-title":"Impaired sensory processing during low-oxygen exposure: a noninvasive approach to detecting changes in cognitive states","volume":"11","author":"Seech","year":"2020","journal-title":"Front. Psychiatry"},{"key":"B47","first-page":"94","article-title":"Effect of chronic hypobaric hypoxia on components of the human event related potential","volume":"120","author":"Singh","year":"2004","journal-title":"Indian J. Med. Res."},{"key":"B48","doi-asserted-by":"publisher","first-page":"2266","DOI":"10.1016\/j.clinph.2005.06.011","article-title":"Nonlinear dynamical analysis of EEG and MEG: review of an emerging field","volume":"116","author":"Stam","year":"2005","journal-title":"Clin. Neurophysiol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1475","DOI":"10.1016\/j.clinph.2008.02.021","article-title":"Effects of moderate hypobaric hypoxia on evoked categorical visuocognitive responses","volume":"119","author":"Tsarouchas","year":"2008","journal-title":"Clin. Neurophysiol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/0378-5955(94)90089-2","article-title":"Effects of hypobaric hypoxia on the human auditory brainstem responses","volume":"76","author":"Urbani","year":"1994","journal-title":"Hear. Res."},{"key":"B51","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/0013-4694(91)90197-C","article-title":"Quantitative EEG during progressive hypocarbia and hypoxia. Hyperventilation-induced EEG changes reconsidered","volume":"79","author":"Van der Worp","year":"1991","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"B52","first-page":"19","article-title":"EEG correlates of G-induced loss of consciousness","volume":"76","author":"Wilson","year":"2005","journal-title":"Aviat. Space Environ. Med."},{"key":"B53","doi-asserted-by":"publisher","first-page":"22746","DOI":"10.1038\/s41598-023-49431-4","article-title":"Acute hypoxia alters visuospatial attention orienting: an electrical neuroimaging study","volume":"13","author":"Zani","year":"2023","journal-title":"Sci. Rep."},{"key":"B54","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3390\/brainsci10030140","article-title":"Electroencephalogram (EEG) alpha power as a marker of visuospatial attention orienting and suppression in normoxia and hypoxia. An exploratory study","volume":"10","author":"Zani","year":"2020","journal-title":"Brain Sci."}],"container-title":["Frontiers in Cognition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcogn.2025.1503028\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T02:11:48Z","timestamp":1738807908000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcogn.2025.1503028\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,6]]},"references-count":54,"alternative-id":["10.3389\/fcogn.2025.1503028"],"URL":"https:\/\/doi.org\/10.3389\/fcogn.2025.1503028","relation":{},"ISSN":["2813-4532"],"issn-type":[{"value":"2813-4532","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,6]]},"article-number":"1503028"}}