Effect of acute hypoxia on cognition: A systematic review and meta-regression analysis

Abstract

A systematic meta-regression analysis of the effects of acute hypoxia on the performance of central executive and non-executive tasks, and the effects of the moderating variables, arterial partial pressure of oxygen (PaO₂) and hypobaric versus normobaric hypoxia, was undertaken. Studies were included if they were performed on healthy humans; within-subject design was used; data were reported giving the PaO₂ or that allowed the PaO₂ to be estimated (e.g. arterial oxygen saturation and/or altitude); and the duration of being in a hypoxic state prior to cognitive testing was ≤6days. Twenty-two experiments met the criteria for inclusion and demonstrated a moderate, negative mean effect size (g=-0.49, 95% CI -0.64 to -0.34, p<0.001). There were no significant differences between central executive and non-executive, perception/attention and short-term memory, tasks. Low (35-60mmHg) PaO₂ was the key predictor of cognitive performance (R²=0.45, p<0.001) and this was independent of whether the exposure was in hypobaric hypoxic or normobaric hypoxic conditions.

Keywords: Arterial partial pressure of oxygen; Carotid body; Catecholamines; Central executive; Glossypharyngeal nerve; Hypobaric; Internal carotid arteries; Normobaric; Perception; Regional cerebral blood flow; Short-term memory; Vertebral arteries.