Neuro Army
Neuro Army
Neuro Army
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978-0-309-12740-0
136 pages
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PAPERBACK (2009)
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Opportunities in
Neuroscience for
Future Army Applications
Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National
Research Council, whose members are drawn from the councils of the National Academy of Sciences, the
National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible
for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by Contract No. W911NF-07-C-0117 between the National Academy of Sciences
and the Department of Defense. Any opinions, findings, conclusions, or recommendations expressed in this
publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies
that provided support for the project.
International Standard Book Number-13: 978-0-309-12740-0
International Standard Book Number-10: 0-309-12740-8
Library of Congress Control Number: 2009927221
Limited copies of this report are available from
Cover: Neuronal pathways in BrainBow mice. Neurons in the hippocampus, a brain area involved in memory,
are labeled in different colors, with their neuronal outgoing projections pointing to the left. This is the first
time so many different neurons have been separately visualized on such a large scale. Courtesy of Jean Livet,
Joshua R. Sanes, and Jeff W. Lichtman, Harvard University, 2008.
Copyright 2009 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
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Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
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engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
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medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the
broad community of science and technology with the Academys purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the
Council has become the principal operating agency of both the National Academy of Sciences and the National
Academy of Engineering in providing services to the government, the public, and the scientific and engineering
communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph
J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
www.national-academies.org
vi
Preface
viii
Preface
Acknowledgments
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical
expertise, in accordance with procedures approved by the
National Research Councils Report Review Committee. The
purpose of this independent review is to provide candid and
critical comments that will assist the institution in making its
published report as sound as possible and to ensure that the
report meets institutional standards for objectivity, evidence,
and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect
the integrity of the deliberative process. We wish to thank the
following individuals for their review of this report:
ix
Contents
SUMMARY
1 INTRODUCTION
Study Background, 8
Statement of Task, 8
Study Approach, 9
Report Organization, 10
Chapter Structure, 10
Response to Statement of Task, 10
References, 11
12
23
xi
xii
CONTENTS
Summary: Status of Soldier Selection and Assessment and the Potential for
Neuroscience-Based Improvements, 30
Monitoring and Predicting Social and Group Interactions, 31
The Scope of Social Neuroscience, 31
Relevance of Social Neuroscience to the Army, 31
Summary, 33
References, 33
4 OPTIMIZING DECISION MAKING
The Sources of Suboptimal Decision Making, 36
Errors in Assessing Relative Risk, 36
Loss Aversion in Decision Making, 37
Making Optimal Use of Individual Variability, 37
Tools for Characterizing Individual Decision Makers, 38
Personality as a Factor in Decision Making, 38
Emotional Reactivity in Decision Making, 39
Emerging Tools: Genetics, Neurohormones, and Brain Imaging, 39
Neuroscience-Related Theories of Decision Making, 39
Belief-Based Decision Making, 40
Intuitive Decision Making and Recognition-Primed Decisions, 42
References, 43
36
45
67
74
xiii
CONTENTS
93
99
APPENDIXES
A Biographical Sketches of Committee Members
B Committee Meetings
C Sampling of Behavioral and Neuropsychological Literature (2001-2007) on
High-Performance Athletes
D Research on Managing Information Overload in Soldiers Under Stress
107
110
112
117
Tables
S-1
S-2
S-3
2-1
7-1
7-2
7-3
Figures
2-1
Various noninvasive imaging technologies provide insight into the brain (anatomy)
and mind (function), 14
5-1
Schematic diagram illustrating the likely interactions between central and peripheral
components of fatigue, 47
5-3-1 Neuronal pathways in BrainBow mice, 60
7-1
Various noninvasive imaging technologies provide insight into the brain (anatomy)
and mind (function), 75
BOXES
1-1
Statement of Task, 9
2-1
3-1
3-2
5-1
5-2
5-3
AFAST
AFQT
AIM
ANAM
LCD
lfp
MEG
MRI
magnetoencephalography
magnetic resonance imaging
NASA
NIRS
NMDA
NonREM
NRC
NSBRI
OEM
OT
PET
PFC
PTSD
PVT
BAST
BCAA
BMI
BOLD
CNS
CRT
CSF
C2V
DARPA
DOT
DSI
DTI
R&D
REM
RPD
EEG
ERP
electroencephalography
event-related potential
SAT
SIFT
FDA
fMRI
GSR
T
TBI
TMS
ToM
TPJ
tesla
traumatic brain injury
transcranial magnetic stimulation
theory of mind
temporoparietal junction
HMI
HPA
humanmachine interface
hypothalamic-pituitary-adrenal
VR
virtual reality
IED
Summary
Emerging neuroscience opportunities have great potential to improve soldier performance and enable the development of technologies to increase the effectiveness of soldiers
on the battlefield. Advances in research and investments by
the broader science and medical community promise new
insights for future military applications. These include traditional areas of interest to the Army, such as learning, decision
making, and performance under stress, as well as new areas,
such as cognitive fitness, braincomputer interfaces, and
biological markers of neural states.
Advances in research-enabling technologies, such as
functional magnetic resonance imaging (fMRI) and computational neuroscience, have resulted in instrumentation and
techniques that can better assess the neural basis of cognition and allow the visualization of brain processes. These
advances have the potential to provide new measures of
training and learning for soldiers while also shedding fresh
light on the traditional approaches to behavioral science used
by the Army. Most current Army neuroscience research is
conducted with little regard given to its longer-term potential
for military operations. The report discusses a spectrum of
ongoing efforts, with an emphasis on nonmedical applications and on current research that is likely to lead to insights
and opportunities for possible military application.
Study Approach
The Assistant Secretary of the Army (Acquisition,
Logistics, and Technology) (ASAALT) asked the National
Research Council to conduct a study of neuroscience in terms
of its potential to support military applications. Chapter 1
discusses the statement of task and explains how the report
responds to each of the tasks.
Members of the Committee on Opportunities in Neuroscience for Future Army Applications, set up in response to
the ASAALT request, had expertise not only in traditional
and emerging subdisciplines of neuroscience but also in
research and development (R&D), in military operations and
Table S-1 High-Priority Opportunities for Army Investment in Neuroscience Technologies (Recommendation 14)
Current Investment
(L, M, or H)
Technology Opportunity
ME
RE
Time Framea
Commercial
Academic
x
x
x
x
x
x
Ongoing
Medium term
Ongoing
L
M
M
M
L
H
x
x
M
L
L
M
L
M
L
M
L
L
x
x
x
Ongoing
Medium term
Medium term
Medium term
Medium term
x
x
x
x
Medium term
Medium term
L
M
L
M
Medium term
Ongoing
M
L
M
M
NOTE: ME, mission-enabling; RE, research-enabling; L/M/H, low, medium, or high; EEG, electroencephalography; MRI, magnetic resonance imaging;
fMRI, functional magnetic resonance imaging; DTI, diffuse tensor imaging; DSI, diffusion spectrum imaging; PET, positron emission tomography; MEG,
magnetoencephalography; NIRS, near-infrared spectroscopy; DOT, diffuse optical tomography; GSR, galvanic skin response.
aIn this column, medium term means between 5 and 10 years and ongoing means that results will be available within 5 years but continuing investment
is recommended to stay at the forefront of the technology.
SOURCE: Committee-generated.
Table S-2 Priority Opportunities for Army Investment in Neuroscience Technologies (Recommendation 15)
Current Investment
(L, M, or H)
Technology Opportunity
ME
x
x
x
x
RE
x
x
x
x
x
x
x
x
x
x
x
Time Framea
Commercial
Academic
Medium term
Medium term
Medium term
Far term
Medium term
Near term
Far term
H
H
L
L
L
L
L
L
H
M
M
M
M
H
Medium term
Far term
Near and medium term
Near and medium term
L
L
L
H
M
L
H
L
NOTE: ME, mission-enabling; RE, research-enabling; L/M/H, low, medium, or high; VR, virtual reality; TMS, transcranial magnetic stimulation.
aIn this column, near term means within 5 years, medium term means between 5 and 10 years, and far term means 10-20 years.
SOURCE: Committee-generated.
SUMMARY
Table S-3 Possible Future Opportunities (Neuroscience Areas Worthy of Monitoring for Future Army Investment)
Current Investment
(L, M, or H)
Technology Opportunity
ME
x
x
RE
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Time Framea
Commercial
Academic
Far term
Far term
Far term
Medium term
Medium term
Far term
Medium term
Medium term
Far term
Far term
Medium term
Far term
Far term
Far term
H
L
M
M
L
M
L
L
L
L
M
L
L
M
H
H
M
M
M
M
H
M
M
M
M
L
M
M
NOTE: ME, mission-enabling; RE, research-enabling; L/M/H, low, medium, or high; fMRI, functional magnetic resonance imaging; MRI, magnetic resonance
imaging; and TMS, transcranial magnetic stimulation.
aIn this column, medium term means between 5 and 10 years and far term means 10-20 years.
SOURCE: Committee-generated.
the insights on individual variability and the human dimension that are emerging from neuroscience.
In particular, these indicators should be employed in identifying individual variability in learning and tailoring training
regimens to optimize individual learning.
The Army currently relies heavily on broad, general
indicators of aptitude to predict training effectiveness and
individual success rates. The importance of predicting
success rates of soldiers before assigning them to given tasks
increases with the cost of training for the task and with the
consequences of not performing the task well. In comparison
with the indicators that have been developed for assessing
how well skills or knowledge have been acquired, neurological predictors of soldier performance need much R&D before
they will be ready for Army applications.
Recommendation 2. The Army should investigate neuropsychological testing of candidates for a training course
that is already established as a requirement to enter a highvalue field. In this way the Army can determine whether
an assignment-specific neuropsychological profile can be
developed that has sufficiently high predictive value to use
in conjunction with established criteria for the assignment.
If results for this investigation are positive, the Army should
investigate development of assignment-specific profiles for
additional assignments.
Optimizing Decision Making
Human decision making is predictably inefficient and
often suboptimal, especially when the decisions require
assessments of risk and are made under pressure. Indi-
SUMMARY
collaborate with the lead laboratories involved in physiological and molecular research on sleep.
Pharmaceutical Countermeasures to
Performance Degradation
Advances in neuroscience are enabling the pharmaceutical industry to develop drugs that act on novel targets to
affect mood, motivation, memory, and executive function.
Recommendation 7. The Army should establish relationships with the pharmaceutical industry, the National Institutes of Health, and academic laboratories to keep abreast
of advances in neuropharmacology, cellular and molecular
neurobiology, and neural development and to identify new
drugs that have the potential to sustain or enhance performance in military-unique circumstances. However, caution
must be exercised to ensure that the benefits outweigh any
unforeseen or delayed side effects.
Among the neuropharmaceuticals approved by the Food
and Drug Administration for specific medical indications, a
number have potential off-label uses in sustaining or optimizing performance. However, any compound, natural or
synthetic, that acts on the CNS must be assumed, until proven
otherwise, to affect multiple neural systems. It is therefore
essential that specificity of action be demonstrated. Second,
the risks of unforeseen or delayed side effects must be considered, particularly before a neuropharmaceutical is widely
administered for sustaining or enhancing performance in
mission-critical tasks without specific medical indication to
justify its use.
Recommendation 8. Before the Army attempts to employ
neuropharmaceuticals for general sustainment or enhancement of soldier performance, the Army should undertake
medically informed evidence-based risk-benefit analyses,
including performance and clinical measures to assess
overall effects, to ensure that the expected benefits of such
medication outweigh the risks of negative side effects or
delayed effects.
Use of new pharmacological agents to restore function, mitigate pain or other responses to trauma, or facilitate
recovery from injury or trauma will be a key application for
new neuroscience technology in the near to medium term.
Highly specific brain receptor targets have been identified
for a number of agents, and the effectiveness of these agents
will be greatly enhanced by technologies that target delivery
of the pharmacological agent to a specific site. The use of
targeted drug delivery to enhance performance, such as situational awareness, is technically feasible, but such uses may
be proscribed by societal and ethical norms.
OverArching recommendationS
The committee found two crosscutting issues that go
beyond any particular request in the statement of task but
that must be addressed by the Army if the potential benefits
of neuroscience are to be fully realized.
A Mechanism for Monitoring New Opportunities
in Neuroscience Research and Technology
The committee could find no single place in the Army
science and technology structure from which progress in
neuroscience, construed broadly, is being monitored for
potential application by the Army and from which coordinating guidance can be disseminated to centers of neurosciencerelevant R&D around the country. This failure to identify and
leverage advances in neuroscience is the most significant
barrier to implementation of the 15 recommendations and
is exacerbated by the diffusion of much of the R&D taking
place in neuroscience.
Most of the opportunities listed in Table S-3, as well as
those in Tables S-1 and S-2, involve areas of neuroscience
that the Army needs to monitor for progress. Additionally,
the committee also identified four important trends in neuro
science research:
Discovering and validating biomarkers for neural
states linked to soldiers performance outcomes.
Using individual variability to optimize unit
performance.
Recognizing opportunities from the vertical integration of neuroscience levels.
SUMMARY
1
Introduction
The Army has made great strides in exploiting technological advances on the battlefield. This success is based in
large part on advances in computers and miniaturization,
which exploit reductions in scale and exponential increases
in performance, and on advances in disciplines such as
information science and network science. The field of neuro
science offers similar potential to achieve further improvements in soldier performance for future operations.
