Opportunities in Neuroscience for Future Army Applications (2009)

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Summary Emerging neuroscience opportunities have great poten- medicine, and in training specialties such as memory and tial to improve soldier performance and enable the develop- learning, assessment, decision making, prediction, and read- ment of technologies to increase the effectiveness of soldiers ing intentionality. The short biographies of the committee on the battlefield. Advances in research and investments by members, given in Appendix A, include their specialties. the broader science and medical community promise new Early briefings on the scope of Army research in insights for future military applications. These include tradi- neuro­science provided the basis for dividing the committee tional areas of interest to the Army, such as learning, ­decision into data-gathering teams. The committee’s meetings and making, and performance under stress, as well as new areas, data-gathering activities are described in Appendix B. The such as cognitive fitness, brain–computer interfaces, and various streams of information were brought together and a biological markers of neural states. consensus was reached on the conclusions and recommenda- Advances in research-enabling technologies, such as tions of the report. The information gathered by the teams is functional magnetic resonance imaging (fMRI) and compu- organized into chapters on training and learning, optimizing tational neuroscience, have resulted in instrumentation and decision making, sustaining soldier performance, improving techniques that can better assess the neural basis of cogni- cognitive and behavioral performance, neuroscience technol- tion and allow the visualization of brain processes. These ogy opportunities, and long-term trends. advances have the potential to provide new measures of The committee was tasked to identify research and training and learning for soldiers while also shedding fresh technology development opportunities and to recommend light on the traditional approaches to behavioral science used those worthy of investment in the near, medium, and far by the Army. Most current Army neuroscience research is terms. High-payoff research opportunities are provided as conducted with little regard given to its longer-term potential Recommendations 1 through 15. The topics considered to for military operations. The report discusses a spectrum of be technology development opportunities were judged high ongoing efforts, with an emphasis on nonmedical applica- priority (Table S-1), priority (Table S-2), and worthy of tions and on current research that is likely to lead to insights monitoring for possible future implementation (Table S-3). and opportunities for possible military application. The committee considered all topics in Tables S-1 and S-2 worthy of immediate investment. Prioritization of the oppor- tunities within the “high-priority” group and the “priority” Study Approach group is dependent on the relative importance to the Army The Assistant Secretary of the Army (Acquisition, of the particular applications served by the topics. Logistics, and Technology) (ASAALT) asked the National The committee’s consensus was that in the near term Research Council to conduct a study of neuroscience in terms the Army would benefit primarily from advances in cogni- of its potential to support military applications. Chapter 1 tive neuroscience—education, assessment, and training, discusses the statement of task and explains how the report as ­ described in Chapters 3-6. Advances in molecular and responds to each of the tasks. c ­ ellular neuroscience were not judged likely to have as much Members of the Committee on Opportunities in Neuro- impact on Army operations, and the chance that advances science for Future Army Applications, set up in response to in systems neuroscience would have an impact was quite the ASAALT request, had expertise not only in traditional remote. In addition, the committee considered that non­ and emerging subdisciplines of neuroscience but also in invasive, technology-based research would be the most likely r ­ esearch and development (R&D), in military operations and to lead to discernible Army applications in the time frame  

 OPPORTUNITIES IN NEUROSCIENCE FOR FUTURE ARMY APPLICATIONS 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 Field-deployable biomarkers of neural state x x Ongoing L M In-helmet EEG for brain–machine interface x x Medium term M L Signal processing and multimodal data fusion, including imaging x x Ongoing M H modalities such as MRI, fMRI, DTI, DSI, PET, and MEG and physiological measures such as heartbeat, interbeat intervals, GSR, optical computer recognition, eye tracking, and pupilometry. Soldier models and biomarkers for sleep x Ongoing M M Vertical fMRI x Medium term L L Fatigue prediction models x Medium term L M Behavioral measures of fatigue x Medium term M L Prospective biomarkers for predictive measures of soldier response to x x Medium term L L environmental stress, including hypoxic and thermal challenges NIRS/DOT x x Medium term L L Biomedical standards and models for head impact protection, including x x Medium term M M torso protection from blast Threat assessment augmentation x Medium term M M fMRI paradigms of military interest x Ongoing L 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 RE Time Framea Commercial Academic Haptic feedback with VR x Medium term H L Augmented reality (virtual overlay onto real world) x x Medium term H H In-helmet EEG for cognitive state detection and threat assessment x x Medium term L M Information workload management x Far term L M Time-locked, in-magnet VR and monitoring for fMRI x Medium term L M Immersive, in-magnet VR x Near term L M EEG