Research Reports - Uncovering latent deficits due to mild traumatic brain injury by using normobaric hypoxia stress

Front Neurol. 2013 Apr 30;4:41

Temme L, Bleiberg J, Reeves D, Still DL, Levinson D, Browning R

Memory deficits and other cognitive symptoms frequently associated with mTBI are
commonly thought to resolve within 7-10 days. This generalization is based
principally on observations made in individuals who are in the unstressed
environmental conditions typical of a clinic and so does not consider the impact
of physiologic, environmental, or psychological stress. Normobaric hypoxic stress
can be generated with normal mean sea level (MSL) air, which is about 21% oxygen
(O2) and 78% nitrogen (N), by reducing the percentage of O2 and increasing the
percentage of N so that the resultant mixed-gas has a partial pressure of O2
approximating that of specified altitudes. This technique was used to generate
normobaric hypoxic equivalents of 8,000, 12,000, and 14,000 feet above MSL in a
group of 36 volunteers with a mTBI history and an equal number of controls
matched on the basis of age, gender, tobacco smoking consumption, weight, height,
and body mass index. Short-term visual memory was tested using the Matching to
Sample (M2S) subtest of the BrainCheckers analog of the Automated
Neuropsychological Assessment Metrics. Although there were no significant
differences in M2S performance between the two groups of subjects at MSL, with
increased altitude, the mTBI group performance was significantly worse than that
of the control group. When the subjects were returned to MSL, the difference
disappeared. This finding suggests that the "hypoxic challenge" paradigm
developed here has potential clinical utility for assessing the effects of mTBI
in individuals who appear asymptomatic under normal conditions.

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