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Opportunities in Neuroscience for Future Army Applications
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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forming high-cost, high-value Army assignments do not have neuropsychological, psychophysiological, neurochemical, or neurogenetic components. As a first step toward using insights from these and other neuroscience-related fields, results from relatively simple neuropsychological testing could be empirically tested to seek correlations with successful performance in one or more of these high-cost, high value assignments. Those assignment-specific correlations could then be tested for predictive value with subsequent candidates in the same assignment.
Recommendation 2. The Army should investigate neuropsychological testing of candidates for a training course that is already established as a requirement to enter a high-value 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
In the past few decades, the boundaries of the behavioral sciences have expanded to incorporate advances in our knowledge of psychology, neuroscience, and economics. These advances cross the hierarchical levels of neuroscience, offering powerful new tools for understanding and improving decision making.
Conclusion 3a. Human decision making is predictably inefficient and often suboptimal, especially when the decisions require assessments of risk and are made under pressure.
Conclusion 3b. Individuals differ in their approach to making decisions. For example, some individuals are more impulsive, while others are more deliberate and less tolerant of risk. These differences do not mean that risk-tolerant individuals are necessarily better or worse decision makers than risk-averse individuals. From an institutional (Army) point of view, different decision-making styles can suit different individuals for different tasks, and different tasks may even require or be better performed by individuals with different decision-making styles. Neuroscience tools are capable of discerning these differences in decision-making style. With enough research, these tools may become capable of discerning neural correlates for the differences.
Recommendation 3. The Army should expand its existing research in behavioral and social sciences to include neuroscience aimed at developing training and assessment tools for decision makers at all levels in the Army.
Sustaining Soldier Performance
The Army generally views the time frame of sustainment in terms of the duration of a single extended operation or action—typically up to 96 hours. In Chapter 5, the committee reviewed neuroscience applications related to understanding, monitoring, and preventing or treating deficits in soldier performance. These deficits may occur during a single extended operation, or, when they are associated with Army concepts such as individual soldier resiliency and unit-level recovery and reset, they can affect performance over longer time frames: weeks, months, and even years. The committee considered prevention interventions not only in the case of events occurring over a day or several days that may be risk factors for acute deficits noticeable immediately, but also in the case of events responsible for longer-term deficits, such as post-traumatic stress disorder (PTSD) and other chronic central nervous system effects of brain trauma.
Individual Variability of Soldiers
In conventional Army operations, a central tenet is to emphasize a common level of operational readiness and performance across individuals as the basis for unit effectiveness rather than individual readiness and performance. Nevertheless, individual soldiers do vary not only in their baseline optimum performance—that is, performance not degraded by sustained stressors—but also in their response to stressors that, on average, cause less-than-optimal performance (performance deficits). In the case of high-value assignments that are very dependent on exceptionally high-performing individuals, such as assignments to Special Operations forces, the Army already acknowledges and takes advantage of individual variability to achieve its objectives.
Conclusion 4. An important lesson from neuroscience is that the ability to sustain and improve performance can be increased by identifying differences in individual soldiers and using individual variability to gauge optimum performance baselines, responses to performance-degrading stressors, and responses to countermeasures to such stressors.
Recommendation 4. To increase unit performance across the full spectrum of operations, the Army should expand its capacity to identify and make use of the individual variability of its soldiers. The Army should undertake R&D and review its training and doctrine to take best advantage of variations in the neural bases of behavior that contribute to performance. In particular, it should seek to understand—and use more widely—individual variability in (1) baseline optimal performance, (2) responses to stressors likely to degrade optimal performance, and (3) responses to countermeasures intended to overcome performance deficits or to interventions intended to enhance performance above an individual’s baseline.
Countermeasures to Environmental Stressors
The degradation of a soldier’s performance under sustained physical or mental stress is due to both peripheral
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(e.g., muscular and cardiovascular) systems and the central nervous system (CNS), which are inextricably linked. However, we lack sufficient fundamental understanding of how these systems interact and how they are influenced by the environmental stressors to which a soldier is exposed. For example, physical and mental fatigue are commonly believed to lead to less-than-optimal performance, but neither is well enough characterized or understood to provide a scientific basis for developing countermeasures to both the peripheral and CNS components of the fatigue.
Conclusion 5. Current nutritional countermeasures to fatigue are based primarily on maintaining cardiovascular and muscle function—that is, they counteract physical fatigue—but they fall short of maintaining brain function—that is, they do not counteract mental fatigue. One reason for this is our insufficient understanding of the CNS components of stress-induced degradation of performance.
Recommendation 5. The Army should increase both the pace of and its emphasis on research designed to understand the neural bases of performance degradation under stress, including but not limited to deficits commonly attributed to fatigue, and the interaction of peripheral and CNS factors in responses to stressors. It should apply the results of this research to develop and improve countermeasures such as nutritional supplements and management of sleep/wake and rest/wakefulness cycles.
Sleep is an active process that plays a fundamental role in cognitive functions such as consolidating memory and promoting synaptic plasticity. Prolonged sleep deprivation interferes with these functions and can thus adversely affect performance.
Conclusion 6. Neuroscience is making progress in understanding the essential stages of sleep and their function in normal neural processes. The molecular mechanisms of sleep homeostasis and circadian rhythms are being elucidated. Gene association studies indicate heritable differences in sleep patterns that could be taken into account in predicting how an individual will respond to sleep deprivation.
Recommendation 6. Since many abilities affected by sleep deprivation—vigilance, memory, and perceptual discrimination, for example—are increasingly important elements of soldier performance, the Army should increase its efforts to collaborate with the lead laboratories involved in physiological and molecular research on sleep.