Advances and major investments by the broader community in neuroscience promise new insights for military
applications. These include traditional areas of importance
to the Army, such as learning, decision making, and performance under stress, as well as newer areas, such as cognitive
fitness, braincomputer interfaces (an extension from earlier
humancomputer ergonomics), and biological markers of
neural states. Advances in such fields as functional magnetic
resonance imaging (fMRI) and bioengineering have resulted
in instrumentation and techniques that can better assess the
neural basis of cognition and enable visualization of brain
processes. These have the potential to provide new measures
of training and learning for soldiers, while also shedding new
light on traditional approaches to behavioral science used by
the Army. Continuing research is certain to give rise to new
opportunities, and the Army would like to better understand
how these neuroscience opportunities can be exploited for
the benefit of the soldier.
Study Background
Most current neuroscience research is at a basic level
with little or no regard for longer-term military potential.
In recent years, however, it has begun to capitalize on the
investments in basic research and move toward applications.
The time is right to apply neuroscience understanding to
applications that have military relevance. What is needed is a
determination of the specific outcomes of this basic research
that are likely to lead to the development of neurotechnologies with possible military application and a discussion of
INTRODUCTION
BoX 1-1
statement of Task
The Assistant Secretary of the Army (Acquisition, Logistics, and Technology) (ASAALT) has requested the NRC BAST to conduct a study of neuroscience in terms of its potential to support military applications. The study will address what neuroscience can be expected to do as well as what
neuroscience advances could do if provided appropriate direction and investment. Given the fact that the field of neuroscience is very extensive and
there are many other investments underway in numerous areas and sub-areas, this study will focus on those areas that have high-payoff potential for
the Army where it is unlikely that others will devote substantial resources to research and exploitation in these areas for Army benefit. The study will
also suggest opportunities for leveraging specific investments where appropriate for the Army. Specifically, the study will
1. Identify and recommend novel technologies, methodologies and approaches for assessing and guiding the training of Army personnel to
enhance soldier learning. The study will consider:
Assessing how neural pathways implicated in functional processing can be enhanced to improve the training of Soldiers in an operational
context
Examining how sleep deprivation and high stress conditions influence training efficiency and effectiveness through degradation of specific
neural pathways involved in learning and memory
Describing how neural pathway approaches can be applied by the Army to more objectively assess training paradigms, including virtual
reality training as compared with constructed reality and operational conditions, regarding their efficacy in improving performance by
Soldiers in combat environments
Whether traditional behavioral science as applied to Soldier training, learning and performance can benefit from developments and new
knowledge being acquired in areas of neuroscience that have significant potential to impact the Soldier.
2. Examine leading-edge methodologies and technologies developed in the government, private and academic sectors to improve cognitive
and behavioral performance, particularly under high stress conditions. Consider representative non-military task environments requiring continuous
operation with high vigilance and risk.
3. Identify additional high-risk, high-payoff opportunities in the neuroscience field with strong potential for Army application. Identify critical
barriers (such as legal and ethical) to research and development that could be surmounted by appropriate science and technology investments assuming
that these are Army critical and unique. Suggest ways to overcome the barriers, and recommend research initiatives. Identify areas and opportunities
where the Army can leverage relevant investments of others for Army application.
4. Determine trends in research and commercial development of neuroscience technologies that are likely to be of importance to the Army in the
longer term.
study approach
The NRC appointed the Committee on Opportunities
in Neuroscience for Future Army Applications to carry
out the study. Special care was devoted to the composition
of the committee. Some members had backgrounds in the
traditional facets of neuroscience such as psychology and
cognitive science and in neurology, including neuronal
stimulation, neuropharmacology, imaging techniques, and
humancomputer interfaces (traditional ergonomics); others
had expertise in newer and emerging subdisciplines and
cross-disciplinary fields such as neuroimmunology, neuroeconomics, neuroergonomics, augmented reality, and computational neuroscience. Members were also selected on
the basis of their experience in research and development
(R&D), military operations, and medicine, and in training
specialties such as memory and learning, assessment, deci-
10
Report Organization
This report contains the committees analysis, conclusions, and recommendations. It focuses on areas of neuroscience research likely to lead to developments of interest
to the Army and provides specific objectives for the Army
to consider.
Chapter Structure
Chapter 1, the Introduction, provides the study background and report organization. Chapter 2, Neuroscience
and the Army, provides a brief history and definition of neuro
science, discusses Army applications likely to be served by
neuroscience advances, and covers issues related to such
advances. Chapter 3, Training and Learning, discusses the
assessment and testing of soldiers and units, and Chapter 4,
Optimizing Decision Making, considers the multiple roles
of leaders and tools for characterizing and predicting behaviors. Chapter 5, Sustaining Soldier Performance, discusses
degradation of performance as a consequence of exposure
to various environmental stressors (e.g., fatigue, metabolic
stressors, pain, and sleeplessness), countermeasures to these
stressors that aim to prevent such degradation or restore baseline performance, including pharmacological approaches,
and countermeasures to the longer-term neural and cognitive effects of brain injury and traumatic stress. Chapter 6,
Improving Cognitive and Behavioral Performance, describes
emerging approaches to enhancing soldier performance that
combine neuroscience insights with cognitive-behavioral
ergonomics; one such approach would come from the new
field of neuroergonomics. It also assesses the potential utility
to the Army of pharmacological and behavioral interventions
to enhance cognitive performance. Chapter 7, Neuroscience
Technology Opportunities, assesses high-risk, high-payoff
technology opportunities in terms of their potential importance to the Army, the likelihood of their development by
others (leveraging opportunities), and the time frame for
initial operational capability. Chapter 8, Long-Term Trends
in Research, describes major trends in neuroscience research
that are likely to yield future opportunities for the Army and
should therefore be monitored by a suitable and continuing
mechanism. Finally, Chapter 9, Conclusions and Recommendations, presents the committees specific conclusions and
recommendations in response to the statement of task, plus
overarching conclusions and recommendations that follow
logically from the specific recommendations.
Response to Statement of Task
The chapter structure of the report does not correlate
in a simple way with the four subtasks in the committees
statement of task (see Box 1-1). This section describes which
parts of the report address each subtask.
Subtask 1 requests that the committee identify technologies, methodologies, and approaches applicable to training
Army personnel, including (1) assessing training paradigms
and improvements to training; (2) examining the influence of
high stress and sleep deprivation; and (3) determining how
traditional behavioral science approaches benefit from new
knowledge in neuroscience. Chapter 3 responds to the first
item by discussing training paradigms and methods, performance assessments of individuals and groups, identification
of training candidates, and metrics for training effectiveness.
The chapter also addresses the third item by describing
the impact of neuroscience advances on traditional behavioral approaches to the assessment of both training and
performance. The second itemthe influence on soldier
performance of high stressors, such as fatigue, pain, and
sleep deprivationis discussed in Chapter 5.
Subtask 2, which requests an examination of methodologies and technologies to improve cognitive and behavioral performance, is addressed in Chapters 4, 6, and 7.
Specifically, Chapter 4 discusses methodologies for studying
decision making and tools to predict how an individual will
approach making a decision. It suggests ways to capitalize
on individual variability and deal with the constraints of a
decision makers belief system on the decisions he or she
makes. As discussed in Chapter 6, improvements in cognitive
and behavioral performance are also likely to arise from the
emerging field of neuroergonomics, as well as from research
by the auto industry and NASA, which are doing research that
is also of interest to the Army. The committee recognizes the
potential for neuropharmacological approaches to improving
performance, but in Chapter 6 urges caution because there
may be unknown side effects and long-term consequences
of using pharmacological agents for this purpose. Technologies that might be used to improve mission-related performance are assessed in Chapter 7. The opportunities include
field-deployable indicators of neural state and advances in
humanmachine interfaces and braincomputer interfaces
such as augmented reality, three-dimensional haptic interfaces, and information management to cope with cognitive
overload.
Subtask 3 asks the committee to identify high-risk,
high-payoff opportunities in neuroscience, critical barriers to
R&D, and areas where the Army can leverage the investments
of others. High-payoff research opportunities are identified
in the recommendations from Chapters 3 through 6; these
opportunities vary in the level of risk associated with them,
as discussed in the respective chapters. Chapter 7 describes
technology development opportunities, and Tables 7-1 and
7-2 summarize the committees evaluations of high-priority
and priority opportunities for Army investment, taking
into account risk-benefit trade-offs and the just-mentioned
potential to leverage investments by others. Legal and ethical
barriers to implementing neuroscience research results (and
technology) are discussed in Chapter 2, while technical bar-
11
INTRODUCTION
disciplines and areas of research and technology development in neuroscience that are likely to produce results of
value to the Army over the longer term.
references
NRC (National Research Council). 2008a. Emerging Cognitive Neuroscience and Related Technologies. Washington, D.C.: The National
Academies Press.
NRC. 2008b. Human Behavior in Military Contexts. Washington, D.C.: The
National Academies Press.
2
Neuroscience and the Army
Nerve
12
13
Neuroscience Technologies
Until the advent of modern computer-based technology, the primary noninvasive tools used to understand the
workings of the central and peripheral nervous system were
the recording of electrical signals from the scalp (electroencephalography [EEG]) and X-ray imaging of the soft
tissue of brain as distinguished from bone and compartments containing cerebral spinal fluid (CSF). EEG allowed
detecting epileptogenic foci that could subsequently be
managed surgically if a discrete region was involved in the
initiation of seizures or pharmacologically if the region was
more generalized. The X-ray imaging allowed detection and
localization of lesions because the lesions displaced readily
identified portions of the brain. However, these technologies
provided very limited insight into neural information processing related to cognition, the central mechanisms involved
in the perception of pain, or other higher-order brain activities. The pioneering work of Penfield and his colleagues was
an exception: It combined EEG with invasive brain surgery
to associate the visual and auditory auras that accompanied
seizures to specific regions in the visual, auditory, or temporal cortices (Penfield and Perot, 1963).
The two decades from the late 1980s to the present have
seen the rapid rise of technologies that can provide highresolution structural images of the gray and white matters of
brain as distinct from one another, clearly delineating details
as small as the foci of white-matter disease and inflammatory changes. These technologies are capable of imaging
the metabolic processes that are associated with functional
activity of the brain in response to specific stimuli (positron
emission tomography [PET] and functional magnetic resonance imaging [fMRI]); the orientation and dimensions of
axonal fiber bundles connecting one brain region to another
(diffusion tensor imaging); and the electrophysiological
localization of brain activation (magnetoencephalography
14
FIGURE 2-1 Various noninvasive imaging technologies provide insight into the brain (anatomy) and mind (function). Resolution boundaries
are approximate. Currently, high resolution requires invasive procedures or injection of pharmacological agents not approved by the Food
and Drug Administration; such technologies are outside the scope of Army applications, but some discussion is provided in Chapter 7. Note
that useful measurements are performed at any point in the brain-mind plane. SOURCE: Adapted from Genik et al., 2005.
15
BoX 2-1
computational Processes in the human Brain
The last half century has seen the emergence of multiple technologies that, when taken in total, can lead to new understanding of the humanmachine
interface and to improving our management of it as an interacting organism. The relatively concurrent development of high-speed computer data processing, anatomic mapping of the human brain, noninvasive imaging technology (capable of visualizing neural information processing at a resolution
of 1 mm3 in three dimensions), decoding of the human genome, and nanotechnology (giving us the ability to prepare molecular entities that can selfassemble in predictable arrays) has permitted researchers and theoreticians to construct models of how humanmachine interfaces can aid training,
increase combat effectiveness, and speed up the acquisition of information by the mind. A summary of some of this can be found in Kurzweil (2005,
pp. 122-128).
Anatomic studies of the brain lead to an estimate that the brain contains about 1011 neurons (information-processing units) and that many neurons
(Purkinje cells in the cerebellum or anterior motor neurons in the spinal cord) have 1,000 information input elements (synapses) and 10 output elements (synapses), yielding about 1014 possible information transactions occurring in seconds (it is assumed that in a local circuit in the cerebellum
there are rapid impulse and repolarization events). If we focus on the neural components that enable all human visual perception, the retina is the initial
image capture and processing element. It is a structure about 2 cm wide by 0.5 mm thick and weighs about 20 mg. This volume of tissue will contain
about 105 neurons. Local information processing occurs between the rod and cone cells, which are activated by the input from the visual field, and the
ganglion cells, which transmit initially processed information to the occipital cortex of the brain for further processing.
The retina provides initial processing capability such as rapid detection of edges of objects by center-surround inhibition/activation, the movement
of elements in the visual field, and the perception of dark/light properties of the objects in the field. The range of light/dark information processing that
can be detected is several orders of magnitude. During the next two decades it is likely that visual input devices will be developed that will be able to
fuse visual data with auditory cues to allow the more rapid detection of threats. These devices will be able to sustain vigilance by fusing measures of
decreases in situational awareness (obtained through electroencephalography (EEG), evoked potentials, or other cues from the soldier) with threats
detected in the area of operations.
17
the term in other disciplines. To avoid confusion, the committee has adopted the following definition, published by
the Biomarkers Definitions Working Group of the National
Institutes of Health (Atkinson et al., 2001, p. 91):
Biological marker (biomarker): A characteristic that is
objectively measured and evaluated as an indicator of normal
biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention.
18
19
Sample Objectives
Societal Issues
The decoding of the human genome and the emergence
of new imaging modalities are making possible the identification of proteomic, genomic, and imaging biomarkers associated with susceptibility to a specific disease, with environmental stressors, or with neuropsychological vulnerabilities
(e.g., pain, reduced perception, anxiety). The aggregate of
multiple biomarkers may provide a susceptibility profile that
would not be achievable through testing for any single marker
alone. These aggregate data can help in monitoring the rate
of progression of clinical disorders or response to treatment.