physiology x x Far term L H Uses of TMS for attention enhancement x Medium term L M In-vehicle TMS deployment x Far term L L Heartbeat variability x x Near and medium term L H Galvanic skin response x x Near and medium term 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. of the study (5-20 years); however, R&D in a few areas of are essential if the Army is to engage the opportunities in neuroscience might well have enough potential that the Army neuroscience effectively. Recommendation 16 concerns the should assemble a group of experts charged with monitoring establishment of a mechanism to monitor advances in a wide progress on multiple fronts. range of neuroscience disciplines in order to stay abreast In addition to the 15 recommendations that respond to of new developments and select for further pursuit those points in the statement of task, the committee offers two most promising for Army applications. Recommendation 17 overarching recommendations, 16 and 17, which it believes e ­ ncourages the Army to examine how to use to its advantage 

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 RE Time Framea Commercial Academic Brain–computer interface system (direct) x Far term H H Imaging cognition x Far term L H Neuropharmacological technology x Far term M M Advanced fMRI data collection x Medium term M M Averaging methodology for fMRI x Medium term L M Brain database aggregation x Far term M M Default mode networks x x Medium term L H Inverse MRI x Medium term L M Low-field MRI x x Far term L M Uses of TMS for brain network inhibition x Far term L M Safety of multiple exposures to TMS x Medium term M M In-helmet TMS deployment x Far term L L Connectomics x Far term L M Atomic magnetometers x x Far term 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 dimen- In particular, these indicators should be employed in identi- sion that are emerging from neuroscience. fying individual variability in learning and tailoring training regimens to optimize individual learning. Opportunities in Army Applications Areas The Army currently relies heavily on broad, general Opportunities exist for the Army to benefit from research indicators of aptitude to predict training effectiveness and in neuroscience by applying and leveraging the results of individual success rates. The importance of predicting work by others (including academic research and R&D by s ­ uccess rates of soldiers before assigning them to given tasks other federal agencies and the commercial sector) or by increases with the cost of training for the task and with the making selective investments in Army-specific problems consequences of not performing the task well. In comparison and applications. with the indicators that have been developed for assessing how well skills or knowledge have been acquired, neurologi- cal predictors of soldier performance need much R&D before Training and Learning they will be ready for Army applications. Neuroscience can extend and improve the Army’s traditional behavioral science approaches to both training Recommendation 2. The Army should investigate neuro- and learning. For example, neuroscience offers new ways psychological testing of candidates for a training course to assess how well current training paradigms and accepted that is already established as a requirement to enter a high- assumptions about learning achieve their objectives. Neuro­ value field. In this way the Army can determine whether psychological indicators can help to assess how well an an assignment-specific neuropsychological profile can be individual trainee has assimilated mission-critical knowledge developed that has sufficiently high predictive value to use and skills. These assessment tools also will allow the Army in conjunction with established criteria for the assignment. to assess individual variability and tailor training regimens If results for this investigation are positive, the Army should to the individual trainee. investigate development of assignment-specific profiles for additional assignments. Recommendation 1. The Army should adjust its research capabilities to take advantage of the current and emerging Optimizing Decision Making advances in neuroscience to augment, evaluate, and extend its approaches to training and learning. Indicators of knowl- Human decision making is predictably inefficient and edge and skill acquisition based in neuroscience should be often suboptimal, especially when the decisions require incorporated into the methods of testing for training success. assess­ments of risk and are made under pressure. Indi- 

 OPPORTUNITIES IN NEUROSCIENCE FOR FUTURE ARMY APPLICATIONS viduals also differ in their approach to making decisions. of its soldiers. The Army should undertake R&D and review For exam­ple, some individuals are more impulsive, while its training and doctrine to take best advantage of variations others are more deliberate and less tolerant of risk. These in the neural bases of behavior that contribute to perfor- differences do not mean that risk-tolerant individuals are mance. In particular, it should seek to understand—and use necessarily better or worse decision makers than risk-averse more widely—individual variability in (1) baseline optimal indi­viduals. From an institutional (Army) point of view, dif- performance, (2) responses to stressors likely to degrade ferent ­decision-making styles can suit different individuals optimal performance, and (3) responses to countermeasures for different tasks. That is to say, a given task may require intended to overcome performance deficits or to interven- or be better performed by an individual with a particular tions intended to enhance performance above an individual’s decision-­making style. With research, neuroscience tools baseline. may become capable of discerning neural