Sep. 1, 2009 New peer-reviewed research on military health issues is being presented this week at the Military Health Research Forum (MHRF), a scientific meeting hosted by the Department of Defense Congressionally Directed Medical Research Programs (CDMRP). The studies focus on topics including potential treatments for spinal cord injury, nutrition's impact on cognitive performance in pilots and the effectiveness of a family-based reintegration program.
The studies are funded by the Peer Reviewed Medical Research Program (PRMRP) or the Psychological Health and Traumatic Brain Injury (PH/TBI) Research Program, both programs managed by the CDMRP. The PRMRP and the PH/TBI program fund research that is relevant to military medical issues; these programs are committed to funding studies that will improve the understanding of disease processes and have a strong impact on the development and implementation of devices, drugs, or clinical guidance that will change the face of diagnosis and treatment for a wide range of clinical applications.
"The research conducted by the PRMRP is very promising in its scope as it can have an impact on the health of not only the military and their families, and the veteran population, but also the American public as a whole," says Captain E. Melissa Kaime, M.D., director of the CDMRP. "This research offers potential solutions to both physical and mental injuries to those who serve our country."
Nutritional Effects on Cognitive Performance
Principal Investigator: Glenda Lindseth, Ph.D., University of North Dakota
Previous research has demonstrated the impact of nutrition on a person's cognitive performance but this study further examines the relationship in a very unique population -- pilots.
To test the effects of diet on cognition and flight performance, Glenda Lindseth, Ph.D., and Paul Lindseth, Ph.D., professors at the University of North Dakota, conducted a clinical study of pilots from a university-based commercial aviation program. Study participants were randomly assigned a rotation of dietary regimens, consisting of high-fat, high-carbohydrate, or high-protein foods. Researchers then evaluated the subjects' flight performance by assigning scores that were determined from flying flight profiles in a full-motion simulator. The Lindseths' research team also used the Sternberg item recognition test and Vandenberg mental rotation test to further evaluate cognitive function.
The team found that overall flight performance scores for pilots who consumed high-fat diets and high-carbohydrate diets were significantly better (p< .05) than pilots who consumed high-protein diets. Analyses indicated that dietary protein intakes, serotonin levels, and irritability scores explained 15 percent of the variance in participants' cognitive flight performance scores. Using the Sternberg test, researchers noticed response times were significantly faster for participants on the high-fat diet, especially at higher memory loads. Pilots on high-protein diets performed significantly worse than pilots on high-fat diets and high-carbohydrate diets. Also interesting, the team found that even a brief manipulation of diet significantly impacted performance on a test of short-term memory.
"These study results contribute significantly to our understanding of the effects diet can have on cognition and performance," says Glenda Lindseth. "With additional research, these findings may help decrease the number of aviation accidents due to pilot error, which is especially important for the warfighter."
Optimal Therapeutic Target for Stereotactic X-Irradiation in Experimental Spinal Cord Injury
Principal Investigator: Richard Zeman, Ph.D.; New York Medical College
Due to the hazardous nature of combat, war veterans represent about 22 percent of spinal cord injury (SCI) cases. While the steroid methylprednisolone is considered the standard treatment aimed at improving function, improvement is modest and the treatment is associated with muscle weakness and immunosuppression. Researchers are seeking new treatments for this debilitating injury that affects predominantly younger soldiers with irreversible paralysis that may last for many decades of life.
Before potential new treatments can be studied with human patients, they must show efficacy in an appropriate animal model of SCI. Preliminary data from research led by Richard J. Zeman, associate professor of cell biology and anatomy at New York Medical College, shows that targeted stereotactic X-irradiation (SXI) of the injury site increased locomotor function following SCI.
The team conducted a trial on SCI-induced rats to determine the proper location and optimal target volume of SXI to improve functional recovery. Because of the precision of SXI, researchers also wanted to determine the optimal region of administration to produce the most effective response in the rats' rehabilitation.
SXI was administered 20 minutes following the injury with a radiation beam centered either at the injury site or within four or eight millimeters in both directions from its location. The team evaluated SXI efficacy on motion recovery, using a locomotor scale, by examining spinal cord function six weeks following treatment of the injury. The greatest increase in locomotor recovery was observed with SXI centered at 4-mm rostral to (above) the point of the injury. This location also resulted in the greatest level of tissue sparing following the procedure.
"These results indicate that SXI in a region several millimeters rostral to the injury is most critical for locomotor recovery," Zeman says. "Optimizing this treatment may lead to a therapeutic modality for spinal cord injuries suitable for use in battlefield conditions."
Post-Deployment Adjustment and Cross-Leveling Concerns of Operation Enduring Freedom and Operation Iraqi Freedom Reserve and National Guard Service Women
Principal Investigator: Anne Gordon Sadler, Ph.D.; VA Medical Center, Iowa City
Women have served in America's military conflicts since the Civil War. Today, nearly 400,000 women serve either through active duty or the reserves and National Guard (R/NG) – making up 16 percent of the total military force. While women have equal rights to serve and deploy with their male counterparts, little is known about women's combat experiences and post-deployment adjustment and even less is known about these experiences specific to women who have served in the R/NG.
Researchers from the VA Medical Center in Iowa City, Iowa, met with R/NG service women to determine this population's post-deployment adjustment concerns. This qualitative research revealed unmet mental health needs and risk factors for violence and post-deployment issues as a result of cross-leveling (deployment with a unit other than one's home unit). Service women noted experiences of social isolation, sexual harassment, and assault risk while they were deployed with units other than their home unit.
After returning home, they expressed concern about reporting the traumatic experience as this specific population of service women felt they were unable to talk to members of their home unit and were wary of seeking help as it could incite potential career consequences. Conversely, those who observed symptoms of possible trauma in their peers were unaware of how to provide support.
"Women in active duty regular military return from deployment to an environment where combat is common," explains principal investigator Anne Gordon Sadler, Ph.D. "R/NG service women return to civilian lives with different everyday demands and without the same support networks. Department of Defense interventions to address the in-military needs to educate and offer services to this unique population and their families is vital."
Strong Families Strong Forces: Preliminary Findings in the Development of a Family-Based Reintegration Program Supporting Military Families with Very Young Children
Principal Investigator: Ellen DeVoe, Ph.D.; Boston University
The challenges of lengthy parental separation for children and the parent-child relationship are many, even without the stresses of war. During deployment, one or both parents can be away from their families anywhere from six to 18 months at a time. While support programs are in place to assist in the assimilation of soldiers from Iraq and Afghanistan, Boston researchers are looking to develop a program that will support the most vulnerable troops – parents with children under age 5, a critical stage of physical, mental, and emotional development.
Principal investigator Ellen DeVoe, an assistant professor of clinical practice at of Boston University School of Social Work, explains the significance of providing special support to young children: "If you think about what that length of separation means for a child from infancy to five years old, they don't really have a way to understand where this person went, even though we tell them and show them pictures."
DeVoe's focus is to both examine the impact of deployment stress and combat trauma on military families with young children and then develop long-lasting approaches to deal with issues such as separation and reassimilation. After completing one year of the multi-phased study, the data demonstrate that inclusion of military family members and service providers is critical to the development of a viable program for families. As their program continues, it will take on a collaborative approach incorporating input from provider-partners and families around what would be helpful to form a pilot program for at-home intervention. The final phase will test the program and compare it with existing services that treat only the soldier.
"This research has the potential to improve the quality of family life for returning service members and their young children," explains DeVoe. "The availability of a field-tested, family-focused reintegration program developed in tandem with key stakeholders holds promise for military families across all branches of the military."
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