Creating a susceptibility profile of such signatures for a
patient can allow for personalized medicine tailored to individual need. The nature (e.g., mutation sites, triplet repeats,
proteomic signatures, and structural and functional imaging
changes) and quantity of biomarkers involved could play an
important role in screening for, diagnosing, and predicting
disease. This same capability has made it possible to select
persons with a low risk of developing disease or succumbing
to a variety of stressors (toxic materials in the environment,
for instance). There may be adverse economic consequences
(uninsurability, reduced rates of compensation) for the individual and his or her career path progression (costly training
programs may intentionally preclude high-risk persons from
20
proposed that all conceptuses that had a parent or close relative with Huntingtons disease should be tested for the gene.
Knowledge of whether one has a genetic predisposition and
hence was certain to develop the disease could have a neutral,
beneficial, or adverse effect on the patient, with outcomes
ranging from acceptance to suicide. Undesired information
on susceptibility to an untreatable disease might be a sword
of Damocles for a young soldier.
The positive aspects of knowing how ones genetic heritage impacts wellness and resilience to toxic insult can be
illustrated by the case of glutathione S-transferase genotype
(GST) and resistance of smokers to lung cancer. A significant
number of studies reveal a twofold increase in the incidence
of squamous cell carcinoma for patients having GST M1 and
GST T1 null genotypes. GST and cytochrome P450 are two
classes of enzymes that metabolize and detoxify potential envi
ronmental toxins. Patients with the null forms do not express
active GST with the properties of GST M1 or GST T1, and the
absence of these enzyme variants might predispose them to
the toxic effects of various chemicals, including some chemical warfare agents or toxic industrial materials. Restricting
the assignment of certain soldiers to areas of high risk might
protect them from exposure to such toxic materials; however,
it might also keep her/him from serving or being advanced
(promoted) in an area of specific interest, or it might prevent
him/her from participating in important missions before any
clinical manifestation of illness.
Federal laws and regulations contained in the Health
Insurance Portability and Accountability Act (HIPAA)
protect patients and the community at large against the
unwarranted and unnecessary disclosure of medical information that is directly or indirectly traceable to a particular
individual to unauthorized parties. The primary concerns
are that such disclosure might (1) affect the promotion of
military or civilian persons in their field of specialization,
(2) affect insurance rates and insurability of a given individual, or (3) affect the psychological/social well-being
of individuals with catastrophic diseases that are currently
largely untreatable (e.g. Huntingtons disease, Alzheimers
disease). These are but a few of the unintended consequences
of inappropriate disclosure.
For additional information on ethical issues relevant to
neuroscience research discussion in this report, the committee recommends the following sources: Karanasiou et al.,
2008; Fins and Shapiro, 2007; Illes, 2007a and 2007b.
Cultural Impediments
The emergence of new bio- and neurotechnologies permits categorizing the human population into subsets having
either increased or decreased susceptibility to disease and
stress on the basis of their genotype and their phenotype.
Phenotype is the result of genes plus environment, and epigenetic changes
that occur in the individual after conception may play an important role.
There is tension between the idea of selecting out individuals for tasks based on presumed genetic susceptibilities
and the belief that extensive training can overcome inherited
limitations and liabilities. The science-fiction film Gattaca
( Columbia Pictures Corporation, 1997) confronts this
dilemma with a dark view of the preselection concept. The
film was made during the early stages of the Human Genome
Project and the first cloning of large animals.
The U.S. military community traditionally aspires to
select individuals for particular tasks or promote them based
on excellence during training and performance in the field.
Selecting in for extended service in closed platforms such
as submarines is rigorous: The training periods are long
and there are particular social/psychological requirements.
Despite this, very little research has been done on selecting
in individuals who have a particular aptitude as assessed
by genetic and phenotype testing for a particular military
position or job. The decoding of the human genome and the
advent of real-time imaging of neural information flow and
noninvasive tracing of major fiber pathways provide an oppor
tunity to learn how we can use these novel methodologies
to enhance training and personalize it to meet the needs of
the soldier, to identify characteristics that are particularly
well suited to complex and extreme environments, and to
detect the early appearance of uncompensated responses to
stress and emerging TBI and post-traumatic stress disorder
(PTSD).
The issues confronting the Army include training to
criterion (90 percent or better appropriate response to challenge), increasing data flow from deployed aerial and ground
sensors, human intelligence, electronic communications,
and tempo of engagement with increasing capability of
lethality. The need to reduce casualties during force-on-force
engagement drives the development of means for conducting
combat at large standoff distances and acquiring extensive
awareness of the adversarys deployment and capability.
At the same time, there is a perceived need to minimize
noncombatant casualties, which militates against extensive
standoffs. These challenges call for a strategy that allows
human cognitive capabilities to operate for 18-20 hours per
day, 7 days a week for 12 to 15 months at a high tempo of
operations. The most affected group will be the command
organization, which is permitted little or no respite from
high-tempo decision making and little organized sleep.
The Use and Abuse of Socially Sensitive
Demographic Categories as Indicators of
Neural State and Performance Capability
As the preceding discussions on societal issues suggest, the committee supports and encourages scientifically validated neuroscience applications across the Armyrelevant areas highlighted in Table 2-1 and addressed in
detail throughout the report. Ethical considerations, such as
those related to genetic screening or improper disclosure of
21
References
Aston-Jones, G., and J.D. Cohen. 2005a. Adaptive gain and the role of the
locus coeruleus-norepinephrine system in optimal performance. Journal
of Comparative Neurology 493(1): 99-110.
Aston-Jones, G., and J.D. Cohen. 2005b. An integrative theory of locus
coeruleus-norepinephrine function: Adaptive gain and optimal performance. Annual Review of Neuroscience 28: 403-450.
Atkinson, A.J., Jr., W.A. Colburn, V.G. DeGruttola, D.L. DeMets, G.J.
Downing, D.F. Hoth, J.A. Oates, C.C. Peck, R.T. Schooley, B.A. Spilker,
J. Woodcock, and S.L. Zeger. 2001. Biomarkers and surrogate endpoints:
Preferred definitions and conceptual framework. Clinical Pharmacology
& Therapeutics 69(3): 89-95.
Bakker, A., C.B. Kirwan, M. Miller, and C.E.L. Stark. 2008. Pattern
separation in the human hippocampal CA3 and dentate gyrus. Science
319(5870): 1640-1642.
Belenky, G., N.J. Wesensten, D.R. Thorne, M.L. Thomas, H.C. Sing, D.P.
Redmond, M.B. Russo, and T.J. Balkin. 2003. Patterns of performance
degradation and restoration during sleep restriction and subsequent
recovery: A sleep dose-response study. Journal
of Sleep Research
12(1): 1-12.
Breslau, N., and J.C. Anthony. 2007. Gender differences in the sensitivity to
posttraumatic stress disorder: An epidemiological study of urban young
adults. Journal of Abnormal Psychology 116(3): 607-611.
22
3
Training and Learning
23
24
25
is a condition of three syndromes common in high-performing female athletes of all ages, though especially in their teen years, and includes
disordered eating, amenorrhea, and osteoporosis. An athlete can experience
one, two, or all three syndromes in the triad.
26
27
the body and mind, which in response initiate complex cognitive and affective coping strategies. Research on expedition
members, soldiers, elite athletes, and competitors in extreme
athletic events provides substantial evidence that exposure to
extreme situations profoundly affects performance. Different
environmental stressors can place different demands on indi
viduals or groups exposed to them. For example, exposure
to extreme cold during an Antarctic expedition may result in
social deprivation, whereas exposure to combat may result
in affective overload. However, beyond these differences in
response that correspond to differences in the environmental
stressors, individual cognitive and affective responses to the
same stressor vary just as widely.
Neuroscience offers some distinct advantages over
behavioral assessment or self-reporting for assessing and
even predicting how an individuals baseline performance
is affected prior to, during, and following exposure to a particular environmental stressor. One key limitation of standard
self-reports and observer reports is their limited ability to
predict future behaviors. Moreover, a number of studies have
shown that individuals do not always report their current
psychological, mental, or emotional status accurately (Zak,
2004). Although there is still no single neural measurement
tool that can unequivocally replace self-reporting, the current tools can depict an individuals status more fully, as a
complement to, rather than a replacement for, self-reporting
and behavioral assessments. Moreover, recent insights enable
researchers to parse cognitive and emotional processes into
more basic modules such as attention, working memory,
cognitive control, and others. These modules can be assessed
efficiently and quantitatively by linking behavioral paradigms to measurements made with electroencephalography,
fMRI, or other imaging modalities.
Finally, behavioral tasks that have been developed
recently for use with these imaging modalities are parametric
in the sense that the imaging results can be used to quantify
the degree to which performance is altered. Quantifying
the degree of underperformance (the performance deficit
relative to the individuals baseline) is crucial to designing
and administering countermeasures. (Chapter 5 discusses in
more detail some countermeasures to stressors that degrade
soldiers cognitive performance.)
A major challenge for neuroimaging used in this way
is to determine its sensitivity and specificity for monitoring performance in extreme environments. Thus far, most
As discussed in Chapter 2, sensitivity and specificity have rigorous
definitions that apply here. Thus, sensitivity measures the proportion of
the actual positive cases that a test identifies as positive. Mathematically, it
is the ratio of true positive test results to the sum of the true positive tests
and the false negative tests (false negatives should have been positive).
Specificity measures the proportion of actual negative cases that the test
identifies as negative. It is the ratio of true negative test results to the sum
of the true negative tests and the false positive tests (false positives should
have been negative). The aim of having a test with both high sensitivity and
high specificity is to identify all the positive cases efficiently while also
distinguishing positive from negative cases.
28
imaging studies have revealed intriguing results on a groupaveraged level. But a key goal of a neuroscience-based
approach to quantifying behavior and performance is greatly
improved ability to predict the future behavior of individuals
(individual-specific prediction). It is not enough to predict
the distribution in performance of a group (or parameters
of that distribution such as the average performance or a
normal range). The goal is to predict which individuals will
perform well and which will not, and even why individuals
perform as they do. Recent results from neuroimaging
studies indicate that such predictions are possible. Most
imaging studies have demonstrated large effect sizes, which
supports the idea that differences among individuals and at
different times for the same individual may be large enough
to be meaningfully measured.
The next step is to determine if neuroimaging or other
neuroscience approaches that combine sensitivity and high
specificity can be used to generate quantitative predictions of
individual behavior in response to environmental stressors.
To be more useful as a predictor of performance than current approaches, neural monitoring methods such as neuroimaging need to track performance states closely, including
considering whether or not the individual is self-reporting a
change in performance and whether or not the self-reporting
is as accurate as objective measures of performance. To be
useful for identifying (and eventually predicting) performance deficits that are due to extreme environments, the
neural monitoring methods must do more than distinguish
poor-performing individuals from normal performers. They
must also consistently distinguish altered activity from normal activity in specific brain structures of those individuals
who subjectively report performing at normal levels but
whose performance has deteriorated by objective measures.
The last-mentioned capability will enable the identifica-
BoX 3-1
Predicting Future Behavior in extreme environments
Imaging techniques could be used to detect individuals who are at high risk for experiencing deterioration of performance on future Army missions.
Paulus et al. (2005) used fMRI to scan the brains of 40 methamphetamine-addicted men who had been sober for 3 to 4 weeks. This imaging technique
can map brain regions involved in specific mental activities. Scans were performed while the men were involved in a decision-making task to identify
brain regions stimulated by the task. Approximately 1 year later, the researchers correlated the fMRI results with subsequent drug abuse in the 18 men
who relapsed and the 22 who remained abstinent (drug-free).
In the scans made at the beginning of the study, the scientists observed low activation patterns in the brains of some of the men in structures that
are known to participate in making decisions. These regions were the right middle frontal gyrus, the right middle temporal gyrus, and the posterior
cingulate cortex. Lower activity in these structures correlated with early relapse to methamphetamine use. The scans also showed that reduced activation in the insula and the dorsolateral prefrontal, parietal, and temporal cortices correlated with drug relapse in 94 percent of cases. By comparison,
significant activation in these same regions correlated with nonrelapse in the 86 percent of the men who remained abstinent after 1 year. Thus, the initial
brain scans provided an indicator of which individuals were at greatest risk of relapsing and which were at least risk. Furthermore, these differences
in activation pattern show both specificity and sensitivity as a predictive indicator for risk of relapse.
29
difficult jobs because trainees are free to repeat the training sequence until they are able to meet minimum performance requirements. Less than 5 percent of helicopter pilot
trainees, for example, wash out of training. This approach
obviously increases training costs. It may also reduce unit
performance; a soldier who requires three times longer than
average to achieve minimal standards of proficiency during
flight training may or may not be a good helicopter pilot. At
the moment, however, the Army has no validated means of
measuring how this approach affects unit performance.
Current Enlisted Soldier Selection
The ASVAB, which is administered to roughly 500,000
applicants each year, is a computer-administered multiplechoice test with two components: the Armed Forces Qualification Test (AFQT) and five subject area tests. The goals of
the AFQT are to predict the likelihood of service completion
by the applicant and to predict overall performance. The
AFQT has four parts: word knowledge, paragraph comprehension, arithmetic reasoning, and mathematics knowledge.
AFQT scores are percentile rankings that have been normed
to the ASVAB applicant pool and are correlated with the
likelihood that the applicant will complete a 2-year tour of
duty. The higher the score, the more likely the applicant is
to complete that tour. Interestingly, the AFQT prediction of
tour completion is most accurate for applicants who hold a
traditional high school diploma. The AFQT score is a poor
predictor of tour completion for applicants who did not
graduate from high school or who have a graduate equivalency diploma.
