9
Conclusions and Recommendations

The previous chapters discussed neuroscience in terms of Army needs and applicable research and technology developments. This chapter presents the committee’s conclusions and its recommendations on opportunities in neuroscience for future Army applications.

The applications relating to traditional behavioral sciences spoken of in the statement of task are of known value to the Army. Accordingly, the committee developed 13 recommendations on neuroscience research in these traditional applications. However, because a key driver for the study was to identify high-risk, cutting-edge, high-payoff research, Army support should clearly not be limited to traditional applications. Indeed, the 13 recommendations are followed in this chapter by two recommendations relating to the material in Chapter 7—specifically, to Tables 7-1 and 7-2. Those tables identified nearly two dozen technology opportunities, about half of which were classed as “high priority” and the remainder as simply “priority.” Lastly, the committee made two overarching recommendations on what it called crosscutting issues. Together, the 17 recommendations should help the Army to methodically exploit the expanding realm of neuroscience research.

RECOMMENDATIONS ON NEUROSCIENCE RESEARCH FOR BEHAVIORAL SCIENCE APPLICATIONS

The committee’s specific recommendations on research opportunities for applications related to traditional behavioral science are presented in this section under headings corresponding to the first four chapters of the report: training and learning (Chapter 3), optimizing decision making (Chapter 4), sustaining soldier performance (Chapter 5), and improving cognitive and behavioral performance (Chapter 6).

Training and Learning

The Army has long relied on the behavioral and social sciences to guide development and implementation of training. Research capabilities in these fields are limited, and in-house capabilities to perform neuroscience research are minimal.


Conclusion 1. Neuroscience can extend and improve the Army’s traditional behavioral science approaches to both training and learning. For example, neuroscience offers new ways to assess how well current training paradigms and accepted assumptions about learning achieve their objectives. Neuropsychological indicators can help assess how well an individual trainee has assimilated mission-critical knowledge and skills. These asssesment tools also will allow the Army to assess individual variability and tailor training regimens to the individual trainee.

Recommendation 1. The Army should adjust its research capabilities to take advantage of the current and emerging advances in neuroscience to augment, evaluate, and extend its approaches to training and learning. Indicators of knowledge and skill acquisition based in neuroscience should be incorporated into the methods of testing for training success. 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 (Conclusion 1), neurological predictors of soldier performance need much research and development before they will be ready for Army applications.


Conclusion 2. Current methods for characterizing individual capabilities and matching them to the requirements for per-



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9 conclusions and recommendations The previous chapters discussed neuroscience in terms ing. Research capabilities in these fields are limited, and of Army needs and applicable research and technology devel- in-house capabilities to perform neuroscience research are opments. This chapter presents the committee’s conclusions minimal. and its recommendations on opportunities in neuroscience Conclusion 1. Neuroscience can extend and improve the for future Army applications. The applications relating to traditional behavioral sci- Army’s traditional behavioral science approaches to both ences spoken of in the statement of task are of known value training and learning. For example, neuroscience offers new to the Army. Accordingly, the committee developed 13 rec- ways to assess how well current training paradigms and ommendations on neuroscience research in these traditional accepted assumptions about learning achieve their objec- applications. However, because a key driver for the study tives. Neuropsychological indicators can help assess how was to identify high-risk, cutting-edge, high-payoff research, well an individual trainee has assimilated mission-critical Army support should clearly not be limited to traditional knowledge and skills. These asssesment tools also will allow applications. Indeed, the 13 recommendations are followed the Army to assess individual variability and tailor training in this chapter by two recommendations relating to the mate- regimens to the individual trainee. Recommendation 1. The Army should adjust its research rial in Chapter 7—specifically, to Tables 7-1 and 7-2. Those tables identified nearly two dozen technology opportunities, capabilities to take advantage of the current and emerging about half of which were classed as “high priority” and the advances in neuroscience to augment, evaluate, and extend remainder as simply “priority.” Lastly, the committee made its approaches to training and learning. Indicators of knowl- two overarching recommendations on what it called cross- edge and skill acquisition based in neuroscience should be cutting issues. Together, the 17 recommendations should incorporated into the methods of testing for training success. help the Army to methodically exploit the expanding realm In particular, these indicators should be employed in identi- of neuroscience research. fying individual variability in learning and tailoring training regimens to optimize individual learning. recommeNdaTioNs oN NeuroscieNce research The Army currently relies heavily on broad, general For Behavioral scieNce aPPlicaTioNs indicators of aptitude to predict training effectiveness and The committee’s specific recommendations on research individual success rates. The importance of predicting suc- opportunities for applications related to traditional behavioral cess rates of soldiers before assigning them to given tasks science are presented in this section under headings corre- increases with the cost of training for the task and with the sponding to the first four chapters of the report: training and consequences of not performing the task well. In comparison learning (Chapter 3), optimizing decision making (Chapter 4), with the indicators that have been developed for assessing sustaining soldier performance (Chapter 5), and improving how well skills or knowledge have been acquired (Conclu- cognitive and behavioral performance (Chapter 6). sion 1), neurological predictors of soldier performance need much research and development before they will be ready for Army applications. Training and learning Conclusion 2. Current methods for characterizing individual The Army has long relied on the behavioral and social sciences to guide development and implementation of train- capabilities and matching them to the requirements for per- 99