correlates for dif- ferences in decision-making style. Countermeasures to Environmental Stressors Recommendation 3. The Army should expand existing The degradation of performance during sustained research in behavioral and social sciences to include neuro- p ­ eriods of physical or mental stress results from both science aimed at developing training and assessment tools p ­ eripheral system (e.g., muscle and cardiovascular) and CNS for decision makers at all levels in the Army. factors, which are inextricably linked. However, we lack sufficient fundamental understanding of how these factors interact and how they are influenced by the range of envi- Sustaining Soldier Performance ronmental stressors to which soldiers engaged in sustained The committee reviewed neuroscience applications operations are exposed. For example, physical and mental related to understanding, monitoring, and preventing or fatigue, commonly assumed to result in less-than-optimal treating deficits in soldier performance. These deficits may performance, are neither well enough defined nor sufficiently affect performance during a single extended operation or well understood to provide a scientific basis for developing over much longer time frames. The report considered pre- effective countermeasures to both the CNS and peripheral vention interventions relevant to acute deficits noticeable components. immediately within the time frame of a day or days as well Current nutritional countermeasures to fatigue are based as longer-term deficits such as post-traumatic stress disorder primarily on maintaining cardiovascular and muscle func- (PTSD) and other chronic effects of brain trauma on the tion, but they fall short of addressing the important role of central nervous system (CNS). nutrition in brain functioning affected by fatigue. One reason for this shortfall is insufficient understanding of the CNS factors that are linked to the stress-induced degradation of Individual Variability of Soldiers performance, including those deficits commonly attributed Conventional Army operations emphasize common to physical and/or mental fatigue. levels of operational readiness and performance among individuals rather than individual variability as the basis Recommendation 5. The Army should increase both the for unit effectiveness. Nevertheless, individual soldiers pace of and its emphasis on research designed to understand do vary, not only in their baseline optimum performance the neural bases of performance degradation under stress, (i.e., performance not degraded by sustained stressors) but including but not limited to deficits commonly attributed to also in their response to stressors that frequently lead to fatigue, and the interaction of peripheral and CNS factors less-than-optimal performance (performance deficits). The in responses to stressors. It should apply the results of this Army ­ acknowledges and uses individual variability to its research to develop and improve countermeasures such as advantage to achieve desired objectives for some high-value nutritional supplements and management of sleep/wake and assignments that are very dependent on exceptionally high- rest/wakefulness cycles. performing individuals, such as in Special Operations. An important lesson from neuroscience is that the abil- Sleep is an active process that plays a fundamental role ity to sustain and improve performance can be increased by in cognitive functions such as consolidating memory and identifying differences in individual soldiers and using indi- promoting synaptic plasticity. Prolonged sleep deprivation vidual variability to gauge optimum performance baselines, interferes with these functions and can thus adversely affect responses to performance-degrading stressors, and responses performance. to countermeasures to such stressors. Recommendation 6. Since many abilities affected by sleep Recommendation 4. To increase unit performance across deprivation—vigilance, memory, and perceptual discrimina- the full spectrum of operations, the Army should expand its tion, for example—are increasingly important elements of capacity to identify and make use of the individual variability soldier performance, the Army should increase its efforts to 

SUMMARY  collaborate with the lead laboratories involved in physiologi- 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 the course of medical interventions to mitigate the adverse Pharmaceutical Countermeasures to effects of physical injury to the brain or another portion of Performance Degradation the nervous system. In the near to medium term, this research Advances in neuroscience are enabling the pharmaceu- should focus on restoring a performance deficit to baseline tical industry to develop drugs that act on novel targets to function rather than enhancing performance beyond that affect mood, motivation, memory, and executive function. baseline. Recommendation 7. The Army should establish relation- Trauma-Induced Stress Disorders, ships with the pharmaceutical industry, the National Insti- Including Response to Brain Injury tutes of Health, and academic laboratories to keep abreast of advances in neuropharmacology, cellular and molecular Resilience refers to the ability to successfully adapt to neurobiology, and neural development and to identify new stressors, maintaining psychological well-being in the face of drugs that have the potential to sustain or enhance perfor- adversity. Neuroscience research has identified biomarkers mance in military-unique circumstances. However, caution for resilience, and studies have identified several attitudes must be exercised to ensure that the benefits outweigh any and behaviors that foster psychological resilience to stress. unforeseen or delayed side effects. Neuroscience has also identified risk factors associated