To address the limitations of the AFQT, the Army
Research Institute (ARI) has developed an alternative test
for candidates who did not complete high school. This
noncognitive test, called the Assessment of Individual
Motivation (AIM), was designed to assess conscientiousness,
stress tolerance, and openness to new experiences. The AIM
in combination with a measure of body mass index is called
the Tier Two Attrition Screen and is now in limited use as a
complement to the ASVAB.
The second part of the ASVAB consists of five tests of
the applicants factual knowledge in general science, automobile and shop information, mechanical comprehension,
electronics information, and assembling objects. The scores
on these tests by soldiers who have successfully completed
a tour of duty in a particular area of specialization are used
as a benchmark or score profile that is associated with successful tour completion in that area of specialization. The
score profiles are used by recruiters and recruits as guides
to a recruits likely job performance when the recruiter and
recruit together select an area of specialization. Essentially,
the score profiles from the five subject tests are derived by
simple linear regression. Their actual predictive power is
low compared with that of best practices in the vocational
assessment and training community.
30
31
2
BoX 3-2
Theory of mind
ToM, a construct that was introduced by Premack and Woodruff (1978) to characterize the mental ability of higher apes, refers to the ability of
individuals to attribute independent mental states to self and others in order to explain and predict behavior (Fletcher et al., 1995). This approach
has been particularly important to characterize cognitive development in children (Frith and Frith, 2003) and dysfunction of cognitive development in
autism and autism spectrum disorders (Happ et al., 1996) as well as in psychosis (Doody et al., 1998). More recently, several conceptual connections
have been made between ToM and other important psychological constructs. For example, it appears that the neural representation of self (Happ,
2003) and, more generally, self-generated beliefs (Leslie et al., 2005) are closely related to the ability of ToM. This proposition is supported by some
imaging studies that suggest the importance of the medial prefrontal cortex as part of both self-relevant as well as ToM-related processing (Wicker
et al., 2003). Therefore, ToM is an important construct that can be used to examine ones ability to infer mental states, related to self, and beliefs but
more important is accessible to experimental modulation using neuroscience approaches.
33
Summary
Neuroscience techniques (neuroimaging, physiological
measures, biochemical assays of brain function) can be
used to measure the training status of individual soldiers.
Specifically, these techniques can be used to determine
(1) functional status, (2) recovery time, or (3) level of
training. The sensitivity, specificity, and accuracy of these
approaches are unknown and require further research. Thus,
a primary short-term goal for the Army should be to conduct
this research, which will allow for assessing the training
status of soldiers. These efforts should last a relatively short
time (<5 years).
There is emerging proof of principle that neuroscience
techniques could be useful not just for short-term predictions
about outcomes and behaviors but also for predicting the
performance, behavior, and potential of individuals over the
long term. It is not clear which targets would be most valuable for the Armyfor example, the best target population
and what outcomes the Army should be most interested in.
Close collaboration between neuroscience laboratories and
Army leadership would help to develop a common agenda
that would benefit both communities. First, the Army would
improve its ability to predict performance and, second, the
laboratories would obtain further proof of principle of the
practicality of their methods. A collaborative effort could be
viewed as a long-term initiative with high potential payoff
over the next 10 years.
References
Baird, A.A., M.K. Colvin, J.D. Van Horn, S. Inati, and M.S. Gazzaniga.
2005. Functional connectivity: Integrating behavioral, diffusion tensor
imaging, and functional magnetic resonance imaging data sets. Journal
of Cognitive Neuroscience 17(4): 687-693.
Balleine, B.W., N.D. Daw, and J.P. ODoherty. 2009. Multiple forms of value
learning and the function of dopamine. Pp. 367-387 in Neuroeconomics:
Decision Making and the Brain. P.W. Glimcher, C.F. Camerer, E. Fehr,
and R.A. Poldrack, eds. New York, N.Y.: Academic Press.
Ben-Shachar, M., R.F. Dougherty, and B.A. Wandell. 2007. White
matter pathways in reading. Current Opinion in Neurobiology 17(2):
258-270.
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2001. Conflict monitoring and cognitive control. Psychological Review
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34
The dynamics of
memory as a consequence of optimal adaptation to a changing body.
Nature Neuroscience 10(6): 779-786.
Kosfeld, M., M. Heinrichs, P.J. Zak, U. Fischbacher, and E. Fehr. 2005.
Oxytocin increases trust in humans. Nature 435(7042): 673-676.
Kosik, K.S. 2003. Beyond phrenology, at last. Nature Reviews Neuroscience
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Leslie, A.M., T.P. German, and P. Polizzi. 2005. Belief-desire reasoning as
a process of selection. Cognitive
35
Yin, H.H., and B.J. Knowlton. 2006. The role of basal ganglia in habit
formation. Nature Reviews: Neuroscience 7(6): 464-476.
Young, L., F. Cushman, M. Hauser, and R. Saxe. 2007. The neural basis of
the interaction between theory of mind and moral judgment. Proceedings
of the National Academy of Sciences of the United States of America
104(20): 8235-8240.
Zak, P.J. 2004. Neuroeconomics. Philosophical Transactions of the Royal
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4
Optimizing Decision Making
37
plan 1, two commanders are likely to lose 100 (2 50) vehicles; for
plan 2, fifty commanders are likely to lose 200 (50 4) vehicles.
For
38
d ecision makers than risk-averse individuals. From an institutional point of viewthat is, what is best for accomplishing the Armys missiona certain decision-making style
may be better or less well suited to a given task.
Economic, psychological, and neurophysiological
studies conducted over the past several decades have shown
that individuals differ in their decision making in predictable ways (see, for example, Wu and Gonzales, 1998) and
that these predictable differences can remain stable for long
periods of time (see, for example, Weber et al., 2002). In an
economic context, the attitudes of an individual to risk are
idiosyncratic, but they appear to be relatively stable personality features. Personality features such as conscientiousness
have been shown to be both measurable and stable across an
individuals life span (see, for example, Costa and McCrea,
1985). At a neurophysiological level, the distributions of
neurochemicals, receptors, and brain activations differ
among individuals, and there is growing evidence that these
differences are related to stable features of personality (see,
for example, Kable and Glimcher, 2007).
A common theme that emerges from all this work is
not that one type of decision maker is inherently better than
another in all circumstances but rather that, given the natural
range of differences in a population, one set of decisionmaking characteristics may be better suited to a particular
task than another. Consider a commanding officer who must
select a lieutenant for command in an area filled with civilians. An individual who is more risk-averse may be better
suited for this task than one who is more risk-tolerant. But
an action conducted with a large force in a highly uncertain
environment may call for a more risk-tolerant individual.
Experienced commanding officers certainly know this, and
they select officers for missions according to their individual
strengths.
Informal assessment occurs routinely throughout the
Army, as it does in every organization. The issue is whether
adopting more formal techniques based on the results of
research in neuroeconomics, neuropsychology, and other
neuroscience disciplines can give the Army an advantage in
decision making. The Army does not now assess officers for
traits such as risk tolerance; nor does it train commanding
officers to make the best use of the differential decisionmaking traits among their subordinates. Battalion-level
commanders are not given objective information about the
decision-making traits of newly assigned subordinates, nor
have those subordinates been trained explicitly in how to
adjust their decision making to different tasks. More generally, the Army has not sought to characterize the decisionmaking characteristics of its individual soldiers and officers
through any set of validated metrics even though such
information could be useful for (1) determining which tasks
an individual appears particularly well suited to perform or
(2) identifying training strategies that might better prepare an
individual for the decision-making responsibilities of his/her
39
The
acronym NEO derives from the first three of the five axes, or major
traits, of personality measured by this tool: neuroticism, extraversion, openness, agreeableness, and conscientiousness. Each axis is further divided
into six subtraits.
Lawrence Katz, research psychologist, Army Research Institute, briefing
to the committee on April 28, 2008.
Neuroscience-Related Theories of
Decision Making
No single theory of decision making is accepted
throughout the multiple disciplines, subdisciplines, and
research paradigms that constitute neuroscience as defined
for this report. Even within a single discipline, researchers
are working on approaches that partly overlap (agree) and
partly compete or conflict with one another. The committee has selected two such approaches from among the
many that could be discussed to illustrate how the general
theories of decision making are relevant to the Army and
which aspects of the ongoing research are worth monitoring to gain insights and practical approaches to improving
decision making in military-relevant contexts. The first
approach is belief-based decision making and the neuro
physiological activation patterns that have been linked
with its more theoretical constructs. The second approach
is intuitive, or naturalistic, decision making, which thus
far has been primarily descriptive (taxonomic) of actual
40
41
possibly with emphasis on the correct or incorrect, acceptable or unacceptable, valence of the belief.
The strength with which one holds to a belief is an
important regulator of human behavior and emotion. A recent
neuroimaging study shows that states of belief, disbelief,
and uncertainty differentially activated distinct regions of
the prefrontal and parietal cortices, as well as the basal
ganglia. The investigators proposed that the final acceptance
of a statement as true or its rejection as false relies on more
primitive, hedonic processing in the medial PFC and the
anterior insula (Harris et al., 2007). Comparing belief-based
and belief-neutral reasoning, some researchers have reported
activation of the left temporal lobe and the parietal lobe,
respectively, and modulations by the lateral PFC in cases
of overcoming belief bias and by the ventral medial PFC in
cases of succumbing to belief bias (Goel and Dolan, 2003).
Examining belief-based decision making in a navigation
task under uncertain conditions showed distinct regions of
PFC activation, which was consistent with an underlying
Bayesian model of decision making that permits efficient,
goal-oriented navigation (Yoshida and Ishii, 2006). Thus,
the dorsolateral and ventromedial PFC may have important
regulatory functions in moderating belief intensity and the
degree to which beliefs influence decision making. Additional brain regions may modulate belief-based processing
by contributing resources to (1) override beliefs, (2) enforce
beliefs, (3) engage in reward-related processing associated
with beliefs (that is, how good it feels to be right or how ones
own belief-based decision affects others).
This brief review of brain areas that are important for
belief-based decision making shows that beliefs are most
likely decomposed in the brain into various component
processesfor example, self-relevance, valence, simulation, social relatedness, and other yet-to-be-examined components. These components are subsequently processed by
various regions of the brain to arrive at preferences that
allow selecting an option and engaging in decision making.
Understanding these component processes may help to better
monitor and potentially modulate belief-based decision
making, particularly considering the significant distortions
and suboptimal decisions that beliefs can generate.
Potential Neural Targets for Modifying
Belief-Based Decision Making
In Army operations, decision making frequently occurs
in extreme environments, which place a high demand on
an individuals physiological, affective, cognitive, or social
processing resources. In other words, extreme environments
strongly perturb the body and mind, which in turn initiate
complex cognitive and affective response strategies. Beliefbased decision making is often a way for the individual
to save resources and to select an action that seems to be
the best under the circumstances. However, as pointed out
above, belief-based decision making frequently results in sub
42
43
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Phelps, E.A. 2002. Issues in the cognitive neuroscience of emotion. P. 539 in
Cognitive Neuroscience: The Biology of Mind, 2nd ed. M.S. Gazzaniga,
R.B. Ivry, and G.R. Mangun, eds. New York, N.Y.: Norton.
Plous, S. 1993. The Psychology of Judgment and Decision Making. New
York, N.Y.: McGraw-Hill.
Samson, D., I.A. Apperly, C. Chiavarino, and G.W. Humphreys. 2004. Left
temporoparietal junction is necessary for representing someone elses
belief. Nature Neuroscience 7(5): 499-500.
Scales, R.H. 2006. Clausewitz and World War IV. Available online at http://
www.afji.com/2006/07/1866019/. Last accessed July 23, 2008.
Shattuck, L.G., J.L. Merlo, and J. Graham. 2001. Cognitive integration:
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Slovic, P., and S. Lichtenstein. 1968. The relative importance of probabilities
and payoffs in risk taking. Journal of Experimental Psychology Monographs 78(3 Pt. 2): 1-18.
5
Sustaining Soldier Performance
Fatigue is typically described as a failure of performance with time on task; however, its causes are multiple
and complex, including muscle overuse, loss of motivation,
circadian disruption, poor nutrition, or depression. Both cen-
Measures to Counter
Performance Degradation
Knowledge of how the body and brain function can serve
to counter degradations in performance resulting from physiological and neurophysiolocical stressors. The operational
performance of soldiers will benefit from research to develop
effective nutritional as well as pharmacological and therapeutic countermeasures to performance degradation from
fatigue, sleep deprivation, and other metabolic stressors.
Fatigue
45
46
just now beginning to be unraveled. Good evidence is emerging that demonstrates how important a role the CNS plays in
the processes of fatigue.
Unfortunately, advances in understanding fatigue and its
consequences for performance have been held back because
physiologists almost exclusively study peripheral factors
in fatigue (e.g., those that involve muscle, heart, or blood)
in isolation from CNS involvement, whereas psychologists
study mental factors (e.g., cognition, mood, vigilance, sleepiness) in isolation from peripheral interactions. Although
mind and body are inextricably linked in the onset and
consequences of fatigue, there has been very little focus on
the neurophysiological basis of the complex interactions
between the brain and peripheral factors.
Nowhere is an understanding of the biological mechanisms by which the CNS and peripheral factors in fatigue
interact more important than in sustaining todays soldiers.
The increased speed, complexity, and lethality of modern
warfare make it even more important than in the past to
understand how to sustain or enhance physical and cognitive performance. It is also important to maintain mood and
motivation as the foundation of both physical and mental
performance. Without such an understanding, it will be difficult to move past outdated strategies such as nutrition and
exercise training to offset muscle-specific fatigue or caffeine
to maintain wakefulness. This section presents a working
model of the factors associated with fatigue during sustained
periods of physical and mental exertion. It then briefly
reviews emerging evidence of the neurobiological basis of
fatigue. This new understanding, along with the likelihood
that nutrition can play an important role in mitigating CNS
fatigue, can provide the foundation for what should become
an area of emphasis in neuroscience research and applications relevant to soldier performance.
