Chen X, et al. - Through a longitudinal study of 49 college freshmen who immigrated to Tibet, the contributors intended to explore the cognitive and cerebral microstructural alterations after chronic high-altitude (HA) exposure. Lower accuracy and longer reaction times in memory tests were exhibited by the high-altitude exposed individuals, in comparison with healthy controls. Furthermore, a significant correlation of the differences in subcortical volume and white matter (WM) integration with the cognitive changes after 2 years' HA exposure indicating potential impairments in the brain structural modifications and microstructural integrity of WM tracts were noted. Impaired cognitive functions such as working memory and psychomotor function during chronic HA was also observed.