with the development of PTSD. Evidence is increasing that Among the neuropharmaceuticals approved by the Food stress disorders, including PTSD, are more common among and Drug Administration for specific medical indications, a soldiers than formerly believed. number have potential off-label uses in sustaining or opti- The statement of task for the study specifically requested mizing performance. However, any compound, natural or that the study not emphasize medical applications, so the synthetic, that acts on the CNS must be assumed, until proven committee focused on PTSD/TBI research that could be otherwise, to affect multiple neural systems. It is therefore leveraged for nonmedical applications and that could lead essential that specificity of action be demonstrated. Second, to ­ increased understanding of issues other than medical the risks of unforeseen or ­delayed side effects must be con- treatment per se. Nevertheless, the growing recognition that sidered, particularly before a neuro­pharmaceutical is widely minimal to moderate brain traumas have chronic effects has administered for sustaining or enhancing performance in long-term implications for future care requirements and mission-critical tasks without specific medical indication to asso­ciated costs. Neuroscience research into immediate care justify its use. in combat areas, rehabilitation, new pharmaceutical treat- ments, and diagnostic tools can provide solutions to these Recommendation 8. Before the Army attempts to employ problems. neuropharmaceuticals for general sustainment or enhance- ment of soldier performance, the Army should undertake Recommendation 10. The Army should support continued medically informed evidence-based risk-benefit analyses, research on the identification of risk factors for the devel­ including performance and clinical measures to assess opment of post-traumatic stress disorder (PTSD). This overall effects, to ensure that the expected benefits of such research could inform interventions that mitigate the risk medication outweigh the risks of negative side effects or for PTSD and related stress disorders, thereby lessening delayed effects. the performance deficits and disability resulting from these disorders. Use of new pharmacological agents to restore func- tion, mitigate pain or other responses to trauma, or facilitate Neuroscience research has identified risk factors asso­ r ­ ecovery from injury or trauma will be a key application for ciated with the development of PTSD and related stress new neuroscience technology in the near to medium term. dis­orders. The evidence is increasing that these stress dis- Highly specific brain receptor targets have been identified orders are more common among soldiers than was formerly for a number of agents, and the effectiveness of these agents believed. will be greatly enhanced by technologies that target delivery of the pharmacological agent to a specific site. The use of Recommendation 11. The Army should apply the rapidly targeted drug delivery to enhance performance, such as situ- advancing understanding of the acute neuropathology of ational awareness, is technically feasible, but such uses may blast-induced traumatic brain injury, including the delayed be proscribed by societal and ethical norms. neuropsychiatric effects of injuries as well. Mitigation strategies should include immediate postblast care using medication and/or other neuroprotective approaches proven 

 OPPORTUNITIES IN NEUROSCIENCE FOR FUTURE ARMY APPLICATIONS to reduce the risk and severity of performance degradation. operational capability and the extent of external investment The Army should also continue its research in protective interest that the Army could leverage. Table S-1 lists the body armor. committee’s recommended high-priority opportunities for Army investments in neuroscience. Improving Cognitive and Behavioral Performance Recommendation 14. The Army should invest in the high- Increased vigilance and enhanced perceptual discrimi- priority technology opportunities listed in Table S-1. The nation, such as being able to recognize salient features or investments should initially include long-term (5 or more patterns, are inherently valuable to military missions. years) commitments to each opportunity. R ­ esearch in a number of neuroscience subdisciplines, includ- ing computational neuroscience, systems neuroscience, and Table S-2 lists “priority” technology development oppor­ neuroergonomics, could lead to significant improvements in tunities that the committee recommends for limited Army the cognitive skills of the soldiers and officers conducting investment. The committee viewed these opportunities as sup- Army operations. plementing those in Table S-1 and recommended providing limited funding for R&D to explore potential applications. Recommendation 12. The Army should structure its announce­ments of opportunities for research to draw broadly Recommendation 15. The Army should consider limited on multiple scientifically sound approaches to improving investments (2 or 3 years for the initial commitment) in the cognitive and behavioral performance, extending across the technology opportunities listed in Table S-2. Evaluation of entire spectrum of neuroscience research rather than relying the results for each initial investment combined with assess- on a single approach. Army research opportunities should ment of outside progress in the field should guide decisions foster peer-reviewed competition and the synergism of col- on whether to continue the funding for additional periods. laboration across subdisciplines and approaches. OverArching recommendationS Neuroergonomics, which is an emerging field within the broader field of brain–machine interfaces, explores the abil- The committee found two crosscutting issues that go ity