A working model of the factors involved in fatigue is
shown in Figure 5-1. Fatigue results from mental and physical factors that ultimately increase the conscious perception
of fatigue and the impairment of mental and physical performance. Physical performance requires not only the capacity
of muscle to maintain its force production but also adequate
motivation or effort, mental alertness, clarity of thought,
decision-making ability, and mood (Davis and Bailey, 1997;
Davis, 2000). Neural processes, including higher-level cognitive processing, are important components of the fatigue
state, whose symptoms at onset include decreased energy,
motivation, arousal, and vigor, as well as increased tiredness,
perception of effort, and force sensation. These feelings of
fatigue almost always occur before the muscle actually loses
the ability to maintain the required force or power output
(Hampson et al., 2001). Although highly trained individuals
(e.g., superathletes) can persevere for longer in a fatigued
state through motivation and willpower, more generally
an individuals perception that he or she can persevere and
perform as well in a fatigued state as when well rested is not
borne out by objective measures of cognitive performance.
47
COMPONENTS OF FATIGUE
Peripheral factors
Mental fatigue
Decreased
mental function
Direct inhibition of
corticospinal output
Impaired motor control
Metabolic and
mechanical
impairments
in muscle
Decreased
physical function
FIGURE 5-1 Schematic diagram illustrating the likely interactions between central and peripheral components of fatigue. SOURCE:
Figure 5-1
Committee-generated.
As fatigue approaches, concentration and decisionmaking abilities often become impaired. There is also good
evidence of direct impairments in central drive to the muscles
and of impairments of motor coordination (Gandevia, 2001;
Smith et al., 2007; Reis et al., 2008). All these factors are
particularly important for todays soldiers, who must have
good decision making, vigilance, mood, and motivation
for mission success. Maintaining these factors for extended
periods of time in harsh environments and at high levels of
physiological and psychological stress is essential for soldiers to perform optimally despite these stressors.
New evidence from fMRI and transcranial magnetic
imaging have begun to provide a better understanding of the
neural correlates of fatigue (Gandevia, 2001; Cook et al.,
2007; van Duinen et al., 2007; Reis et al., 2008). However,
these studies have not been applied to whole-body exercise
during sustained periods of physiological and psychological
stress.
Neurophysiological Basis of CNS Fatigue
Very little neuroscience research has focused on the
possible biological basis of CNS fatigue. However, recent
evidence suggests testable hypotheses about the factors
underlying CNS fatigue. These factors include (1) an
inadequate supply of energy (glucose), (2) an imbalance
among several neurotransmitters/neuromodulators, and
48
Altering brain glucose availability can affect both physical and mental performance. For example, Koslowski et al.
(1981) showed that glucose infusion into the carotid artery
delayed fatigue in dogs during treadmill exercise. McNay et
al. (2000) found that performance of demanding cognitive
tasks reduced tissue glucose availability in a specific region
of the brain (hippocampus) that is very active during mental
functions, even though blood glucose was well maintained.
They also showed that intravenous infusion of glucose
blocked the decrease in glucose in the hippocampus and
improved performance of the cognitive task. Evidence from
human studies also shows important benefits of carbohydrate
supplementation for mental function, including perceived
exertion, vigilance, and mood (Lieberman et al., 2002; Nybo,
2003). Recent elegant studies in humans provide direct evidence for the important role cerebral carbohydrate availability and energy turnover play in physical performance during
prolonged exercise (Nybo et al., 2003a, 2003b).
Adenosine, Ammonia, and Dopamine Increased metabolic stress and decreased glucose availability can lead
to an increase in brain levels of adenosine and ammonia.
A denosine is a product of the breakdown of ATP, the
bodys most important energy molecule. Increased levels
of adenosine in the brain have been linked to tiredness and
sleep (Huston et al., 1996; Porkka-Heiskanen et al., 1997;
Porkka-Heiskanen, 1999).
Plasma ammonia concentration can become markedly
elevated during prolonged strenuous exercise. Ammonia can
easily penetrate the blood-brain barrier and is toxic to the
brain. It has been proposed that increased levels of circulating ammonia may play a role in CNS fatigue (Banister and
Cameron, 1990; Davis and Bailey, 1997). Direct evidence of
exercise-induced increases in brain ammonia and impaired
brain function was shown in rats by Guezennec et al. (1998)
and, more recently, in humans by Nybo et al. (2005). The
latter study found a good association between arterial
ammonia concentration, brain uptake of ammonia, cerebral
spinal fluid (CSF) ammonia concentration, and perceived
exertion during prolonged exercise in human subjects.
A high concentration of brain dopamine is associated
with energetic mood, arousal, motivated behaviors, and
movement initiation. Control of dopamine is responsible for
the effects of many stimulants such as caffeine and ephedrine
(Davis, 2000). Dopamine levels in the brain initially increase
during endurance exercise and then decrease at the point of
fatigue (Bailey et al., 1993). Through various modulatory
interactions, increases in serotonin and adenosine play roles
in decreasing dopamine levels (Fredholm et al., 1999; Davis,
2000).
Brain Inflammation, Interleukin-1, and Fatigue
Cytokines are an important link between the immune system
inflammatory responses and CNS fatigue. During times
of inflammation, this cross-talk enables the development
49
50
51
et al., 2006; Min et al., 2007; Sharma et al., 2007) and other
inflammatory mediators such as COX-2 and NF-B from
many types of cells, including astrocytes, following treatment with various inflammatory agents (OLeary et al., 2004;
Martinez-Florez et al., 2005). Quercetin is generally known
to have a much wider safety margin when administered for
extended periods (Harwood et al., 2007; Lakhanpal and Rai,
2007) than do anti-inflammatory pharmaceuticals, which are
sometimes used for off-label medical indications. In short,
based on the literature cited above, quercetin may mitigate
CNS fatigue during sustained operations and incidentally
provide some protection from other stressors such as injury,
infection, and toxic exposures.
Understanding the role of inflammation in fatigue
is important when examining the possible benefits of
another nutritional countermeasure, curcumin. Curcumin
(diferuloylmethane) is an anti-inflammatory component
of turmeric, an east Asian plant root familiar as a spice in
curries but also a traditional herbal medicine used to treat
inflammations of arthritis, heartburn and stomach ulcer, and
gallstones (NCCAM, 2008). In recent research, curcumin
hastened recovery to baseline performance after exerciseinduced muscle damage partly because it attenuated the
inflammatory response in muscle and presumably also in
the brain (Davis et al., 2007b). However, the specific role of
curcumin in brain inflammation, interleukin-1, and fatigue
requires further study.
Herbal Products Herbals are a relatively new area of
research, and the mechanisms of their actions remain unclear.
Ginseng is by far the most studied of the herbal products.
Reay et al. (2005) showed that a single 200-mg dose of
Panax ginseng was associated with improved cognitive
performance and lower subjective feelings of mental fatigue
on a visual analog scale. In a follow-up study, Reay et al.
(2006) tested the possible interaction between P. ginseng
and a carbohydrate drink. Both the carbohydrate drink and
P. ginseng showed improvements on some of the cognitive
tests and lowered subjective feelings of mental fatigue, but
there was no additive effect by P. ginseng and glucose on
any of the cognitive outcomes measured. It should be noted,
however, that ingestion of P. ginseng often reduces blood
glucose levels, which could be detrimental to cognitive
performance.
Because studies of the potential beneficial effects of
ginseng on physical exercise performance often involve
long-term vs. sporadic/occasional ginseng supplementation,
their results are equivocal. Without a reasonable mechanism
of action, the evidence that ginseng ingestion can improve
exercise performance is not convincing.
Guarana (whose active component is caffeine) in commercial supplements is often found in combination with P.
ginseng. Few studies have assessed the effects of guarana
on cognitive and behavioral measures in humans. Haskell
et al. (2005) evaluated guarana extract given in doses of
37.5 mg, 75 mg, 150 mg, and 300 mg. Increased secondary memory performance and increased mood (alertness
and content) were seen, with the two lower doses showing
more beneficial cognitive outcomes than the higher doses.
Kennedy et al. (2004) gave subjects single doses of 75 mg
guarana extract, 200 mg P. ginseng, or a guarana/ginseng
mixture (75 mg/200 mg). Guarana supplementation led to
improvements in attention tasks, a sentence verification
task, and a serial subtraction task. The combination of
guarana and ginseng also led to improvements on a speedof-memory task.
A few studies examined the effects of ginkgo biloba on
cognitive effects in healthy young volunteers. Acute administration of ginkgo (120 mg) improved sustained attention
and pattern recognition memory but had no effects on mood,
planning, mental flexibility, or working memory (Elsabagh
et al., 2005). However, 6-week chronic administration of
ginkgo biloba (120 mg) had no effect on any of the cognitive
or mood variables measured (Elsabagh et al., 2005; Burns et
al., 2006). Some studies have shown slight positive cognitive
effects of higher doses (360 mg) of ginkgo (Kennedy et al.,
2002) and combination ginkgo/ginseng mixtures (Kennedy
et al., 2001, 2002).
Choline Supplements Choline serves as the dietary
precursor to the neurotransmitter acetylcholine. One study
reported that plasma choline levels dropped in marathon participants, and the authors suggested that choline
supplementation before or during exercise might improve
endurance performance (Conlay et al., 1992). However,
there is insufficient evidence to support claims that choline
supplementation improves physical or mental performance
outcomes. Warber et al. (2000) studied the effects of choline
citrate ingestion during a treadmill run to exhaustion, with
subjects carrying a load of 34.1 kg. They found that choline
supplementation had no effect on time to exhaustion, squat
tests, or ratings of perceived exertion. In a similar treadmill
test while carrying a load, Deuster et al. (2002) found that
choline supplementation (50 mg per kilogram body weight)
had no effects on physical or cognitive performance, including tests of reaction time, logical reasoning, vigilance, spatial
memory, and working memory.
Summary of CNS Fatigue Countermeasures
Performance during prolonged periods of physiological
and mental stress depends not only on the ability to maintain
the physical effort required but also the ability to maintain
good mental functioningfor instance, to maintain alertness, clarity of thought, decision-making ability, and mood.
52
53
54
Pharmaceutical Countermeasures to
Neurophysiological Stressors
Over the past two decades, neuroscience has made
remarkable advances in understanding the neural circuitry of
memory, drive, mood, and executive function. Furthermore,
the neurochemical features that mediate neurotransmission
for components of these circuits have largely been characterized. This knowledge has provided the pharmaceutical
industry with targets for developing drugs that perturb specific
neurotransmitters, with the potential for treating disorders in
which these neural systems have been implicated, such as
schizophrenia, Alzheimers disease, severe mood disorders,
and critical behaviors affected by specific neuropsychiatric
disorders. Prospective neuropharmacological agents that act
on wholly novel targets include a nicotinic acetylcholine
receptor modulator to improve attention and executive function in attention deficit disorder, N-methyl-d-aspartic acid
(NMDA), a receptor-positive modulator to enhance memory
consolidation, and a metabotropic glutamate receptor agonist
to treat psychosis (Patil et al., 2007).
Over the next 5 to 10 years, it is highly likely that many
new classes of drugs will be developed that mitigate symptoms and deviant behaviors associated with neuropsychiatric
disorders. Beyond their approved therapeutic indications,
these new medications have the potential for sustaining or
optimizing the performance of soldiers. In addition, some of
them are likely to alleviate the adverse neuropsychological
consequences of combat and other extreme stressors, including major depression and stress-related disorders such as
post-traumatic stress disorder (PTSD).
As the Army debates using pharmaceuticals that have
been approved by the Food and Drug Administration (FDA)
for off-label uses such as sustaining or optimizing performance, it needs to consider a number of issues. First, drugs
that affect the CNS by acting on a specific neurotransmitter
are likely to affect multiple neural circuits, as a particular
neurotransmitter is generally used in several functionally
distinct circuits, such as dopamine in the striatum modulating
BoX 5-1
is salivary cortisol a reliable Biomarker?
The levels of cortisol in salivary samples would appear at first glance to serve as an easily applied, dynamic index of the output of the adrenal
cortex and therefore of an individuals reaction to environmental or internal stress, broadly defined (Smyth et al., 1998). However, the interpretation
of cortisol level for a given person in a particular context is a complex matter. Salivary cortisol measurement kits vary significantly in their ability to
obtain paralleling plasma cortisol levels (assumably the gold standard). That issue aside, researchers agree that to get an accurate area-under-the-curve
measure of daily cortisol, measurements at 1, 4, 9, and 11 hours after the subject wakes up can provide good coverage.1
Single-day assessments are nonetheless very weak approaches to this problem, since cortisol levels are affected by many day-to-day events (Stone et
al., 2001). Many factors are thought to be important in cortisol measurement: (1) stable characteristics such as age and gender; (2) state characteristics
such as menstrual cycle stage and use of contraceptives and other medications; (3) disease and/or chronic conditions such as liver disease, PTSD,
malnutrition or fasting, or lifestyle (e.g., jet lag or shift work); (4) dynamic characteristics such as food intake (e.g., carbohydrates increase cortisol),
sleep status (e.g., assess sleep quality and quantity on night prior to cortisol measurement), exercise (e.g., level and timing), and wake-up time; and
(5) psychological characteristics such as positive and negative affect, passivity, or coping.
In short, before salivary cortisol can be used as a reliable biomarker (in the sense defined in Chapter 2), a standard method for assessing individual
cortisol baseline must be validated. As well, the difference between the individuals baseline cortisol reading and the reading at another time must be
validated as a sensitive and specific marker of the biological condition or outcome it is intended to measure.
