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Neurovascular Coupling in Special Operations Forces Combat Soldiers

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Abstract

The purpose of this study was to investigate how concussion history affects neurovascular coupling in Special Operations Forces (SOF) combat Soldiers. We studied 100 SOF combat Soldiers [age = 33.5 ± 4.3 years; height = 180.4 ± 6.0 cm; 55 (55.0%) with self-reported concussion history]. We employed transcranial Doppler (TCD) ultrasound to assess neurovascular coupling (NVC) via changes in posterior cerebral artery (PCA) velocity in response to a reading and a visual search task. Baseline TCD data were collected for 2 min. NVC was quantified by the percent change in overall PCA response curves. We employed linear mixed effect models using a linear spline with one knot to assess group differences in percent change observed in the PCA velocity response curves between SOF combat Soldiers with and without a concussion history. Baseline PCA velocity did not significantly differ (t98 = 1.28, p = 0.20) between those with and without concussion history. Relative PCA velocity response curves did not differ between those with and without a concussion history during the reading task (F1,98 = 0.80, p = 0.37) or the visual search task (F1,98 = 0.52, p = 0.47). When assessing only SOF combat Soldiers with a concussion history, differential response to task was significantly greater in those with 3 or more concussions (F1,4341 = 27.24, p < 0.0001) relative to those with 1–2 concussions. Despite no main effect of concussion history on neurovascular coupling response in SOF combat Soldiers, we observed a dose-response based on lifetime concussion incidence. While long-term neurophysiological effects associated with head impact and blast-related injury are currently unknown, assessing NVC response may provide further insight into cerebrovascular function and overall physiological health.

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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 at Chapel Hill 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 Shane Larson, LTC Kane Morgan, MSG Zac Prengler, SGM John Sims, MSG Daniel Carver, and SGM Lance Doody for assistance with the study and dissemination.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

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

    Patricia R. Roby, Jamie P. DeCicco, Avinash Chandran, Nikki 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 Barczak-Scarboro & Jason P. Mihalik

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

    Avinash Chandran

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

    Stephen M. DeLellis

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

    Cassie B. Ford

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

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

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

    Shawn F. Kane

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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., DeCicco, J.P., Chandran, A. et al. Neurovascular Coupling in Special Operations Forces Combat Soldiers. Ann Biomed Eng 49, 793–801 (2021). https://doi.org/10.1007/s10439-020-02604-y

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