Morphological Brain Changes after Climbing to Extreme Altitudes-A Prospective Cohort Study.

Kottke, Raimund; Pichler Hefti, Jacqueline Renée; Rummel, Christian; Hauf, Martinus; Hefti, Urs; Merz, Tobias Michael (2015). Morphological Brain Changes after Climbing to Extreme Altitudes-A Prospective Cohort Study. PLoS ONE, 10(10), e0141097. Public Library of Science 10.1371/journal.pone.0141097

http___www.plosone.org_article_fetchObject.action_uri=info_doi_10.1371_journal.pone.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (2MB) | Preview


Findings of cerebral cortical atrophy, white matter lesions and microhemorrhages have been reported in high-altitude climbers. The aim of this study was to evaluate structural cerebral changes in a large cohort of climbers after an ascent to extreme altitudes and to correlate these findings with the severity of hypoxia and neurological signs during the climb.


Magnetic resonance imaging (MRI) studies were performed in 38 mountaineers before and after participating in a high altitude (7126m) climbing expedition. The imaging studies were assessed for occurrence of new WM hyperintensities and microhemorrhages. Changes of partial volume estimates of cerebrospinal fluid, grey matter, and white matter were evaluated by voxel-based morphometry. Arterial oxygen saturation and acute mountain sickness scores were recorded daily during the climb.


On post-expedition imaging no new white matter hyperintensities were observed. Compared to baseline testing, we observed a significant cerebrospinal fluid fraction increase (0.34% [95% CI 0.10-0.58], p = 0.006) and a white matter fraction reduction (-0.18% [95% CI -0.32--0.04], p = 0.012), whereas the grey matter fraction remained stable (0.16% [95% CI -0.46-0.13], p = 0.278). Post-expedition imaging revealed new microhemorrhages in 3 of 15 climbers reaching an altitude of over 7000m. Affected climbers had significantly lower oxygen saturation values but not higher acute mountain sickness scores than climbers without microhemorrhages.


A single sojourn to extreme altitudes is not associated with development of focal white matter hyperintensities and grey matter atrophy but leads to a decrease in brain white matter fraction. Microhemorrhages indicative of substantial blood-brain barrier disruption occur in a significant number of climbers attaining extreme altitudes.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Kottke, Raimund, Pichler, Jacqueline, Rummel, Christian, Hauf, Martinus, Merz, Tobias


600 Technology > 610 Medicine & health




Public Library of Science




Martin Zbinden

Date Deposited:

08 Jan 2016 13:03

Last Modified:

02 Mar 2023 23:27

Publisher DOI:


PubMed ID:





Actions (login required)

Edit item Edit item
Provide Feedback