1See
Web site of the MacArthur Network on Socioeconomic Status and Health at http://www.macses.ucsf.edu/Research/Allostatic/notebook/salivarycort.html. Accessed
December 1, 2008.
BoX 5-2
Pharmacoimaging with fmri to Predict drug effects
Although there are many gaps in knowledge and challenges in technology that must be bridged before brain imaging can be successfully and routinely
applied to monitor soldiers performance in the field, current imaging techniques can be applied to laboratory-based research directed at answering
key questions about drug efficacy. Several recent results support the use of fMRI as a tool for predicting drug effects (Paulus and Stein, 2007; Phan et
al., 2008). To function as a test with predictive validity for new treatment agents, a pharmaco-fMRI technique must meet stringent requirements. The
insights gained can, however, be readily applied to predicting performance in extreme conditions or assessing the utility of training interventions.
Four steps need to be successfully implemented for pharmaco-fMRI to give valid and useful results: First, one has to identify a brain area that is
important for the target process of interest. This area has to be shown to be functionally altered when an individuals performance changes. Second,
one has to identify an experimental paradigm that probes (monitors) this brain area. The experimental paradigm should be sensitive to the behavioral
effects of anxiety, show no ceiling or floor effects, and be repeatable with negligible learning effects (i.e., have good test-retest reproducibility). It
should be simple and relatively independent of volitional effects, be sensitive to basic pharmacological manipulations, activate areas in the brain that
are of relevance for anxiety, and show behavioral effects and/or brain-imaging effects that correlate with ratings of anxiety. Third, one has to determine
whether there is a correlation between reduction in performance and the BOLD change in the predicted direction with standard interventions (training,
etc.). Fourth, one has to demonstrate that the standard pharmacological intervention affects the brain area in the hypothesized direction. Moreover,
this effect should show a dose-response relationship (i.e., larger or more frequent doses of the intervention should have a stronger effect).
BraiN iNJury
As noted in Chapter 1, the committee was tasked to focus
its study on nonmedical applications in light of the numerous
studies of medical neuroscience research and applications.
Nevertheless, biomedical and neurophysiological knowledge of combat-related brain injury and stress disorders is a
prerequisite for assessing opportunities for mitigating these
effects of combat, whether through preventive strategies or
by prompt and efficient treatment after a soldier has experienced a potentially injurious event. Accordingly, the section
begins with a brief overview of the most salient aspects of
current biomedical understanding of brain injuries.
The Iraq war has increased awareness and programmatic
emphasis on mitigating, preventing, treating, and protecting
against neurological damage. This war has seen a marked
increase in the risk for traumatic brain injury (TBI) because
of the high proportion of soldiers who have been injured
by strong explosions due to improvised explosive devices
(IEDs) and who have survived because they received prompt
medical care. Blasts from IEDs may cause a unique type of
brain damage compared with the more typical penetrating
57
58
59
0
BoX 5-3
connectomics and Neural Pathway degeneration
Connectomics, the study of the brains neural pathways for information transfer, is an emerging area that addresses fundamental issues in how the
brain processes information. The name connectomics refers to the concept of considering the entire collection of neural pathways and connections
as a whole, analogous to viewing the collection of genes in a human cell nucleus as the genome. An emerging technology known as diffusion tensor
imaging is used as an enabling technology for the new field.
An example of how research on connectomics could be relevant to the Army is the problem of accounting for the progression of diffuse axonal
injury resulting from a blast trauma. The current understanding is that pressure waves produced by the blast propagate across soft tissue interfaces in
the brain, creating a shear force that degrades the junctions between white and gray matter. After the immediate physical effect of the blastand even
when no overt signs or symptoms of damage are observed, as in mild TBIa degenerative pathology often develops over time. The effects of this
neural pathway degeneration eventually lead to symptoms that appear months to years after the injury: short-term memory loss, degraded affect, and
depression. In extreme cases, patients suffer from Parkinsons-like tremors like those that boxers develop (Erlanger et al., 1999; Jordan, 2000; Toth et
al., 2005). This combination of symptoms, with others, may present as PTSD. If this progressive degeneration occurs because neurons are lost along
the neural pathways connecting to the cells or junctions that were damaged directly by the pressure waves from the blast, then connectomics may help
to explain how the cell loss spreads from the initial foci of damage to other brain regions.
An example of progress in connectomics with long-term relevance for TBI is a recent technique by which researchers can trace individual neural
pathways in the brains of transgenic mouse models. While the brain of the mouse embryo is still developing, multiple copies of modified genes are
transferred into the cells that will develop into the brain. These genes produce three proteins that fluoresce in yellow, red, or cyan, producing a palate
of nearly 100 colors that are randomly distributed. When the mouse is mature, the brain tissue is excised and its neural pathways can be traced by the
color coding (Lichtman et al., 2008). This technique is appropriate only for animal models such as these BrainBow mice (see Figure 5-3-1), which are
used to learn about the brains wiring diagram and how it develops. In time, however, this fundamental knowledge should contribute to understanding
how the brain normally processes information and what happens when disease or injury progressively degrades the neural pathways.
One hypothesis about the long-term effects of TBI is that the white-matter networks are injured. Experiments with BrainBow mice or similar animal
models exposed to IED-like blast effects might in the future allow optical measurement of how the injury progresses. Since the immediate effects of a
blast trauma can be observed in the field, experiments with blast effects on these animal models might provide proof-of-concept laboratory evidence
for whether and how battlefield treatments and neuronal protection technologies could mitigate the immediate blast damage.
FIGURE 5-3-1 Neuronal pathways in BrainBow mice. Neurons in the hippocampus, a brain area involved in memory, are labeled in different colors, with their neuronal
outgoing projections pointing to the left. This is the first time so many different neurons have been separately visualized on such a large scale. SOURCE: Jean Livet,
Joshua R. Sanes, and Jeff W. Lichtman, Harvard University (2008).
61
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6
Improving Cognitive and Behavioral Performance
68
Kruse, Defense Sciences Office, DARPA, Briefing to the committee on June 30, 2008.
69
There
NeuroErgonomics
Neuroergonomics has been defined by the individual
who coined the term as the study of the brain and behavior
at work (Parasuraman and Rizzo, 2007). It is one facet, or
formalized expression, of the broader field of brainmachine
(or sometimes mindmachine) interfaces (Levine et al.,
2000; Lebedev and Nicolelis, 2006). Much of the broader
field, as discussed in Chapters 5 and 7, has focused on ways
to restore full functioning to individuals who have lost limbs
or who have suffered some form of cognitive deficit following concussive or kinetic injuries. Although many of the
advances in knowledge and in technology for these medical
applications are inherently important to all application areas
for brainmachine interfaces, the focus of this section is not
medical prostheses. Rather, a typical application in neuro
ergonomics is concerned with enhancing selected capabilities beyond an unaided level, whether or not the individual
aided by the system has experienced some degradation in
capability. Neuroergonomics deals as much with performance improvement and performance enhancement as with
performance recovery. The brief summary below examines
some of the opportunities envisioned by those working in
this field, as well as some of the barriers, acknowledged and
implied, to successful realization of these opportunities.
Specificity of Brain Signals as Control Inputs to a
BrainMachine Interface
For a nonexpert, the advances in neuroscience described
in the popular pressand sometimes in proposals seeking
fundingcan easily be interpreted in ways that overstate
the specificity of the signal patterns within the brain that can
be monitored with current techniques. Thus, lay individuals
frequently ask whether current diagnostic techniques allow
an observer to know what the person being observed is
thinking. A similarly unrealistic flight of fantasy is that the
weapons system of an advanced aircraft can be controlled by
thinking in the language of the aircrafts designers or pilots.
In general, an expectation that higher levels of cognition can
be immediately comprehended by assessing a small number
of neural signals is destined for disappointment.
However, the confluence of insights from neuroscience
and improvements in complex systems control functions
will provide limited opportunities for sending discrete control signals directly to an external system. We can, to some
degree, elicit and subsequently measure, with a fair degree of
accuracy, discrete responses from the brain. A prime example
is the P300 wave, which not only is a potential index of
cognitive workload but also can be employed as a form of
binary (yes/no) control to a hybrid humanmachine monitoring system. Although it remains difficult to distill the P300
wave on a single trial, the signal-to-noise ratio is constantly
being improved, as it is for other neurophysiological and
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A second NSBRI team, the Human Factors and Performance team, is studying ways to improve daily living and
keep crew members healthy, productive, and comfortable
during extended space exploration missions. Overall aims of
this team are to reduce performance errors by studying environmental and behavioral factors that could threaten mission
success. The team develops information tools to support crew
performance and guidelines for human systems design.
Team members are examining ways to improve sleep
and scheduling of work shifts and looking at how lighting can improve alertness and performance. Other projects
address nutritional countermeasures and how factors in the
environment, such as lunar dust, can impact crew health.
Recent projects of the Human Factors and Performance team
includes research on sleep disruption in space and finding a
nutritional counterbalance for the loss of muscle mass and
function attributed to long spaceflights. Because rapidly
changing light-dark cycles in space can affect the human
bodys natural circadian cycle, Lockley et al. (2006) have
been investigating whether exposure to short-wavelength
blue light can be an effective means of shifting the circadian
pacemaker, suppressing melatonin, and essentially increasing alertness. Gronfier et al. (2007) found that a modulated
light exposure, with bright light pulses of 100 lux being
supplied in the evening, can retrain human subjects to a
light-dark cycle.
NeuroPharmaceutical Approaches to
Performance Enhancement
Chapter 5 discusses nutritional supplements and pharmaceuticals used to sustain performance (measures to
counter environmental stressors) as opposed to enhancing
it above an individuals baseline optimum. The committee
has significant concerns about the potential for inappropriate
use of currently available performance-enhancing drugs by
the military.
The caveats noted in Chapter 5 to the off-label use of
neuropharmaceuticals to sustain performance, outside the
FDA-approved medical indications for prescribing them,
apply even more stringently when the intent is to enhance
performance beyond the baseline capability. The requirements for specificity and selectivity must be set high and
must be clearly met with scientifically sound evidence. And
the risk of undesirable and still-unknown side effects must
be weighed carefully against any performance benefit using
tools to measure the performance improvement and clinical
measures to assess the overall effects of the intervention.
Such tools may need to be developed. Despite these concerns, it may be worthwhile to continue research on the use
of pharmacological agents to optimize performance if the
benefits to unique military circumstances clearly outweigh
the risks. Future studies may discover enhancers with more
striking effects then those currently available (Narkar et al.,
2008).
72
Neuropharmaceuticals might also be applied to influence adversary behavior and decision making. Because pharmaceuticals can no doubt modulate the neurophysiological
underpinnings of behavior and performance, they can in principle be used to weaken or incapacitate an adversary, just as
they can be used to sustain and strengthen our own soldiers.
Although this might be a direction for long-term research,
it would also raise substantial ethical, legal (from the perspectives of both U.S. and international law), and strategic
issues that should be addressed before the Army supports any
such research and before assessing the relevance for Army
applications of any non-Army research in this area. As with
chemical and biological weapons, the most relevant opportunity for the counteradversary use of pharmaceuticals may be
in developing the means to protect our soldiers (and civilians)
against pharmacological weapons used against us.
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7
Neuroscience Technology Opportunities
75
FIGURE 7-1 Various noninvasive imaging technologies provide insight into the brain (anatomy) and mind (function). The spatial resolution
of a given technology defines the largest and smallest brain structures that can be observed, while the temporal resolution defines the elements
of mind function to be measured. Academic and commercial research is primarily geared to improving resolution, although important measurements for the prediction of behavior can be made at any point in the brain-mind plane. Shown are several of the technologies discussed
in Chapter 7. SOURCE: Adapted from Genik et al., 2005.
Mission-Enabling Technologies
The Army has a basic requirement to process, distribute, and apply information efficiently. These requirements
will only increase with the demands of a network-centric
environment. Better cognitive performance must be achieved
if soldiers are to contend with an ever-increasing river of
information. Solutions are needed to address demonstrated
operational requirements, such as avoidance of information
overload and successful synthesis of information that selectively highlights the mission-critical features from multiple
sources. The technologies described in this section apply
knowledge and techniques from neuroscience to help solve
these and related challenges in sustaining and improving
soldier performance.
Mission-enabling (deployable) instruments or technologies of interest to the Army must be capable of being
scientifically validated and include brainmachine interface
(BMI) technologies, remote physiological monitoring to
extend performance in combat, and optimization of sensorshooter responses under cognitive stress. BMI technology
examples include near-term extensions of current train-
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Research-Enabling Technologies
Several of the mission-enabling technologies in the
preceding section require for their further development a
fuller understanding of common neurophysiological patterns in human behavior. Research-enabling technologies
are also needed to develop tools to study and assess underlying aspects of performance such as ground-truth workload
and attention to detail. The advances made with researchenabling technologies will be deployed with soldiers on a
limited basis, or used in training, simulations, or laboratory
environments. Some of the mission-enabling technology
described in the previous section will also find uses in the
research environment.
Investment in research-enabling technology is crucial
for adapting current technology to Army applications, as
well as for advancing to future generations of Army applications. Such technology might also help the Army conduct
scientifically rigorous validation and testing for emerging
mission-enabling technology. Some of the opportunities
simply involve bridging gaps in technologyfor instance,
the ability to use fMRI and concomitant eye tracking across
a wide visual angle. In this section the committee discusses
signal processing challenges, control strategies for BMIs,
fatigue and sleep models for soldiers, advances in functional
paradigm technology, adapting laboratory neuroimaging
technologies for use in the field, and data fusion. The committee also touches briefly on the science of connectonomics.