of the brain to directly control systems beyond traditional beyond any particular request in the statement of task but human effector systems (hands and voice) by structuring the that must be addressed by the Army if the potential benefits brain’s output as a signal that can be transduced into a control of neuroscience are to be fully realized. input to an external system (a machine, electronic system, computer, semiautonomous air or ground vehicle, etc.). The A Mechanism for Monitoring New Opportunities Army Research Laboratory is now exploring the potential in Neuroscience Research and Technology benefits of neuroergonomics. In the Army context, the goal of neuroergonomics is to facilitate a soldier–system symbiosis The committee could find no single place in the Army that measurably outperforms conventional human–system science and technology structure from which progress in interfaces. neuroscience, construed broadly, is being monitored for ­ potential application by the Army and from which coordinat- Recommendation 13. The Army should continue its focus on ing guidance can be disseminated to centers of neuroscience- neuroergonomic research, using measured improvements in relevant R&D around the country. This failure to identify and performance over selected conventional soldier–system inter­ leverage advances in neuroscience is the most significant faces as the metric to evaluate the potential of neuro­physiology barrier to implementation of the 15 recommendations and and other neuroscience disciplines in Army-relevant R&D for is exacerbated by the diffusion of much of the R&D taking improving cognitive and behavioral performance. 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 Technology Development Opportunities that the Army needs to monitor for progress. Additionally, The committee identified and assessed cutting-edge and the committee also identified four important trends in neuro­ high-payoff technology opportunities, emphasizing their science research: potential value for Army applications. Technologies were categorized as mission-enabling (directly enabling Army mis- • Discovering and validating biomarkers for neural sion areas), research-enabling (supporting neuroscience-based states linked to soldiers’ performance outcomes. research of high relevance to Army applications), or both. • Using individual variability to optimize unit To arrive at a set of high-priority investments, the com- performance. mittee assessed not only the potential value of prospective • Recognizing opportunities from the vertical integra- opportunities but also the time frame for developing an initial tion of neuroscience levels. 

SUMMARY  • Gaining new insights into the behaviors of that offers great potential for increasing Army capabilities. adversaries. Recommendations 2 (on training), 3 (on decision making), and 4 (on soldier stress response) all point to a larger theme Opportunities arising from the four research trends— that is emerging from current neuroscience research: Indi- and the many others yet to surface—will continue to revolu- vidual differences in behavior, cognition, and performance tionize our understanding of the embodied mind and foster of skilled tasks are as deeply rooted in the neural structure practical applications in civilian, commercial, and military of individuals as differences in strength, stamina, height, or affairs. perceptual acuity are rooted in their physiology. This com- Neuroscience research and applications are advanc- mon theme, as it pertains to opportunities for the Army to ing at a lightning pace, and the Army needs a reliable way apply neuroscience, is explicitly explored in Chapter 8 of to monitor progress in areas of nonmilitary neuroscience the report as a significant long-term research trend: using research and technology development. Direct Army invest- individual variability to optimize unit performance. ment in these areas will probably not be warranted unless Neuroscience is establishing the role that neural struc- an Army-unique application of substantial value emerges. tures play in the individual variability observed in cognition, Nonetheless, the Army should stay abreast of what is hap- memory, learning behaviors, resilience to stressors, and pening in these areas and have mechanisms in place to decision-making strategies and styles. Individual differences leverage the research results and adapt new technology for among soldiers have consequences for many Army applica- Army applications. tions and can influence operational readiness and the ability of Army units to perform assigned tasks optimally. Individual Recommendation 16. The Army should establish a group variability is in many ways at odds with the conventional consisting of recognized leaders in neuroscience research a ­ pproach of training soldiers to be interchangeable compo- in both the academic and private sectors to track progress nents of a unit. in nonmilitary neuroscience R&D that could be relevant to Army applications. To ensure that the monitoring group Recommendation 17. Using insights from neuroscience on remains sensitive to and abreast of Army needs, the member- the sources and characteristics of individual variability, the ship should also include Army civilians and soldiers whose Army should consider how to take advantage of the variabil- backgrounds and interests would suit them for meaningful ity rather than ignoring it or attempting to eliminate it from participation in the group’s deliberations. a soldier’s behavior patterns in performing assigned tasks. The goal should be to seek ways to use individual variability to improve unit readiness and performance. Individual Variability as a Future Force Multiplier A number of the recommendations reflect a common theme that may challenge traditional Army approaches but