RT Journal Article
SR Electronic
T1 Investigating Sea-Level Brain Predictors for Acute Mountain Sickness: A Multimodal MRI Study before and after High-Altitude Exposure
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A8206
A1 Zhang, Wei
A1 Feng, Jie
A1 Liu, Wenjia
A1 Zhang, Shiyu
A1 Yu, Xiao
A1 Liu, Jie
A1 Shan, Baoci
A1 Ma, Lin
YR 2024
UL http://www.ajnr.org/content/early/2024/04/25/ajnr.A8206.abstract
AB BACKGROUND AND PURPOSE: Acute mountain sickness is a series of brain-centered symptoms that occur when rapidly ascending to high altitude. Predicting acute mountain sickness before high-altitude exposure is crucial for protecting susceptible individuals. The present study aimed to evaluate the feasibility of predicting acute mountain sickness after high-altitude exposure by using multimodal brain MR imaging features measured at sea level.MATERIALS AND METHODS: We recruited 45 healthy sea-level residents who flew to the Qinghai-Tibet Plateau (3650 m). We conducted T1-weighted structural MR imaging, resting-state fMRI, and arterial spin-labeling perfusion MR imaging both at sea level and high altitude. Acute mountain sickness was diagnosed for 5 days using Lake Louise Scoring. Logistic regression with Least Absolute Shrinkage and Selection Operator logistic regression was performed for predicting acute mountain sickness using sea-level MR imaging features. We also validated the predictors by using MR images obtained at high altitude.RESULTS: The incidence rate of acute mountain sickness was 80.0%. The model achieved an area under the receiver operating characteristic curve of 86.4% (sensitivity = 77.8%, specificity = 100.0%, and P < .001) in predicting acute mountain sickness At sea level, valid predictors included fractional amplitude of low-frequency fluctuations (fALFF) and degree centrality from resting-state fMRI, mainly distributed in the somatomotor network. We further learned that the acute mountain sickness group had lower levels of fALFF in the somatomotor network at high altitude, associated with smaller changes in CSF volume and higher Lake Louise Scoring, specifically relating to fatigue and clinical function.CONCLUSIONS: Our study found that the somatomotor network function detected by sea-level resting-state fMRI was a crucial predictor for acute mountain sickness and further validated its pathophysiologic impact at high altitude. These findings show promise for pre-exposure prediction, particularly for individuals in need of rapid ascent, and they offer insight into the potential mechanism of acute mountain sickness.AMSacute mountain sicknessASLarterial spin-labelingAUCarea under the curveDCdegree centralityfALFFfractional amplitude of low-frequency fluctuationsLASSO-LRLeast Absolute Shrinkage and Selection Operator logistic regressionLLSLake Louise Scorers-fMRIresting-state fMRIROCreceiver operating characteristicSMNsomatomotor networkSpO2saturation of pulse oxygen