It looks at the development of a few pieces of hardware and
imaging methodologies that could dramatically advance
several basic science techniques.
Signal Processing Challenges
At present the methods for extracting information from
the brain and nervous system can be divided into two categories: invasive and noninvasive. Invasive methods include
multielectrode recordings, local field potentials (lfps), and
High operations tempo (OpTempo) refers to missions carried out as
quickly and fully as feasible, to apply overwhelming force in a time frame
such that opposing forces are unable to respond and counter effectively. By
their nature, High OpTempo missions are characterized by high levels of
psychological and physical stress, including constant awareness of mortal
danger and potential for mission failure, combined with heavy decisionmaking loads. When High OpTempo is combined with sustained operations
(SUSOPS) (missions lasting longer than 12 hours before resupply), cognitive capabilities are easily overtaxed and prone to degradation or failure.
82
stimulus.
to enhance performance and improve therapies depends critically on the signal-processing methods used to extract that
information.
All of the popular noninvasive methods for measuring
neural states in humans have unanswered questions concerning their underlying neurophysiology. Although one
can certainly glean useful methodology without probing
deeply, fundamental questions remain. If research answers
them, more applications and measurement techniques may
open up, including, eventually, field-deployable indicators
of neural state.
Fatigue and Sleep Models for Soldiers
Chapter 5 talks in detail about fatigue and sleep research,
as well as mitigation strategies. Two important technologies
enabling the performance-sustaining research discussed in
these areas are (1) the computational models for predicting
behavior and (2) the physical models for transferring results
to the appropriate warfighter population.
The computational model used is a vector of parameters
important for sleep or fatigue, and inputs calibrated to a
specific individual soldier. The additional strategies the
officers employ in the fieldnaps, nutritional supplements,
etc.should be included in the model, and it should account
for the difference between an academic research subject used
to construct a model and a soldier.
Ideally, the physical model used in research would be an
actual soldier in the state of readiness expected at the start
of a mission. However, the multitude of research variables
that must be tested necessitates using an ordinary civilian to
stand in for the soldier. Chapter 3 described an opportunity
to leverage research using high-performance athletes. In an
academic setting, it would be preferable to use persons from
a university community for most of the studies and reserve
actual soldiers for experimental runs once the paradigms are
well understood and being tested for validity.
Research in the area of fatigue might also include a systematic study of the differences between cognitive fatigue,
physical fatigue, and fatigue, including environmental stress,
from hypoxic or thermal challenges; biomarkers predictive
of a soldiers susceptibility to fatigue under extreme environmental conditions; and behavioral measures of fatigue
to advance screening and testing procedures for soldier
assessment.
Functional MRI and Hardware to Support
fMRI Research on Army Applications
Functional MRI is detailed in Chapter 2. Technology
associated with fMRI for use in clinical health care is
receiving sufficient investment from industry. However,
clinical applications require only medium spatial resolution
(3-4 mm) and low temporal resolution (tens of seconds).
These resolutions are usually sufficient for a clinical deter-
83
mination of whether a major circuit in the brain is functioning normally; however, they are inadequate for measuring
neural responses to instantaneous events in rapid succession,
among other research paradigms. Academic research laboratories, funded mainly by the National Institutes of Health,
possess fMRI technology that is superior to the equipment
available commercially (~2-mm and 1-sec resolutions for
whole human head scans). This improved spatiotemporal
resolution is primarily achieved through use of advanced
imaging electronics, such as parallel signal receiver channels
rather than an exclusive concentration on ever-increasing
static field strength. Cutting-edge laboratories have advanced
measurement techniques that are a vast improvement over
conventional imaging, but even typical facilities have
invested in excess of $10 million for equipment and facilities,
an investment that could be leveraged by the Army for the
evolutionary application of current technology. The Army
needs to monitor advances in existing facilities and consider
ways to utilize them.
Some areas of research could be of great value for
Army applications but are not being addressed by industry
or academia because they have little if any potential for
use in the clinical market. These areas are likely to require
Army investment to achieve sufficient understanding to
adapt results from laboratory environments to the field.
They include vertical-bore MRI; full-motion, interactive
stimulation; wide-angle, immersive visual stimulation; and
high-temporal-precision stimulation and monitoring.
Currently, all fMRI research is done with the subject
lying down. There are physiological and perceptual differences between horizontal and vertical orientation. To determine whether and to what extent supine-orientation fMRI is
applicable to field situations, the least that must be done is to
conduct experiments with the subject sitting up or, possibly,
standing. Subjecting participants to heat, humidity, smells,
and other such stimulants encountered in combat situations
will also be required. This necessary work will require
designing and building a specialized MRI machine, with its
supporting laboratory, that is capable of scanning subjects in
the vertical position while also exposing them to relatively
rapid environmental changes.
Developing such an fMRI system is likely to entail an
investment horizon of at least 5-10 years. One company
(Fonar) produces vertical MRI machines for humans, but
these machines are primarily for orthopedic imaging rather
than brain imaging and lack the high temporal resolution
needed for Army-relevant research. At least one Army appli
cation laboratory would be required.
The committee estimates that setting up a facility to
perform vertical fMRI at 3 T or more using state-of-the-art
84
liquid crystal display technology, unlike with the older cathode ray
tube (CRT) displays, merely pumping up the input video frequency does
not result in faster displays. The liquid crystal elements have a limit to their
on-off transition timetypically 15-20 msec for a standard desktop. This
transition time explains why flat-panel displays do not flicker like CRTs and
therefore cause less eyestrain. Top-of-the-line gaming displays can transition in as little as 2 msec, providing a true 500-Hz refresh.
A limbus tracker illuminates the eye with infrared light (IR) and uses a
single photodiode to collect the IR reflection. The motion of the edges of
pupil and iris induce changes in the total reflected IR intensity. Standard
eye trackers use a camera to transmit IR video of the pupil, iris, and sclera,
which is processed using image analysis software. Limbus trackers are
good at detecting any motion of the eye but do not provide any directional
or absolute gaze information.
85
86
There are several challenges for technology development in designing brainmachine interfaces for upper-limb
prosthetics using cortical control. One is to design implants
that ensure longevity of recording, ideally for the lifetime
of the individual. Current implants typically last only a year
or so; however, some implants have lasted for a number
of years. Understanding biocompatibility and durability
and other factors that affect the longevity of implants is an
important area of research. A second developmental challenge is the integration of electronics with electrodes. Ideally
the substrate of the electrodes should be metal leads on a silicon substrate. This type of electrode can easily be integrated
as a single unit with integrated circuit electronics.
A third challenge is to make the electrodes movablethat
is, able to automatically search out cells for optimal recording and move to new cells when cells are lost. A fourth challenge is the use of local field potentials and spikes to improve
recording decodes, particularly for determining behavioral
states and transitions between them. Fifth, implantable electronics need to be developed that allow on-board processing
and decoding of neural signals and wireless transmission of
the signals to controllers within the prosthetic limb. Finally,
limb robotic technologies need to be advanced to achieve
lightweight limbs that can generate forces similar to those in
natural limbs and with power sources that can last for long
periods of time before recharging.
Given all of the challenges and the delicate nature of
direct neural connection technology, it is unlikely that the
interfaces could be made battlefield robust in the foreseeable
future. Invasive technology is currently utilized in medical
prosthetics, including direct brain connections such as multi
channel cochlear implants to replace the sense of hearing.
These direct connections are able to capture and generate
individual neuronal currents, as well as monitor or induce
coherent neural activity at much greater signal-to-noise
ratio than noninvasive technology. The invasive technologies
should therefore be considered the best possible case of both
signal detection and interface complexity for what could be
achieved via noninvasive technologies. These medical appli
cations are therefore important for the Army to monitor as a
guide for what may be possible noninvasively.
Other Prosthetics Applications with Relevance to
BrainMachine Interfaces
In addition to BMI systems to facilitate recovery of
motor function, other prosthetic devices are on the horizon.
These include devices that carry out deep brain stimulation to improve cognitive function and arousal state and
to treat depression. There has also been work recently on
central auditory neural prostheses that stimulate the inferior
colliculus and visual neural prostheses using stimulation
in the retina or lateral geniculate nucleus. In most of these
cases, research has demonstrated the feasibility of devices
either stimulating a given brain region or using information
87
88
89
TABLE 7-1 High-Priority Opportunities for Army Investment in Neuroscience Technologies (Recommendation 14)
Current Investment
(L, M, or H)
Technology Opportunity
ME
RE
Time Framea
Commercial
Academic
x
x
x
x
x
x
Ongoing
Medium term
Ongoing
L
M
M
M
L
H
x
x
M
L
L
M
L
M
L
M
L
L
x
x
x
Ongoing
Medium term
Medium term
Medium term
Medium term
x
x
x
x
Medium term
Medium term
L
M
L
M
Medium term
Ongoing
M
L
M
M
NOTE: ME, mission-enabling; RE, research-enabling; L/M/H, low, medium, or high; EEG, electroencephalography; MRI, magnetic resonance imaging;
fMRI, functional magnetic resonance imaging; DTI, diffuse tensor imaging; DSI, diffusion spectrum imaging; PET, positron emission tomography; MEG,
magnetoencephalography; NIRS, near-infrared spectroscopy; DOT, diffuse optical tomography; GSR, galvanic skin response.
aIn this column, medium term means between 5 and 10 years and ongoing means that results will be available within 5 years, but continuing investment
is recommended to stay at the forefront of the technology.
SOURCE: Committee-generated.
90
Table 7-2 Priority Opportunities for Army Investment in Neuroscience Technologies (Recommendation 15)
Current Investment
(L, M, or H)
Time Framea
Commercial
Academic
Medium term
Medium term
Medium term
Far term
Medium term
Near term
Far term
H
H
L
L
L
L
L
L
H
M
M
M
M
H
Medium term
Far term
L
L
M
L
x
x
L
H
H
L
Technology Opportunity
ME
RE
x
x
x
x
x
x
Heartbeat variability
Galvanic skin response
x
x
x
x
x
NOTE: ME, mission-enabling; RE, research-enabling; L/M/H, low, medium, or high; VR, virtual reality; TMS, transcranial magnetic stimulation.
aIn this column, near term means within 5 years, medium term means between 5 and 10 years, and far term means 10-20 years.
SOURCE: Committee-generated.
Table 7-3 Possible Future Opportunities (Neuroscience Areas Worthy of Monitoring for Future Army Investment)
Current Investment
(L, M, or H)
Technology Opportunity
ME
x
x
RE
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Time Framea
Commercial
Academic
Far term
Far term
Far term
Medium term
Medium term
Far term
Medium term
Medium term
Far term
Far term
Medium term
Far term
Far term
Far term
H
L
M
M
L
M
L
L
L
L
M
L
L
M
H
H
M
M
M
M
H
M
M
M
M
L
M
M
NOTE: ME, mission-enabling; RE, research-enabling; L/M/H, low, medium, or high; fMRI, functional magnetic resonance imaging; MRI, magnetic resonance
imaging; and TMS, transcranial magnetic stimulation.
aIn this column, medium term means between 5 and 10 years and far term means 10-20 years.
SOURCE: Committee-generated.
91
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Long-Term Trends in Research
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9
Conclusions and Recommendations
100
The degradation of a soldiers performance under sustained physical or mental stress is due to both peripheral
101
Recommendation 7. The Army should establish relationships with the pharmaceutical industry, the National Institutes of Health, and academic laboratories to keep abreast
of advances in neuropharmacology, cellular and molecular
neurobiology, and neural development and to identify new
drugs that have the potential to sustain or enhance performance in military-unique circumstances. However, caution
must be exercised to ensure that the benefits outweigh any
unforeseen or delayed side effects.
Conclusion 8. Among the neuropharmaceuticals approved
by the Food and Drug Administration for specific medical indications, a number have potential off-label uses in
sustaining or optimizing performance. However, any compound, natural or synthetic, that acts on the CNS must be
assumed, until proven otherwise, to affect multiple neural
systems. It is therefore essential that specificity of action be
demonstrated. Moreover, the risks of unforeseen or delayed
side effects must be considered, particularly before a neuro
pharmaceutical is widely administered for sustaining or
enhancing performance in mission-critical tasks without a
specific medical indication to justify its use.
Recommendation 8. Before the Army attempts to employ
neuropharmaceuticals for general sustainment or enhancement of soldier performance, the Army should undertake
medically informed evidence-based risk-benefit analyses,
including performance and clinical measures to assess
overall effects, to ensure that the expected benefits of such
medication outweigh the risks of negative side effects or
delayed effects.
Conclusion 9. The use of new pharmacological agents to
restore function, mitigate pain, or otherwise respond to
trauma or facilitate recovery from injury or trauma will be
a key contribution of neuroscience in the near to medium
term. New, highly specific brain receptors have been identified for a number of agents that could have profound effects
on the brain and nervous system. The effectiveness of these
agents, and the reduction of unwanted systemic side effects,
will be enhanced by technologies that target delivery of the
pharmacological agent to a specific site. Targeting of drugs
to enhance an ability such as situational awareness is technically feasible, but it may be proscribed by societal and ethical norms and is subject to the caveats on pharmacological
enhancement of behavior or performance that the committee
discussed in Chapters 5 and 6.
Recommendation 9. The Army should support research
on novel mechanisms for noninvasive, targeted delivery of
pharmacological agents to the brain and nervous system in
the course of medical interventions to mitigate the adverse
effects of physical injury to the brain or another portion of
the nervous system. In the near to medium term, this research
should focus on restoring a performance deficit to baseline
function rather than enhancing performance beyond that
baseline.