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00 OPPORTUNITIeS IN NeUROSCIeNCe fOR fUTURe ARMY APPLICATIONS forming high-cost, high-value Army assignments do not have action—typically up to 96 hours. In Chapter 5, the committee neuropsychological, psychophysiological, neurochemical, reviewed neuroscience applications related to understanding, or neurogenetic components. As a first step toward using monitoring, and preventing or treating deficits in soldier insights from these and other neuroscience-related fields, performance. These deficits may occur during a single results from relatively simple neuropsychological testing extended operation, or, when they are associated with Army could be empirically tested to seek correlations with suc- concepts such as individual soldier resiliency and unit-level cessful performance in one or more of these high-cost, high recovery and reset, they can affect performance over longer value assignments. Those assignment-specific correlations time frames: weeks, months, and even years. The committee could then be tested for predictive value with subsequent considered prevention interventions not only in the case of candidates in the same assignment. events occurring over a day or several days that may be risk Recommendation 2. The Army should investigate neuro- factors for acute deficits noticeable immediately, but also in psychological testing of candidates for a training course the case of events responsible for longer-term deficits, such that is already established as a requirement to enter a high- as post-traumatic stress disorder (PTSD) and other chronic value field. In this way the Army can determine whether central nervous system effects of brain trauma. an assignment-specific neuropsychological profile can be developed that has sufficiently high predictive value to use Individual Variability of Soldiers in conjunction with established criteria for the assignment. If results for this investigation are positive, the Army should In conventional Army operations, a central tenet is to investigate development of assignment-specific profiles for emphasize a common level of operational readiness and per- additional assignments. formance across individuals as the basis for unit effectiveness rather than individual readiness and performance. Neverthe- less, individual soldiers do vary not only in their baseline optimizing decision making optimum performance—that is, performance not degraded In the past few decades, the boundaries of the behav- by sustained stressors—but also in their response to stressors ioral sciences have expanded to incorporate advances in our that, on average, cause less-than-optimal performance (per- knowledge of psychology, neuroscience, and economics. formance deficits). In the case of high-value assignments These advances cross the hierarchical levels of neuroscience, that are very dependent on exceptionally high-performing offering powerful new tools for understanding and improving individuals, such as assignments to Special Operations decision making. forces, the Army already acknowledges and takes advantage of individual variability to achieve its objectives. Conclusion 3a. Human decision making is predictably Conclusion 4. An important lesson from neuroscience is inefficient and often suboptimal, especially when the decisions require assessments of risk and are made under pressure. that the ability to sustain and improve performance can be Conclusion 3b. Individuals differ in their approach to increased by identifying differences in individual soldiers and making decisions. For example, some individuals are more using individual variability to gauge optimum performance impulsive, while others are more deliberate and less tolerant baselines, responses to performance-degrading stressors, and of risk. These differences do not mean that risk-tolerant indi - responses to countermeasures to such stressors. Recommendation 4. To increase unit performance across viduals are necessarily better or worse decision makers than risk-averse individuals. From an institutional (Army) point the full spectrum of operations, the Army should expand its of view, different decision-making styles can suit different capacity to identify and make use of the individual variability individuals for different tasks, and different tasks may even of its soldiers. The Army should undertake R&D and review require or be better performed by individuals with different its training and doctrine to take best advantage of variations decision-making styles. Neuroscience tools are capable of in the neural bases of behavior that contribute to perfor- discerning these differences in decision-making style. With mance. In particular, it should seek to understand—and use enough research, these tools may become capable of discern- more widely—individual variability in (1) baseline optimal ing neural correlates for the differences. performance, (2) responses to stressors likely to degrade Recommendation 3. The Army should expand its existing optimal performance, and (3) responses to countermeasures research in behavioral and social sciences to include neuro- intended to overcome performance deficits or to interven- science aimed at developing training and assessment tools tions intended to enhance performance above an individual’s for decision makers at all levels in the Army. baseline. Countermeasures to Environmental Stressors sustaining soldier Performance The Army generally views the time frame of sustainment The degradation of a soldier’s performance under sus- in terms of the duration of a single extended operation or tained physical or mental stress is due to both peripheral