Pharmaceutical Countermeasures to Performance Degradation
Conclusion 7. 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.
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 neuropharmaceutical 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.
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Trauma-Induced Stress Disorders, Including Response to Brain Injury
Conclusion 10. Neuroscience research has identified risk factors associated with the development of PTSD and related stress disorders. The evidence is increasing that these stress disorders are more common among soldiers than was formerly believed.
Recommendation 10. The Army should support continued research on the identification of risk factors for the development of post-traumatic stress disorder (PTSD). This research could inform interventions that mitigate the risk for PTSD and related stress disorders, thereby lessening the performance deficits and disability resulting from these disorders.
Conclusion 11. A blast may cause unique brain injuries resulting in persistent deleterious effects on mood, motivation, and cognition. These effects are likely to undermine the resilience of the soldiers who experience them by degrading their performance and to detract from the unit morale that is so essential for effective reset and recovery following combat operations. Although improved protective materials and headgear (helmet) configurations might help, body armor improvements seem unlikely to resolve most of the persistent neurological effects. Medication and other neurophysiological remediation, starting with immediate postblast care, are likely to have a much more profound effect than further improvements to body and head armor.
Recommendation 11. The Army should apply the rapidly advancing understanding of the acute neuropathology of blast-induced traumatic brain injury, including the delayed neuropsychiatric effects of injuries as well. Mitigation strategies should include immediate postblast care using medication and/or other neuroprotective approaches proven to reduce the risk and severity of performance degradation. The Army should also continue its research in protective body armor.
Improving Cognitive and Behavioral Performance
Conclusion 12. Increased vigilance and enhanced perceptual discrimination, such as being able to recognize salient features or patterns, are inherently valuable to military missions. Research in a number of neuroscience subdisciplines, including computational neuroscience, systems neuroscience, and neuroergonomics, could lead to significant improvements in the skills and capabilities of soldiers and officers along these lines.
Recommendation 12. The Army should structure its announcements of opportunities for research to draw broadly on multiple scientifically sound approaches to improving cognitive and behavioral performance, extending across the entire spectrum of neuroscience research rather than relying on a single approach. Army research opportunities should foster peer-reviewed competition and the synergism of collaboration across subdisciplines and approaches.
Conclusion 13. Neuroergonomics, an emerging field within the broader field of brain–machine interfaces, explores the ability of the brain to directly control systems by means that go beyond the usual human effector system (hands and the voice). This is accomplished by structuring the brain’s output as a signal that can be transduced into an input to an external machine, electronic system, computer, semiautonomous air or ground vehicle, and the like. The Army Research Laboratory is now exploring the potential benefits of neuroergonomics. In the Army context, the goal of neuroergonomics is to facilitate a soldier–system symbiosis that measurably outperforms conventional human–system interfaces.
Recommendation 13. The Army should continue its focus on neuroergonomic research, using measured improvements in performance over selected conventional soldier–system interfaces as the metric to evaluate the potential of neurophysiology and other neuroscience disciplines in Army-relevant R&D for improving cognitive and behavioral performance.
RECOMMENDATIONS ON NEUROSCIENCE TECHNOLOGY DEVELOPMENT
In Chapter 7, the committee identified and assessed cutting-edge, high-payoff technology opportunities, emphasizing 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.
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Recommendation 14. The Army should invest in the high-priority 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 four trends in neuroscience research likely to one day yield opportunities of great benefit to the Army:
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.
Gaining new insights into the behaviors of adversaries.
These pursuits for research will continue to revolutionize our understanding of the embodied mind and foster practical applications in civilian, commercial, and military affairs.
Conclusion 16. Neuroscience research and applications are advancing at a lightning pace. To assess on a continuing basis the potential of these advances on many fronts and to make sound decisions for funding priorities based on them, the Army needs a reliable way to monitor progress in areas of nonmilitary neuroscience research and technology development. Direct Army investment in these areas will probably not be warranted unless an Army-unique application of substantial value emerges. Nonetheless, the Army should stay abreast of what is happening and have mechanisms in place to leverage the research results and adapt new technology to Army applications.
Recommendation 16. The Army should establish a group consisting of recognized leaders in neuroscience research in both the academic and private sectors to track progress in nonmilitary neuroscience R&D that could be relevant to Army applications. To ensure that the monitoring group remains sensitive to and abreast of Army needs, the membership should also include Army civilians and soldiers whose backgrounds and interests would suit them for meaningful participation in the group’s deliberations.
Individual Variability as a Future Force Multiplier
A number of conclusions drawn by the committee (Conclusions 2, 3b, and 4) and Long-Term Trend 2, discussed in Chapter 8, relate to a common theme emerging from current neuroscience research—namely, that individual differences in behavior, cognition, and performance of skilled tasks are as deeply rooted in the neural structure of individuals as differences in strength, stamina, height, or perceptual acuity are rooted in physiology. This common theme offers great opportunity to the future Army.
Conclusion 17. Neuroscience is establishing the role that neural structures play in the individual variability observed in cognition, memory, learning behaviors, resilience to stressors, and decision-making strategies and styles. Dif-
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ferences from one soldier to the next have consequences for most of the Army applications discussed in this report. Individual variability influences operational readiness and the ability of military units to perform assigned tasks optimally, but it is in many ways at odds with the conventional approach of training soldiers to be interchangeable components of a unit.
Recommendation 17. Using insights from neuroscience on the sources and characteristics of individual variability, the Army should consider how to take advantage of variability rather than ignoring it or attempting to eliminate it from 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.
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