102
RECOMMENDATIONS ON NEUROSCIENCE
Technology DEVELOPMENT
In Chapter 7, the committee identified and assessed
c utting-edge, high-payoff technology opportunities, emphasiz
ing their potential value for Army applications. Technologies
were evaluated first with respect to their ability to enable Army
missions (these were called mission-enabling technologies)
and then with respect to their ability to support neuroscience
research of high relevance to Army applications (these were
called research-enabling). Sometimes, a technology is both
mission enabling and research enabling, but in all cases, it
must be capable of being scientifically validated.
To arrive at opportunities it could recommend for Army
investment, the committee considered not only the potential
value of the technologies to the Army but also the time frame
for developing an initial operational capability and the extent
of external investment that the Army could leverage. In this
way it came up with a set of high-priority technology
opportunities it believed would have the greatest potential for
high payoffs in Army applications and best deserved Army
investment. It also identified a second set of priority opportunities that could augment the first set, and a third set whose
progress should be monitored for future consideration.
Conclusion 14. Table 7-1 lists the set of opportunities in
neuroscience technology development that the committee
believes are a high priority for Army investments. It is critical that the emerging technology development pursued by
the Army be subjected to rigorous scientific and operational
validation.
103
Recommendation 14. The Army should invest in the highpriority technology opportunities listed in Table 7-1. The
investments should initially include long-term (5 or more
years) commitments to each opportunity.
Conclusion 15. Table 7-2 lists additional opportunities in
neuroscience that the committee recommends for Army
investment. The committee views these opportunities as
supplementing those in Table 7-1 and as deserving of somewhat less R&D funding, to at least explore their potential
applications.
Recommendation 15. The Army should consider limited
investments (2 or 3 years for the initial commitment) in the
technology opportunities listed in Table 7-2. Evaluation of
the results for each initial investment combined with assessment of outside progress in the field should guide decisions
on whether to continue the funding for additional periods.
OverArching recommendationS
The preceding 15 recommendations respond directly
to one or more items in the statement of task for the committee. In reflecting on the feasibility of actually implementing these recommendations, the committee found two
crosscutting issues that go beyond any particular request
in the statement of task but that the Army must address
if the potential value of neuroscience is to be tapped in a
substantial way.
A Mechanism for Monitoring New Opportunities in
Neuroscience Research and Technology
Neuroscience is growing rapidly as discoveries in
multiple fields are linked to our expanding knowledge and
understanding of brain functions. This expansion of neuroscience applications in multiple areas of importance to the
Army has led to a division of responsibilities for developing
objectives and implementing neuroscience research among
multiple organizations. A more serious problem is that there
is currently no single point in the Army science and technology structure where progress in neuroscience, construed
broadly, is being monitored for potential Army applications
and from which coordinating guidance can be disseminated
to the distributed centers of relevant neuroscience-based
R&D. The committee views this lack of focus on identifying
and leveraging the rapid advances in neuroscience, together
with the dispersion of largely isolated R&D activities, as the
most significant barrier to implementation of the specific
recommendations presented above.
In addition to the specific technology development
opportunities for Army investment listed in Tables 7-1 and
7-2, the committee identified future opportunities where
external progress in neuroscience R&D needs to be monitored by the Army (Table 7-3). The committee also identified
104
Appendixes
Appendix A
Biographical Sketches of Committee Members
108
setts Institute of Technology. She performs research in collaborative humancomputer decision making for command
and control domains and is a recognized expert in the area of
human superviory control. Dr. Cummings graduated from the
U.S. Naval Academy with a B.S. in mathematics in 1988. She
received an M.S. in space systems engineering from the Naval
Postgraduate School in 1994 and a Ph.D. in systems engineering from the University of Virginia in 2003. Dr. Cummings
served as a naval officer from 1988 to 1999 and was among
the first female fighter pilots in the Navy.
J. Mark Davis is professor and director of the Psychoneuro
immunology, Exercise and Nutrition Laboratory in the
Division of Applied Physiology within the Department of
Exercise Science at the University of South Carolina. He
has published over 110 peer-reviewed articles of relevance
to soldier nutrition, physical training, and mental/physical
performance, including Possible mechanisms of central
nervous system fatigue during exercise and Effects of
branched-chain amino acids and carbohydrate on fatigue during intermittent, high-intensity running. He earned a Ph.D.
from Purdue University and a B.S. from California Polytech
in San Luis Obispo.
Michael S. Gazzaniga (IOM) is the first director of the Sage
Center for the Study of Mind at the University of California,
Santa Barbara. He is past director of the Center for Neuroscience at the University of California, Davis. Through his
extensive work with split-brain patients, Dr. Gazzaniga has
made important advances in our understanding of functional
lateralization in the human brain and of how the cerebral
hemispheres communicate with one another. His research
is well known in both clinical and basic science circles, and
he has written several highly acclaimed books, including
the landmark 1995, 2000, and 2004 editions of The Cognitive Neurosciences, which is recognized as the sourcebook
in the field. Dr. Gazzaniga is the president of the Cognitive
Neuroscience Institute, which he founded, and is the editor
in chief emeritus of the Journal of Cognitive Neuroscience.
Dr. Gazzaniga was elected to the American Academy
of Arts and Sciences. He is the elected president of the
American Psychological Society, and he also serves on the
Presidents Council on Bioethics. He received a Ph.D. in
psychobiology from the California Institute of Technology.
He will be delivering the Gifford Lectures at the University
of Edinburgh in 2009.
Richard J. Genik, II, is director of the Emergent Technology
Research Division and research assistant professor in the
Department of Psychiatry and Behavioral Neurosciences at
Wayne State University. Among his many areas of expertise
are the use of magnetic resonance imaging and the use of
fMRI to measure cognitive workload in naturalistic, multi
tasking environments. Dr. Genik has 131 peer-reviewed publications, including Watching people think and Scientific
methods that may predict behaviors, which appeared in Biotechnology Trends Relevant to Warfare Initiatives in 2005. He
has a Ph.D. in physics from Michigan State University and a
B.S. in applied physics from Wayne State University.
Paul W. Glimcher is professor of neural sciences, economics,
and psychology at New York Universitys Center for Neural Science and is the director of the Center for Neuro
economics at New York University. He has achieved the
following: A.B., Princeton University, magna cum laude;
Ph.D., University of Pennsylvania, neuroscience; fellow of
the McKnight, Whitehall, Klingenstein, and McDonnell
foundations. Dr. Glimcher is an investigator for the National
Eye Institute, the National Institute of Mental Health, and the
National Institute of Neurological Disorders and Stroke. He
was the founding president of the Society for Neuroeconomics;
winner of the Margaret and Herman Sokol Faculty Award in
the Sciences, 2003; and winner of NYUs Distinguished
(Lifetime Accomplishment) Teaching Award, 2006. He has
had articles published in Nature, Science, Neuron Journal of
Neurophysiology, American Economic Review, Games and
Economic Behavior, Vision Research, Experimental Brain
Research, and the MIT Encyclopedia of Cognitive Science
and was international author of Decisions, Uncertainty, and
the Brain: The Science of Neuroeconomics from MIT Press
and winner of the American Association of Publishers Medical
Sciences Book of the Year, 2003. Professor Glimchers work
has been covered by The Wall Street Journal, Time, Newsweek,
The Los Angeles Times, Money Magazine, and The New Scientist and featured on National Public Radio, the BBC, and
Fox News, among others.
Peter A. Hancock is provost distinguished research professor
for the Department of Psychology, the Institute for Simulation and Training, and the Department of Civil and Environmental Engineering at the University of Central Florida in
Orlando. He is an expert in human factors and ergonomics
and serves on the National Research Councils Committee
on Human Factors. Among his many awards, he received
the John C. Flanagan Award from the Society of Military
Psychologists of the American Psychological Association in
2007. Dr. Hancock has authored over 500 refereed scientific
articles and publications, including the handbook on perception and cognition Human Performance and Ergonomics.
He earned a D.Sci. as well as a E.Ed. in anatomy and
physiology at Loughborough University in Loughborough,
England. He also earned a Ph.D. at the University of Illinois
at Champaign.
Steven Kornguth is director of the Center for Strategic and
Innovative Technologies and a professor of pharmacy at the
University of Texas at Austin. He is a member of the American Society of Neurochemistry, the Neuroscience Society,
and the Army Science Board. Dr. Kornguth is professor
emeritus, neurology and biomolecular chemistry, at the Uni-
109
APPENDIX A
Paul J. Zak is professor of economics and founding director of the Center for Neuroeconomics Studies at Claremont
Graduate University. Dr. Zak also serves as professor of
neurology at Loma Linda University Medical Center and
is a senior researcher at the University of California at Los
Angeles. He is credited with the first published use of the
term neuroeconomics and has been at the vanguard of
this new discipline, which integrates neuroscience and economics. He organized the worlds first doctoral program in
neuroeconomics at Claremont Graduate University and now
administers it. Dr. Zaks lab discovered in 2004 that a chemical in our brains, oxytocin, allows us to determine whom to
trust. This knowledge is being used to understand the basis
for modern civilizations and economies, for negotiating,
and for treating patients with neurological and psychiatric
disorders. He has degrees in mathematics and economics
from San Diego State University, a Ph.D. in economics from
the University of Pennsylvania, and postdoctoral training in
neuroimaging from Harvard.
Appendix B
Committee Meetings
111
APPENDIX B
Appendix C
Sampling of Behavioral and Neuropsychological Literature
(2001-2007) on High-Performance Athletes
112
113
APPENDIX C
27. Donohue B, Covassin T, Lancer K, Dickens Y, Miller A, Hash A, et
al. Examination of psychiatric symptoms in student athletes. J Gen
Psychol. 2004
Jan;131(1):29-35.
28. Donohue B, Silver NC, Dickens Y, Covassin T, Lancer K. Development and initial psychometric evaluation of the sport interference
checklist. Behav Modif. 2007 Nov;31(6):937-57.
29.
Erlanger D, Feldman D, Kutner K, Kaushik T, Kroger H, Festa J, et al.
Development and validation of a web-based neuropsychological test
protocol for sports-related return-to-play decision-making. Arch Clin
Neuropsychol. 2003 Apr;18(3):293-316.
30. Everhart B, Kernodle M, Ballard K, McKey C, Eason B, Weeks M.
Physical activity patterns of college students with and without high
school physical education. Percept Mot Skills. 2005 Jun;100(3 Pt
2):1114-20.
31. Filaire E, Sagnol M, Ferrand C, Maso F, Lac G. Psychophysiological
stress in judo athletes during competitions. J Sports Med Phys Fitness.
2001 Jun;41(2):263-8.
32. Finaud J, Degoutte F, Scislowski V, Rouveix M, Durand D, Filaire E.
Competition and food restriction effects on oxidative stress in judo.
Int J Sports Med. 2006 Oct;27(10):834-41.
33. Fontani G, Lodi L, Felici A, Migliorini S, Corradeschi F. Attention
in athletes of high and low experience engaged in different open skill
sports. Percept Mot Skills. 2006 Jun;102(3):791-805.
34. Fung L. Task familiarity and task efficacy: a study of sports coaches.
Percept Mot Skills. 2002 Oct;95(2):367-72.
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Other Topics
161. Bishop DT, Karageorghis CI, Loizou G. A grounded theory of young
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Appendix D
Research on Managing Information Overload in
Soldiers Under Stress
118
such a system and thus about the time frame for an initial
operational capability. Unfortunately, no follow-on studies
have reported how the successful CSGs could or would
be combined in an operational system. The engineering
obstacles to combining EEG, fNIR, and eye-tracking devices
are substantial. Unless dramatic leaps are made soon in the
miniaturization of these technologies and in improved signalprocessing algorithms, the realization of a single headset that
can combine allor even a subsetof these technologies is
at least a decade away.
Other engineering problems, such as how to measure
EEG signals in a dynamic, noisy environment, have not been
addressed, at least in the open literature. Basic sensor system
engineering problems like these will be critical to any operational deployment of these technologies. A similar engineering problem underlay the use of the eye-tracking devices
assumed for AugCog applications. These devices currently
require a sophisticated head-tracking device in addition to the
eye-tracking device, and encapsulating this technology into
an unobtrusive device that can be worn in the field appears
also to be at least 10 years in the future.
In addition to hardware limitations on the use of neural
and physiological technologies in an operational field setting,
the software/hardware suite required to interpret cognitive
state reliably in real time is beyond current capabilities,
particularly in the highly dynamic, stochastic settings typical of command-and-control environments. The experiments
for the AugCog program were conducted under controlled
laboratory conditions. While this is to be expected for preliminary, proof-of-concept studies, such a limitation constrains the extrapolation of the reported results. For example,
the communications scheduler in the Phase 2 experiments
made changes in information presentation based on gross
differences in perceived cognitive state. In actual battlefield
conditions, the amount of task-relevant information and
the degrees of freedom in cognitive state will require more
precision and reliability in ascertaining an operators condition and making situation-appropriate adjustments rather
than limiting access, perhaps inappropriately, to information
that may be critical for a real-time decision. Not only must
the sensors and signal-processing algorithms improve substantially; significant advances are also needed in decisiontheoretic modeling. In particular, these models will have to
accommodate a significant range of individual variability.
Overall, the AugCog goal of enhancing operator performance through psychophysiological sensing and automationbased reasoning is desirable but faces major challenges as an
active information filter. Suppose a system is implemented
that can change information streams and decrease the volume
by filtering incoming information presented to a user. How
is the system to know that its filtering in a specific situation is both helpful to this user and passes along the correct
information for the current situation? The system software
must correctly determine an optimal cognitive load for an
individual in a dynamic, highly uncertain context and decide
119
APPENDIX D
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