INTRODUCTION: Neurologic decompression sickness (NDCS) can affect high-altitude pilots, causing variable central nervous system symptoms. Five recent severe episodes prompted further investigation. METHODS: We report the hyperintense white matter (HWM) lesion imaging findings in 50 U-2 pilot volunteers, and compare 12 U-2 pilots who experienced clinical NDCS to 38 U-2 pilots who did not. The imaging data were collected using a 3T magnetic resonance imaging scanner and high-resolution (1-mm isotropic) three-dimensional fluid-attenuated inversion recovery sequence. Whole-brain and regional lesion volume and number were compared between groups. RESULTS: The NDCS group had significantly increased whole brain and insular volumes of HWM lesions. The intergroup difference in lesion numbers was not significant. CONCLUSION: A clinical episode of NDCS was associated with a significant increase in HWM lesion volume, especially in the insula. We postulate this to be due to hypobaric exposure rather than hypoxia since all pilots were maintained on 100% oxygen throughout the flight. Further studies will be necessary to better understand the pathophysiology underlying these lesions.
INTRODUCTION:Neurologic decompression sickness (NDCS) can affect high-altitude pilots, causing variable central nervous system symptoms. Five recent severe episodes prompted further investigation. METHODS: We report the hyperintense white matter (HWM) lesion imaging findings in 50 U-2 pilot volunteers, and compare 12 U-2 pilots who experienced clinical NDCS to 38 U-2 pilots who did not. The imaging data were collected using a 3T magnetic resonance imaging scanner and high-resolution (1-mm isotropic) three-dimensional fluid-attenuated inversion recovery sequence. Whole-brain and regional lesion volume and number were compared between groups. RESULTS: The NDCS group had significantly increased whole brain and insular volumes of HWM lesions. The intergroup difference in lesion numbers was not significant. CONCLUSION: A clinical episode of NDCS was associated with a significant increase in HWM lesion volume, especially in the insula. We postulate this to be due to hypobaric exposure rather than hypoxia since all pilots were maintained on 100% oxygen throughout the flight. Further studies will be necessary to better understand the pathophysiology underlying these lesions.
Authors: Emmanuel Gempp; Fabrice Sbardella; Eric Stephant; Pascal Constantin; Sebastien De Maistre; Pierre Louge; Jean-Eric Blatteau Journal: Aviat Space Environ Med Date: 2010-11
Authors: Stephen M Smith; Mark Jenkinson; Mark W Woolrich; Christian F Beckmann; Timothy E J Behrens; Heidi Johansen-Berg; Peter R Bannister; Marilena De Luca; Ivana Drobnjak; David E Flitney; Rami K Niazy; James Saunders; John Vickers; Yongyue Zhang; Nicola De Stefano; J Michael Brady; Paul M Matthews Journal: Neuroimage Date: 2004 Impact factor: 6.556
Authors: Sean L Jersey; Gregory L Hundemer; Rory P Stuart; Kelly N West; Robert S Michaelson; Andrew A Pilmanis Journal: Aviat Space Environ Med Date: 2011-07
Authors: Peter Kochunov; David Glahn; Anderson Winkler; Ravindranath Duggirala; Rene L Olvera; Shelley Cole; Thomas D Dyer; Laura Almasy; Peter T Fox; John Blangero Journal: Stroke Date: 2009-10-15 Impact factor: 7.914
Authors: David F Tate; Angela L Jefferson; Adam M Brickman; Karin F Hoth; John Gunstad; Kathryn Bramley; Robert H Paul; Athena Poppas; Ronald A Cohen Journal: Brain Imaging Behav Date: 2008-09-01 Impact factor: 3.978
Authors: Jennifer A McGuire; Paul M Sherman; Erica Dean; Jeremy M Bernot; Laura M Rowland; Stephen A McGuire; Peter V Kochunov Journal: Mil Med Date: 2017-05 Impact factor: 1.437
Authors: Stephen A McGuire; Meghann C Ryan; Paul M Sherman; John H Sladky; Laura M Rowland; S Andrea Wijtenburg; L Elliot Hong; Peter V Kochunov Journal: Hum Brain Mapp Date: 2019-03-29 Impact factor: 5.038
Authors: Stephen A McGuire; David F Tate; Joe Wood; John H Sladky; Kent McDonald; Paul M Sherman; Elaine S Kawano; Laura M Rowland; Beenish Patel; Susan N Wright; Elliot Hong; Jennifer Rasmussen; Adam M Willis; Peter V Kochunov Journal: Neurology Date: 2014-07-09 Impact factor: 9.910
Authors: Peter Kochunov; Joshua Chiappelli; Susan N Wright; Laura M Rowland; Beenish Patel; S Andrea Wijtenburg; Katie Nugent; Robert P McMahon; William T Carpenter; Florian Muellerklein; Hemalatha Sampath; L Elliot Hong Journal: Psychiatry Res Date: 2014-05-21 Impact factor: 3.222
Authors: Stephen McGuire; Paul Sherman; Leonardo Profenna; Patrick Grogan; John Sladky; Anthony Brown; Andrew Robinson; Laura Rowland; Elliot Hong; Beenish Patel; David Tate; Elaine S Kawano; Peter Fox; Peter Kochunov Journal: Neurology Date: 2013-08-20 Impact factor: 9.910
Authors: Stephen A McGuire; Paul M Sherman; S Andrea Wijtenburg; Laura M Rowland; Patrick M Grogan; John H Sladky; Andrew Y Robinson; Peter V Kochunov Journal: Ann Neurol Date: 2014-09-17 Impact factor: 10.422
Authors: Peter Kochunov; Mao Fu; Katie Nugent; Susan N Wright; Xiaoming Du; Florian Muellerklein; Mary Morrissey; George Eskandar; Dinesh K Shukla; Neda Jahanshad; Paul M Thompson; Binish Patel; Teodor T Postolache; Kevin A Strauss; Alan R Shuldiner; Braxton D Mitchell; L Elliot Hong Journal: Hum Brain Mapp Date: 2015-11-05 Impact factor: 5.038