Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland.
Swiss-Kyrgyz High Altitude Medicine and Research Initiative, Zurich, Switzerland/ Bishkek, Kyrgyz Republic.
PLoS One. 2023 Jan 20;18(1):e0280585. doi: 10.1371/journal.pone.0280585. eCollection 2023.
Altitude travel is increasingly popular also for middle-aged and older tourists and professionals. Due to the sensitivity of the central nervous system to hypoxia, altitude exposure may impair visuomotor performance although this has not been extensively studied. Therefore, we investigated whether a sojourn at moderately high altitude is associated with visuomotor performance impairments in healthy adults, 40y of age or older, and whether this adverse altitude-effect can be prevented by acetazolamide, a drug used to prevent acute mountain sickness.
In this randomized placebo-controlled parallel-design trial, 59 healthy lowlanders, aged 40-75y, were assigned to acetazolamide (375 mg/day, n = 34) or placebo (n = 25), administered one day before ascent and while staying at high altitude (3100m). Visuomotor performance was assessed at 760m and 3100m after arrival and in the next morning (post-sleep) by a computer-assisted test (Motor-Task-Manager). It quantified deviation of a participant-controlled cursor affected by rotation during target tracking. Primary outcome was the directional error during post-sleep recall of adaptation to rotation estimated by multilevel linear regression modeling. Additionally, adaptation, immediate recall, and correct test execution were evaluated.
Compared to 760m, assessments at 3100m with placebo revealed a mean (95%CI) increase in directional error during adaptation and immediate recall by 1.9° (0.2 to 3.5, p = 0.024) and 1.1° (0.4 to 1.8, p = 0.002), respectively. Post-sleep recall remained unchanged (p = NS), however post-sleep correct test execution was 14% less likely (9 to 19, p<0.001). Acetazolamide improved directional error during post-sleep recall by 5.6° (2.6 to 8.6, p<0.001) and post-sleep probability of correct test execution by 36% (30 to 42, p<0.001) compared to placebo.
In healthy individuals, 40y of age or older, altitude exposure impaired adaptation to and immediate recall and correct execution of a visuomotor task. Preventive acetazolamide treatment improved visuomotor performance after one night at altitude and increased the probability of correct test execution compared to placebo.
CLINICALTRIALS.GOV IDENTIFIER: ClinicalTrials.gov NCT03536520.
海拔旅行对于中年和老年人以及专业人士来说越来越受欢迎。由于中枢神经系统对缺氧敏感，尽管尚未对此进行广泛研究，但海拔暴露可能会损害视动表现。因此，我们研究了在高海拔地区逗留是否与 40 岁或以上健康成年人的视动表现受损有关，以及乙酰唑胺（一种用于预防急性高原病的药物）是否可以预防这种不利的海拔影响。
在这项随机安慰剂对照平行设计试验中，59 名年龄在 40-75 岁的健康低地居民被分配到乙酰唑胺（375mg/天，n=34）或安慰剂（n=25）组，在登山前一天和高海拔（3100m）时服用。到达后和次日早晨（睡眠后），通过计算机辅助测试（Motor-Task-Manager）评估视动表现。它量化了受目标跟踪期间旋转影响的参与者控制光标在适应旋转后的偏差。主要结果是通过多水平线性回归模型估计的睡眠后回忆中适应旋转的方向误差。此外，还评估了适应、即时回忆和正确测试执行。
与 760m 相比，在服用安慰剂的情况下，3100m 的评估显示，在适应和即时回忆期间，方向误差的平均（95%CI）分别增加了 1.9°（0.2 至 3.5，p=0.024）和 1.1°（0.4 至 1.8，p=0.002）。睡眠后回忆没有变化（p=NS），但是睡眠后正确测试执行的可能性降低了 14%（9 至 19，p<0.001）。与安慰剂相比，乙酰唑胺可使睡眠后回忆的方向误差改善 5.6°（2.6 至 8.6，p<0.001），睡眠后正确测试执行的概率提高 36%（30 至 42，p<0.001）。
在 40 岁或以上的健康人群中，海拔暴露会损害适应、即时回忆和视动任务的正确执行。预防性乙酰唑胺治疗可改善一夜高海拔后视动表现，并增加与安慰剂相比正确测试执行的概率。
ClinicalTrials.gov NCT03536520。
