Army Medicine's Brain Health Consortium just a beginning
May 6, 2014
By Mike O'Toole
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- Official Website of U.S. Army Medical Command
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- STAND-TO!: Performance Triad: Activity
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- Army Surgeon General meets with double-arm transplant recipient Sgt. Brendan Marrocco
FALLS CHURCH, Va. (May 6, 2014) -- We have more than 70,000 thoughts a day. One person's brain generates more electrical impulses each day than all the telephones in the world combined.
Army Medicine has taken a major first step in partnering with academia, the healthcare industry and a variety of thought leaders to better understand brain health for Soldiers, the Army Family, and society as a whole.
Lt. Gen. Patricia Horoho, the Army surgeon general and commanding general, U.S. Army Medical Command, hosted the inaugural Brain Health Consortium April 10-11, at Defense Health Headquarters, Falls Church, Va.
Military professionals, researchers in neurology, neuroscience, psychiatry and psychology, and other clinical and public health experts converged and engaged in challenging, spirited discussions on ways to define and improve brain health. The consortium sets the stage for Soldiers, spouses, and their children to optimize how they think in order to make the very best decisions possible.
In keeping with the event's theme, "Brain Health: Partnering to Explore the New Frontier," subject matter experts' presentations, panel discussions, and breakout sessions explored such topics as Performance Triad (Sleep, Activity and Nutrition) and Brain Health; Readiness and Resiliency; Cognitive Performance; Neuroplasticity; Mindfulness Training, the Human Dimension Program and more.
Within the presentations, perhaps the greatest challenges were the expectations sought by a pair of battle-tested combat leaders -- U.S. Army Training and Doctrine Command Commander Gen. David Perkins and Col. Dave Hodne, commander of 1st Brigade Combat Team, 4th Infantry Division.
Perkins, defining his command as the "architects" of the Army, called the brains of its Soldiers the ultimate weapon.
"We are banking on our cognitive capability," he explained.
Hodne spoke of the long-held ethos of "sleep as a crutch" disappearing due to evidence showing its lack not only undermines resilience, but exacerbates conditions like post traumatic stress and suicidal ideation. Both combat commanders stressed mind fitness "to reinforce strategic leadership and address organizational uncertainty."
The question was raised: "What is brain health and how does it relate to military performance?"
Some symposium participants defined a healthy brain as one that could optimize its dynamic range in its ability to adapt to any challenge presented to it, especially the unknown. One participant ventured that a healthy brain, as seen in refinement and efficiency measured in sports performance, "is not noisy," but achieves a state of mindfulness with a "diminishing emotionality" better suited to deal with uncertainty. Other participants defined desired outcomes as "hardiness" and "grit." By the symposium's end, however, there was general agreement that a definition of "brain health" was elusive for the moment, pending additional discussions and research.
Retired Lt. Gen. Eric Schoomaker, former Army surgeon general, echoed the combat commanders' call for their Soldiers to be given a "new set of tools to make judgments," capable of "attentiveness, tolerant of uncertainty, agility and flexibility."
Schoomaker asked how the Army could achieve that
"We are a requirements-based Army," he said. "The big challenge is taking a range of trainings that can be done to impact the brain and translate that into practical solutions for an Army that demands specific requirements."
One of the civilian participants proposed a "BFT -- brain fitness test," which other participants likened to an existing psychomotor vigilance test, administered at different levels to different skill groups, and with competition fostered to excel at the test, with time off as a possible incentive. Another participant referenced Perkins' call for training that shows "how to adapt to unusual situations," then asked "are we funding the right research?"
Other participants also believed a brain health index for Soldiers and families would potentially be useful. They added that elements used to define brain health include: measures of cognition; effects of sleep quality and duration, nutrition, and substance abuse; measures of mood and the role of social connectedness. They called for the development of biomarkers to assess brain health.
Recommendations posed by participants include: Having TRADOC make the Performance Triad a part of regular Army training doctrine, with subordinate commanders required to brief their senior leaders as part of their mission analysis; creation of reparative gaming/technology like 'HALO' for Soldiers' use and as a way to incentivize and earn promotion points for completing Performance Triad training. Schoomaker and others called for more consultation from educators and organizational psychologists, because implementing any activity throughout the Army is as much as "training issue" as it is a health issue.
"We can share what we started here," Horoho said in her closing remarks.
The surgeon general recounted the story of Sgt. Brandon Marrocco, who, after losing all of his limbs from a roadside bombing in Iraq, underwent a successful double arm transplant. Someone had a "vision" more than 15 years ago, challenging what is possible that made such a medical milestone a reality.
"Now we are at a similar precipice, we need to be asking the questions and finding answers to something that could make a difference 15-20 years from now," she said. "I'm hoping this is only the beginning."