High-Altitude Exposure: Effects on Cognitive Performance, Neurovascular Mechanisms, and Mitigation Strategies

Serum analysis revealed a 390.1 pg/mL increase in chitinase-3-like protein 1 (CHI3L1), indicating inflammatory activation, and a 37.1 pg/mL compensatory rise in brain-derived neurotrophic factor (BDNF). Mediation analyses suggested an indirect association of high-altitude exposure with Stroop errors through ΔHbR. Furthermore, our findings suggested that a few minutes of oxygen supplementation at high altitude may improve cerebral oxygenation, with behavioral changes in a favorable but non-significant direction, while cognitive and neurovascular measures tended to move toward baseline after return to low altitude.

These findings provide evidence that high-altitude exposure is associated with significant yet potentially reversible neurocognitive effects, underscoring the need for confirmation in larger cohorts and further evaluation of strategies to mitigate neurocognitive risks.