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0 CONCLUSIONS AND ReCOMMeNDATIONS Recommendation 7. The Army should establish relation- (e.g., muscular and cardiovascular) systems and the central nervous system (CNS), which are inextricably linked. How- ships with the pharmaceutical industry, the National Insti- ever, we lack sufficient fundamental understanding of how tutes of Health, and academic laboratories to keep abreast these systems interact and how they are influenced by the of advances in neuropharmacology, cellular and molecular environmental stressors to which a soldier is exposed. For neurobiology, and neural development and to identify new example, physical and mental fatigue are commonly believed drugs that have the potential to sustain or enhance perfor- to lead to less-than-optimal performance, but neither is well mance in military-unique circumstances. However, caution enough characterized or understood to provide a scientific must be exercised to ensure that the benefits outweigh any basis for developing countermeasures to both the peripheral unforeseen or delayed side effects. and CNS components of the fatigue. Conclusion 8. Among the neuropharmaceuticals approved Conclusion 5. Current nutritional countermeasures to fatigue by the Food and Drug Administration for specific medi- are based primarily on maintaining cardiovascular and cal indications, a number have potential off-label uses in muscle function—that is, they counteract physical fatigue— sustaining or optimizing performance. However, any com- but they fall short of maintaining brain function—that is, pound, natural or synthetic, that acts on the CNS must be they do not counteract mental fatigue. One reason for this assumed, until proven otherwise, to affect multiple neural is our insufficient understanding of the CNS components of systems. It is therefore essential that specificity of action be stress-induced degradation of performance. demonstrated. Moreover, the risks of unforeseen or delayed Recommendation 5. The Army should increase both the side effects must be considered, particularly before a neuro- pace of and its emphasis on research designed to understand pharmaceutical is widely administered for sustaining or the neural bases of performance degradation under stress, enhancing performance in mission-critical tasks without a including but not limited to deficits commonly attributed to specific medical indication to justify its use. Recommendation 8. Before the Army attempts to employ fatigue, and the interaction of peripheral and CNS factors in responses to stressors. It should apply the results of this neuropharmaceuticals for general sustainment or enhance- research to develop and improve countermeasures such as ment of soldier performance, the Army should undertake nutritional supplements and management of sleep/wake and medically informed evidence-based risk-benefit analyses, rest/wakefulness cycles. including performance and clinical measures to assess overall effects, to ensure that the expected benefits of such Sleep is an active process that plays a fundamental role medication outweigh the risks of negative side effects or in cognitive functions such as consolidating memory and delayed effects. promoting synaptic plasticity. Prolonged sleep deprivation Conclusion 9. The use of new pharmacological agents to interferes with these functions and can thus adversely affect performance. restore function, mitigate pain, or otherwise respond to trauma or facilitate recovery from injury or trauma will be Conclusion 6. Neuroscience is making progress in under- a key contribution of neuroscience in the near to medium standing the essential stages of sleep and their function in term. New, highly specific brain receptors have been identi- normal neural processes. The molecular mechanisms of sleep fied for a number of agents that could have profound effects homeostasis and circadian rhythms are being elucidated. on the brain and nervous system. The effectiveness of these Gene association studies indicate heritable differences in agents, and the reduction of unwanted systemic side effects, sleep patterns that could be taken into account in predicting will be enhanced by technologies that target delivery of the how an individual will respond to sleep deprivation. pharmacological agent to a specific site. Targeting of drugs Recommendation 6. Since many abilities affected by sleep to enhance an ability such as situational awareness is techni- deprivation—vigilance, memory, and perceptual discrimina- cally feasible, but it may be proscribed by societal and ethi- tion, for example—are increasingly important elements of cal norms and is subject to the caveats on pharmacological soldier performance, the Army should increase its efforts to enhancement of behavior or performance that the committee collaborate with the lead laboratories involved in physiologi- discussed in Chapters 5 and 6. Recommendation 9. The Army should support research cal and molecular research on sleep. on novel mechanisms for noninvasive, targeted delivery of pharmacological agents to the brain and nervous system in Pharmaceutical Countermeasures to the course of medical interventions to mitigate the adverse Performance Degradation effects of physical injury to the brain or another portion of Conclusion 7. Advances in neuroscience are enabling the the nervous system. In the near to medium term, this research pharmaceutical industry to develop drugs that act on novel should focus on restoring a performance deficit to baseline targets to affect mood, motivation, memory, and executive function rather than enhancing performance beyond that function. baseline.

