Abstract Details

Title Assessing the Alterations in Brain Morphological Characteristics and White Matter Hyperintensity Burdens in Professionals with High-Altitude Occupations: A Systematic Review and Meta-Analysis

Topic General Neurology

Presentation(s) P2 - Poster Session 2 (8:00 AM-9:00 AM)

Poster/Presentation
Number 2-003

Objective

To systematically review and meta-analyze morphological brain changes, specifically white matter hyperintensities (WMH), in high-altitude careers and spaceflights.

Background Occupational exposure to hypobaric, hypoxic, and microgravity environments, such as in high-altitude careers and spaceflights, poses significant neurological risks. White matter hyperintensities, detected via MRI, are abnormal lesions associated with cognitive decline, cardiovascular diseases, and neurocognitive impairments. Despite their prevalence, there is limited understanding of the incidence and causes of WMHs in these professions. This study aims to explore the relationship between occupational high-altitude exposure and WMHs.

Design/Methods This systematic review and meta-analysis was registered on Prospero (CRD42023487668) and followed PRISMA guidelines. A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane was conducted to identify relevant studies. Studies were screened independently by two reviewers, and data were extracted and analyzed using R software. Mean differences (MD) with 95% confidence intervals (CI) were used for statistical analyses, with significance defined as p<0.05.

Results A total of 1,565 articles were identified, with 5 studies meeting the inclusion criteria after screening. The meta-analysis included 441 individuals (264 pilots, 177 controls). The pooled burden of WMHs was 6.97 per pilot. Our single-armed analysis revealed a pooled WMH volume of 0.27 cm³. Pilots had a significantly higher number of WMHs compared to controls (MD: 3.57, 95% CI: 1.71–5.43, p=0.0002) and greater WMH volume (MD: 0.09 cm³, 95% CI: 0.04–0.14, p=0.0001). No heterogeneity was observed (I² = 0%).

Conclusions The results suggest that occupational exposure to high altitudes is associated with an increased burden of WMHs. Given the potential cognitive and health implications, periodic neurological screening is recommended for individuals in high-altitude and spaceflight professions. Further research is needed to explore the etiopathogenesis and long-term effects of WMHs in these populations.

Authors/Disclosures
Nsser Abdelall, MD (LSU Health Sciences - CALS Bldg) PRESENTER	Dr. Abdelall has nothing to disclose.
Mohamed Ibrahim A. Mohamed, MD	Mr. Mohamed has nothing to disclose.
Yomna Dean, MBBS	Ms. Dean has nothing to disclose.
Shree Rath, MBBS	Miss Rath has nothing to disclose.
Atta Ur Rehman, MBBS	Dr. Rehman has nothing to disclose.
Muhammad Ali Aleem, MBBS	Dr. Aleem has nothing to disclose.
Adham F. Hamza, MD	Dr. Hamza has nothing to disclose.

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