McGuire Stephen A, Sherman Paul M, Brown Anthony C, Robinson Andrew Y, Tate David F, Fox Peter T, Kochunov Peter V
U.S. Air Force School of Aerospace Medicine, Aerospace Medicine Consultation Division, Wright-Patterson AFB, OH, USA.
Aviat Space Environ Med. 2012 Dec;83(12):1117-22. doi: 10.3357/asem.3395.2012.
Neurologic decompression sickness (NDCS) can affect high-altitude pilots, causing variable central nervous system symptoms. Five recent severe episodes prompted further investigation.
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.
The NDCS group had significantly increased whole brain and insular volumes of HWM lesions. The intergroup difference in lesion numbers was not significant.
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.
神经减压病（NDCS）会影响高空飞行员，引发多种中枢神经系统症状。最近发生的五起严重事件促使我们展开进一步调查。
我们报告了50名U - 2飞行员志愿者的高强度白质（HWM）病变成像结果，并将12名经历临床NDCS的U - 2飞行员与38名未经历的飞行员进行比较。成像数据使用3T磁共振成像扫描仪和高分辨率（1毫米各向同性）三维液体衰减反转恢复序列收集。比较了两组之间全脑和局部病变的体积及数量。
NDCS组全脑和岛叶的HWM病变体积显著增加。两组间病变数量差异不显著。
NDCS的临床发作与HWM病变体积显著增加有关，尤其是在岛叶。我们推测这是由于低压暴露而非缺氧所致，因为所有飞行员在整个飞行过程中都持续吸入100%氧气。需要进一步研究以更好地理解这些病变背后的病理生理学机制。