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02 OPPORTUNITIeS IN NeUROSCIeNCe fOR fUTURe ARMY APPLICATIONS Trauma-Induced Stress Disorders, on a single approach. Army research opportunities should Including Response to Brain Injury foster peer-reviewed competition and the synergism of col- laboration across subdisciplines and approaches. Conclusion 10. Neuroscience research has identified risk Conclusion 13. Neuroergonomics, an emerging field within factors associated with the development of PTSD and related the broader field of brain–machine interfaces, explores the stress disorders. The evidence is increasing that these stress ability of the brain to directly control systems by means that disorders are more common among soldiers than was for- go beyond the usual human effector system (hands and the merly believed. voice). This is accomplished by structuring the brain’s output Recommendation 10. The Army should support continued as a signal that can be transduced into an input to an external research on the identification of risk factors for the devel- machine, electronic system, computer, semiautonomous air or opment of post-traumatic stress disorder (PTSD). This ground vehicle, and the like. The Army Research Laboratory research could inform interventions that mitigate the risk is now exploring the potential benefits of neuroergonomics. for PTSD and related stress disorders, thereby lessening In the Army context, the goal of neuroergonomics is to facili- the performance deficits and disability resulting from these tate a soldier–system symbiosis that measurably outperforms disorders. conventional human–system interfaces. Recommendation 13. The Army should continue its focus Conclusion 11. A blast may cause unique brain injuries on neuroergonomic research, using measured improvements resulting in persistent deleterious effects on mood, motiva- in performance over selected conventional soldier–system tion, and cognition. These effects are likely to undermine the interfaces as the metric to evaluate the potential of neuro- resilience of the soldiers who experience them by degrading physiology and other neuroscience disciplines in Army- their performance and to detract from the unit morale that relevant R&D for improving cognitive and behavioral is so essential for effective reset and recovery following performance. combat operations. Although improved protective materials and headgear (helmet) configurations might help, body recommeNdaTioNs oN NeuroscieNce armor improvements seem unlikely to resolve most of the TechNoloGy develoPmeNT persistent neurological effects. Medication and other neuro- physiological remediation, starting with immediate postblast In Chapter 7, the committee identified and assessed care, are likely to have a much more profound effect than cutting-edge, high-payoff technology opportunities, emphasiz- further improvements to body and head armor. ing their potential value for Army applications. Technologies Recommendation 11. The Army should apply the rapidly were evaluated first with respect to their ability to enable Army advancing understanding of the acute neuropathology of missions (these were called mission-enabling technologies) blast-induced traumatic brain injury, including the delayed and then with respect to their ability to support neuroscience neuropsychiatric effects of injuries as well. Mitigation research of high relevance to Army applications (these were strategies should include immediate postblast care using called research-enabling). Sometimes, a technology is both medication and/or other neuroprotective approaches proven mission enabling and research enabling, but in all cases, it to reduce the risk and severity of performance degradation. must be capable of being scientifically validated. The Army should also continue its research in protective To arrive at opportunities it could recommend for Army body armor. investment, the committee considered not only the potential value of the technologies to the Army but also the time frame improving cognitive and Behavioral Performance for developing an initial operational capability and the extent of external investment that the Army could leverage. In this Conclusion 12. Increased vigilance and enhanced perceptual way it came up with a set of “high-priority” technology discrimination, such as being able to recognize salient fea- opportunities it believed would have the greatest potential for tures or patterns, are inherently valuable to military missions. high payoffs in Army applications and best deserved Army Research in a number of neuroscience subdisciplines, includ- investment. It also identified a second set of “priority” oppor- ing computational neuroscience, systems neuroscience, and tunities that could augment the first set, and a third set whose neuroergonomics, could lead to significant improvements progress should be monitored for future consideration. in the skills and capabilities of soldiers and officers along these lines. Conclusion 14. Table 7-1 lists the set of opportunities in Recommendation 12. T he Army should structure its neuroscience technology development that the committee announcements of opportunities for research to draw broadly believes are a high priority for Army investments. It is criti- on multiple scientifically sound approaches to improving cal that the emerging technology development pursued by cognitive and behavioral performance, extending across the the Army be subjected to rigorous scientific and operational entire spectrum of neuroscience research rather than relying validation.

