AUTHOR=Scheiwiller P. M. , Furian M. , Buergin A. , Mayer L. C. , Schneider S. R. , Mademilov M. , Lichtblau M. , Muralt L. , Sheraliev U. , Sooronbaev T. M. , Ulrich S. , Bloch K. E. 

TITLE=Visuomotor performance at high altitude in COPD patients. Randomized placebo-controlled trial of acetazolamide

JOURNAL=Frontiers in Physiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2022.980755

DOI=10.3389/fphys.2022.980755

ISSN=1664-042X

ABSTRACT=<p><bold>Introduction:</bold> We evaluated whether exposure to high altitude impairs visuomotor learning in lowlanders with chronic obstructive pulmonary disease (COPD) and whether this can be prevented by acetazolamide treatment.</p><p><bold>Methods:</bold> 45 patients with COPD, living &lt;800 m, FEV1 ≥40 to &lt;80%predicted, were randomized to acetazolamide (375 mg/d) or placebo, administered 24h before and during a 2-day stay in a clinic at 3100 m. Visuomotor performance was evaluated with a validated, computer-assisted test (Motor-Task-Manager) at 760 m above sea level (baseline, before starting the study drug), within 4h after arrival at 3100 m and in the morning after one night at 3100 m. Main outcome was the directional error (DE) of cursor movements controlled by the participant via mouse on a computer screen during a target tracking task. Effects of high altitude and acetazolamide on DE during an adaptation phase, immediate recall and post-sleep recall were evaluated by regression analyses. <ext-link ext-link-type="uri" xlink:href="http://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</ext-link> NCT03165890.</p><p><bold>Results:</bold> In 22 patients receiving placebo, DE at 3100 m increased during adaptation by mean 2.5°, 95%CI 2.2° to 2.7° (<italic>p</italic> &lt; 0.001), during immediate recall by 5.3°, 4.6° to 6.1° (<italic>p</italic> &lt; 0.001), and post-sleep recall by 5.8°, 5.0 to 6.7° (<italic>p</italic> &lt; 0.001), vs. corresponding values at 760 m. In 23 participants receiving acetazolamide, corresponding DE were reduced by −0.3° (−0.6° to 0.1°, <italic>p</italic> = 0.120), −2.7° (−3.7° to −1.6°, <italic>p</italic> &lt; 0.001) and −3.1° (−4.3° to −2.0°, <italic>p</italic> &lt; 0.001), compared to placebo at 3100 m.</p><p><bold>Conclusion:</bold> Lowlanders with COPD travelling to 3100 m experienced altitude-induced impairments in immediate and post-sleep recall of a visuomotor task. Preventive acetazolamide treatment mitigated these undesirable effects.</p>