Abstract
Objective: Headache and memory impairment are the primary clinical symptoms of chronic mountain sickness (CMS). In this study, we used voxel-based morphometry (VBM) and the amplitude of the low-frequency fluctuation method (ALFF) based on blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) to identify changes in the brain structure and function caused by CMS.Materials and Methods: T1W anatomical images and a resting-state functional MRI (fMRI) of the whole brain were performed in 24 patients diagnosed with CMS and 25 normal controls matched for age, sex, years of education, and living altitude. MRI images were acquired, followed by VBM and ALFF data analyses.Results: Compared with the control group, the CMS group had increased gray matter volume in the left cerebellum crus II area, left inferior temporal gyrus, right middle temporal gyrus, right insula, right caudate nucleus, and bilateral lentiform nucleus along with decreased gray matter volume in the left middle occipital gyrus and left middle temporal gyrus. White matter was decreased in the bilateral middle temporal gyrus and increased in the right Heschl's gyrus. Resting-state fMRI in patients with CMS showed increased spontaneous brain activity in the left supramarginal gyrus, left parahippocampal gyrus, and left middle temporal gyrus along with decreased spontaneous brain activity in the right cerebellum crus I area and right supplementary motor area.Conclusion: Patients with CMS had differences in gray and white matter volume and abnormal spontaneous brain activity in multiple brain regions compared to the controls. This suggests that long-term chronic hypoxia may induce changes in brain structure and function, resulting in CMS.
Highlights
Chronic mountain sickness (CMS) was initially described by Monge in 1928 and was later replicated by other groups in the early medical literature [1,2,3,4,5,6]
Wei et al suggested that the differences in cortical morphometry in the brains of native Tibetans may reflect adaptations related to high altitudes [18]
Our research aims to study structural and functional changes simultaneously, using voxel-based morphometry (VBM) and the amplitude of low-frequency fluctuation (ALFF) methods, from resting-state functional MRIs (fMRIs) in patients with CMS
Summary
Chronic mountain sickness (CMS) was initially described by Monge in 1928 and was later replicated by other groups in the early medical literature [1,2,3,4,5,6]. Structural MRI studies of adolescents migrating from sea level to a high altitude environment demonstrated the following changes: (a) decreased gray matter volume in the right postcentral gyrus, right superior frontal gyrus, bilateral anterior insula, right anterior cingulate cortex, bilateral pre-frontal cortex, left precentral cortex, and right lingual cortex, and (b) increased gray matter volume in the right middle frontal gyrus, right parahippocampal gyrus, right inferior and middle temporal gyri, bilateral inferior ventral pons, and right cerebellum crus I [19, 20]. Our research aims to study structural and functional changes simultaneously, using voxel-based morphometry (VBM) and the amplitude of low-frequency fluctuation (ALFF) methods, from resting-state fMRI in patients with CMS. To the best of our knowledge, no studies have used both structural MRI volumetrics and restingstate fMRI to study CMS
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