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0 CONCLUSIONS AND ReCOMMeNDATIONS Recommendation 14. The Army should invest in the high- four trends in neuroscience research likely to one day yield priority technology opportunities listed in Table 7-1. The opportunities of great benefit to the Army: investments should initially include long-term (5 or more • Discovering and validating biomarkers for neural years) commitments to each opportunity. states linked to soldiers’ performance outcomes. • Using individual variability to optimize unit Conclusion 15. Table 7-2 lists additional opportunities in neuroscience that the committee recommends for Army performance. • Recognizing opportunities from the vertical integra- investment. The committee views these opportunities as supplementing those in Table 7-1 and as deserving of some- tion of neuroscience levels. • Gaining new insights into the behaviors of what less R&D funding, to at least explore their potential applications. adversaries. Recommendation 15. The Army should consider limited investments (2 or 3 years for the initial commitment) in the These pursuits for research will continue to revolu- technology opportunities listed in Table 7-2. Evaluation of tionize our understanding of the embodied mind and foster the results for each initial investment combined with assess- practical applications in civilian, commercial, and military ment of outside progress in the field should guide decisions affairs. on whether to continue the funding for additional periods. Conclusion 16. Neuroscience research and applications are advancing at a lightning pace. To assess on a continuing basis overarchiNG recommeNdaTioNs the potential of these advances on many fronts and to make The preceding 15 recommendations respond directly sound decisions for funding priorities based on them, the to one or more items in the statement of task for the com - Army needs a reliable way to monitor progress in areas of mittee. In reflecting on the feasibility of actually imple - nonmilitary neuroscience research and technology develop- menting these recommendations, the committee found two ment. Direct Army investment in these areas will probably crosscutting issues that go beyond any particular request not be warranted unless an Army-unique application of sub- in the statement of task but that the Army must address stantial value emerges. Nonetheless, the Army should stay if the potential value of neuroscience is to be tapped in a abreast of what is happening and have mechanisms in place substantial way. to leverage the research results and adapt new technology to Army applications. Recommendation 16. The Army should establish a group a mechanism for monitoring New opportunities in consisting of recognized leaders in neuroscience research Neuroscience research and Technology in both the academic and private sectors to track progress in nonmilitary neuroscience R&D that could be relevant Neuroscience is growing rapidly as discoveries in to Army applications. To ensure that the monitoring group multiple fields are linked to our expanding knowledge and remains sensitive to and abreast of Army needs, the member- understanding of brain functions. This expansion of neuro- ship should also include Army civilians and soldiers whose science applications in multiple areas of importance to the backgrounds and interests would suit them for meaningful Army has led to a division of responsibilities for developing participation in the group’s deliberations. objectives and implementing neuroscience research among multiple organizations. A more serious problem is that there individual variability as a Future Force multiplier is currently no single point in the Army science and tech- nology structure where progress in neuroscience, construed A number of conclusions drawn by the committee (Con- broadly, is being monitored for potential Army applications clusions 2, 3b, and 4) and Long-Term Trend 2, discussed in and from which coordinating guidance can be disseminated Chapter 8, relate to a common theme emerging from current to the distributed centers of relevant neuroscience-based neuroscience research—namely, that individual differences R&D. The committee views this lack of focus on identifying in behavior, cognition, and performance of skilled tasks are and leveraging the rapid advances in neuroscience, together as deeply rooted in the neural structure of individuals as with the dispersion of largely isolated R&D activities, as the differences in strength, stamina, height, or perceptual acuity most significant barrier to implementation of the specific are rooted in physiology. This common theme offers great recommendations presented above. opportunity to the future Army. In addition to the specific technology development Conclusion 17. Neuroscience is establishing the role that opportunities for Army investment listed in Tables 7-1 and 7-2, the committee identified future opportunities where neural structures play in the individual variability observed external progress in neuroscience R&D needs to be moni- in cognition, memory, learning behaviors, resilience to tored by the Army (Table 7-3). The committee also identified stressors, and decision-making strategies and styles. Dif-

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0 OPPORTUNITIeS IN NeUROSCIeNCe fOR fUTURe ARMY APPLICATIONS Recommendation 17. Using insights from neuroscience on ferences from one soldier to the next have consequences for most of the Army applications discussed in this report. the sources and characteristics of individual variability, the Individual variability influences operational readiness and Army should consider how to take advantage of variability the ability of military units to perform assigned tasks opti- rather than ignoring it or attempting to eliminate it from a mally, but it is in many ways at odds with the conventional soldier’s behavior patterns in performing assigned tasks. The approach of training soldiers to be interchangeable compo- goal should be to seek ways to use individual variability to nents of a unit. improve unit readiness and performance.