Running at altitude is gaining greater popularity but it may expose participants to the risk of acute mountain sickness (AMS). The study investigated electroencephalographic (EEG) changes and eventual symptoms suggestive of AMS in 5 well-trained lowland native male runners (average age, 38.2 ? 4.6 years; VO2 peak 61.4 ? 2.7 mL?kg–1?min–1 at sea level; best marathon performance at sea level under 3 hours), who completed a marathon at 4300 m altitude. EEG, percentage of peripheral arterial oxygen saturation (% SpaO2) and heart rate (HR) were recorded during wakefulness at rest (supine position) and in comfort: 1) at sea level; 2) at 3600 m after 32 - 38 hours of acute acclimatization; 3) at 4300 m after 145 - 153 hours of chronic acclimatization; and 4) at 4300 m immediately after a marathon race. Symptoms of AMS were evaluated with the Lake Louise questionnaire before any ECG recording. There was a significant decrease in low-voltage high-frequency activities at rest after acute hypoxic-hypobaric exposure at 3600 m as compared to sea level. After six days of acclimatization at 4300 m there was a significant increase in the power of low-voltage high-frequency activities, particularly beta and gamma, indicating an aroused waking state and an integrated activity across widely distributed cortical regions. An increase in the power of low-voltage high-frequency activities over the entire cortex was observed, particularly after completion of the marathon at 4300 m. The increase in the high-frequency activities was probably due to direct and indirect reflex activation of the forebrain and reticular activating system involved in behavioral and metabolic integration of autonomic control and arousal and due to residual activation of the somatomotor and parietal cortex after the end of the marathon. Lake Louise score always resulted lower than 3, indicating no signs of AMS in all the runners. The results of this study indicate that in well-trained and acclimatized athletes, arousal has a protective role in preventing excessive oxygen deprivation also after an endurance exercise performed at high altitude. The absence of AMS fond in our study bear out that well trained and acclimatized runners, can safely participate in a marathon at high altitude that gives rise to temporary EEG changes without inducing paroxysmal phenomena.
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