考德威尔极度珠峰探险：一项关于环境性缺氧对认知功能影响的前瞻性研究。
Caudwell Xtreme Everest: A prospective study of the effects of environmental hypoxia on cognitive functioning.
作者信息
Griva Konstadina, Stygall Jan, Wilson Mark H, Martin Daniel, Levett Denny, Mitchell Kay, Mythen Monty, Montgomery Hugh E, Grocott Mike P, Aref-Adib Golnar, Edsell Mark, Plant Tracie, Imray Chris, Cooke Debbie, Harrington Jane, Khosravi Maryam, Newman Stanton P
机构信息
Health Services Research Group, City University London, College Building Room A224, London, United Kingdom.
Department of Psychology, National University of Singapore, 9 Arts Link AS4-02-28, Singapore, Singapore.
出版信息
PLoS One. 2017 Mar 27;12(3):e0174277. doi: 10.1371/journal.pone.0174277. eCollection 2017.
BACKGROUND
The neuropsychological consequences of exposure to environmental hypobaric hypoxia (EHH) remain unclear. We thus investigated them in a large group of healthy volunteers who trekked to Mount Everest base camp (5,300 m).
METHODS
A neuropsychological (NP) test battery assessing memory, language, attention, and executive function was administered to 198 participants (age 44.5±13.7 years; 60% male). These were studied at baseline (sea level), 3,500 m (Namche Bazaar), 5,300 m (Everest Base Camp) and on return to 1,300 m (Kathmandu) (attrition rate 23.7%). A comparable control group (n = 25; age 44.5±14.1 years; 60% male) for comparison with trekkers was tested at/or near sea level over an equivalent timeframe so as to account for learning effects associated with repeat testing. The Reliable Change Index (RCI) was used to calculate changes in cognition and neuropsychological function during and after exposure to EHH relative to controls.
RESULTS
Overall, attention, verbal ability and executive function declined in those exposed to EHH when the performance of the control group was taken into account (RCI .05 to -.95) with decline persisting at descent. Memory and psychomotor function showed decline at highest ascent only (RCI -.08 to -.56). However, there was inter-individual variability in response: whilst NP performance declined in most, this improved in some trekkers. Cognitive decline was greater amongst older people (r = .42; p < .0001), but was otherwise not consistently associated with socio-demographic, mood, or physiological variables.
CONCLUSIONS
After correcting for learning effects, attention, verbal abilities and executive functioning declined with exposure to EHH. There was considerable individual variability in the response of brain function to sustained hypoxia with some participants not showing any effects of hypoxia. This might have implications for those facing sustained hypoxia as a result of any disease.
背景
暴露于环境低压缺氧（EHH）的神经心理学后果仍不清楚。因此，我们在一大群徒步前往珠穆朗玛峰大本营（5300米）的健康志愿者中对其进行了调查。
方法
对198名参与者（年龄44.5±13.7岁；60%为男性）进行了一组评估记忆、语言、注意力和执行功能的神经心理学（NP）测试。在基线（海平面）、3500米（南池市场）、5300米（珠峰大本营）以及返回1300米（加德满都）时对他们进行了研究（损耗率为23.7%）。为了考虑与重复测试相关的学习效应，在相同时间段内在海平面或接近海平面的位置对一个可比的对照组（n = 25；年龄44.5±14.1岁；60%为男性）进行测试，以便与徒步旅行者进行比较。可靠变化指数（RCI）用于计算暴露于EHH期间及之后相对于对照组认知和神经心理学功能的变化。
结果
总体而言，考虑到对照组的表现，暴露于EHH的人群注意力、语言能力和执行功能下降（RCI为0.05至 -0.95），下降在下山时仍持续存在。记忆和心理运动功能仅在上升到最高海拔时下降（RCI为 -0.08至 -0.56）。然而，个体反应存在差异：虽然大多数人的NP表现下降，但一些徒步旅行者的表现有所改善。老年人的认知下降更为明显（r = 0.42；p < 0.0001），但在其他方面与社会人口统计学、情绪或生理变量并无一致关联。
结论
校正学习效应后，注意力、语言能力和执行功能随着暴露于EHH而下降。大脑功能对持续缺氧的反应存在相当大的个体差异，一些参与者未表现出任何缺氧影响。这可能对因任何疾病而面临持续缺氧的人具有启示意义。
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