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Cerebrovascular Reactivity in Special Operations Forces Combat Soldiers

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Abstract

The purpose of this study was to investigate how concussion history affects cerebrovascular reactivity (CVR) in Special Operations Forces (SOF) combat soldiers. We studied 104 SOF soldiers [age = 33.5 ± 4.3 years; height = 179.7 ± 6.3 cm; 59 (56.7%) with self-reported concussion history]. We employed transcranial Doppler (TCD) ultrasound to measure middle cerebral artery (MCA) velocity. Baseline TCD data were collected for 2 min. Changes in MCA velocity were measured in response to five breath-holding trials and five hyperventilation trials. Cerebrovascular reactivity was quantified by the breath-holding index (BHI), vasomotor reactivity reserve (VMRr), and percent change in overall response curves. Independent t tests were employed to assess group differences in BHI, and VMRr values. We employed mixed effects models with quadratic mean structures to assess group differences in percent change MCA velocity response curves. There were no significant group differences in BHI (t102 = 0.04, p = 0.97) or VMRr (t102 = -0.33, p = 0.75). There were no group differences in relative MCA velocity response curves during the breath-holding task (F1,5092 = 0.19, p = 0.66) or during the hyperventilation task (F1,5092 = 0.41, p = 0.52) between SOF soldiers with and without a self-reported concussion history. If CVR deficits exist immediately post-concussion, our study suggests that these deficits recover over time in this population. While long-term neurophysiological effects of blast-related injury are currently unknown, assessing CVR response may provide further insight into cerebrovascular function and overall physiological health following blast exposure.

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Acknowledgments

This project was funded with contract grant support from the United States Army Special Operations Command (USASOC) to the University of North Carolina at Chapel Hill (Chapel Hill, NC, USA). This work was also supported by funding secured by the Preservation of the Force and Family Program at US Special Operations Command and executed as a subaward issued to the University of North Carolina by the Henry M. Jackson Foundation under a cooperative agreement with the Uniformed Services University. Co-authors DeLellis, Healy, Kane, Lynch, and Means were employed by USASOC for part or all of the study period. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. We would like to thank the research team at the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center for assistance with data collection. We would also like to thank LTC Kane Morgan, SFC Zac Prengler, SGM John Sims, MSG Daniel Carver, and SGM Lance Doody for assistance with the study.

Conflict of interest

The authors have no other conflicts of interest to report.

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Authors and Affiliations

  1. Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, 2207 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC, 27599, USA

    Patricia R. Roby, Avinash Chandran, Nikki E. Barczak-Scarboro, Cassie B. Ford, Shawn F. Kane & Jason P. Mihalik

  2. Curriculum in Human Movement Science, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Patricia R. Roby, Nikki E. Barczak-Scarboro & Jason P. Mihalik

  3. Defense Medical Strategies, LLC, Fayetteville, NC, USA

    Stephen M. DeLellis

  4. United States Army Special Operations Command, Fort Bragg, NC, USA

    Marshall L. Healy, Gary E. Means & James H. Lynch

  5. Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Shawn F. Kane

  6. Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN, USA

    Avinash Chandran

  7. Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA

    Cassie B. Ford

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  1. Patricia R. Roby
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Correspondence to Jason P. Mihalik.

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Associate Editor Joel D Stitzel oversaw the review of this article.

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Roby, P.R., Chandran, A., Barczak-Scarboro, N.E. et al. Cerebrovascular Reactivity in Special Operations Forces Combat Soldiers. Ann Biomed Eng 48, 1651–1660 (2020). https://doi.org/10.1007/s10439-020-02514-z

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