Cervical transcutaneous vagal nerve stimulation (ctVNS) improves human cognitive performance under sleep deprivation stress.

Fatigue is a pervasive public health and safety issue. Common fatigue countermeasures include caffeine or other chemical stimulants. These can be effective in limited circumstances but other non-pharmacological fatigue countermeasures such as non-invasive electrical neuromodulation have shown promise. It is reasonable to suspect that other types of non-invasive neuromodulation may be similarly effective or perhaps even superior. The objective of this research was to evaluate the efficacy of cervical transcutaneous vagal nerve stimulation (ctVNS) to mitigate the negative effects of fatigue on cognition and mood. Two groups (active or sham stimulation) of twenty participants in each group completed 34 h of sustained wakefulness. The ctVNS group performed significantly better on arousal, multi-tasking, and reported significantly lower fatigue ratings compared to sham for the duration of the study. CtVNS could be a powerful fatigue countermeasure tool that is easy to administer, long-lasting, and has fewer side-effects compared to common pharmacological interventions.

The Effects of Anodal Transcranial Direct Current Stimulation on Sleep Time and Efficiency.

A single session of anodal transcranial direct current stimulation (tDCS) has been shown to increase arousal in healthy participants for up to 24 h post-stimulation. However, little is known about the effects of tDCS on subsequent sleep in this population. Based on previous clinical studies, we hypothesized that anodal stimulation to the left dorsolateral prefrontal cortex (lDLPFC) would produce higher arousal with decreased sleep time and stimulation to the primary motor cortex (M1) would have the converse effect. Thirty-six active duty military were randomized into one of three groups (n = 12/group); active anodal tDCS over the lDLPFC, active anodal tDCS over left M1, or sham tDCS. Participants answered questionnaires 3 times a day and wore a wrist activity monitor (WAM) to measure sleep time and efficiency for 3 weeks. On weeks 2 and 3 (order counterbalance), participants received stimulation at 1800 h before 26 h of sustained wakefulness testing (sleep deprived) and at 1800 h without sleep deprivation (non-sleep deprived). There were no significant effects for the non-sleep deprived portion of testing. For the sleep deprived portion of testing, there were main effects of group and night on sleep time. The DLPFC group slept less than the other groups on the second and third night following stimulation. There is no negative effect on mood or sleep quality from a single dose of tDCS when participants have normal sleep patterns (i.e., non-sleep deprived portion of testing). The results suggest that stimulation may result in faster recovery from fatigue caused by acute periods of sleep deprivation, as their recovery sleep periods were less.

Single Session Low Frequency Left Dorsolateral Prefrontal Transcranial Magnetic Stimulation Changes Neurometabolite Relationships in Healthy Humans.

Background: Dorsolateral prefrontal cortex (DLPFC) low frequency repetitive transcranial magnetic stimulation (LF-rTMS) has shown promise as a treatment and investigative tool in the medical and research communities. Researchers have made significant progress elucidating DLPFC LF-rTMS effects-primarily in individuals with psychiatric disorders. However, more efforts investigating underlying molecular changes and establishing links to functional and behavioral outcomes in healthy humans are needed. Objective: We aimed to quantify neuromolecular changes and relate these to functional changes following a single session of DLPFC LF-rTMS in healthy participants. Methods: Eleven participants received sham-controlled neuronavigated 1 Hz rTMS to the region most activated by a 7-letter Sternberg working memory task (SWMT) within the left DLPFC. We quantified SWMT performance, functional magnetic resonance activation and proton Magnetic resonance spectroscopy (MRS) neurometabolite measure changes before and after stimulation. Results: A single LF-rTMS session was not sufficient to change DLPFC neurometabolite levels and these changes did not correlate with DLPFC activation changes. Real rTMS, however, significantly altered neurometabolite correlations (compared to sham rTMS), both with baseline levels and between the metabolites themselves. Additionally, real rTMS was associated with diminished reaction time (RT) performance improvements and increased activation within the motor, somatosensory and lateral occipital cortices. Conclusion: These results show that a single session of LF-rTMS is sufficient to influence metabolite relationships and causes widespread activation in healthy humans. Investigating correlational relationships may provide insight into mechanisms underlying LF-rTMS.

Transcranial direct current stimulation versus caffeine as a fatigue countermeasure.

BACKGROUND: To assess the efficacy of using transcranial direct current stimulation (tDCS) to remediate the deleterious effects of fatigue induced by sleep deprivation and compare these results to caffeine, a commonly used fatigue countermeasure. OBJECTIVE/HYPOTHESIS: Based on previous research, tDCS of the dorsolateral prefrontal cortex (DLPFC) can modulate attention and arousal. The authors hypothesize that tDCS can be an effective fatigue countermeasure. METHODS: Five groups of ten participants each received either active tDCS and placebo gum at 1800, caffeine gum with sham tDCS at 1800, active tDCS and placebo gum at 0400, caffeine gum with sham tDCS at 0400, or sham tDCS with placebo gum at 1800 and 0400 during 36-h of sustained wakefulness. Participants completed a vigilance task, working memory task, psychomotor vigilance task (PVT), and a procedural game beginning at 1800 h and continued every two hours throughout the night until 1900 the next day. RESULTS: tDCS dosed at 1800 provided 6 h of improved attentional accuracy and reaction times compared to the control group. Caffeine did not produce an effect. Both tDCS groups also had an improved effect on mood. Participants receiving tDCS reported feeling more vigor, less fatigue, and less bored throughout the night compared to the control and caffeine groups. CONCLUSIONS: We believe tDCS could be a powerful fatigue countermeasure. The effects appear to be comparable or possibly more beneficial than caffeine because they are longer lasting and mood remains more positive.

The Effects of Transcranial Direct Current Stimulation (tDCS) on Multitasking Throughput Capacity.

Background: Multitasking has become an integral attribute associated with military operations within the past several decades. As the amount of information that needs to be processed during these high level multitasking environments exceeds the human operators' capabilities, the information throughput capacity reaches an asymptotic limit. At this point, the human operator can no longer effectively process and respond to the incoming information resulting in a plateau or decline in performance. The objective of the study was to evaluate the efficacy of a non-invasive brain stimulation technique known as transcranial direct current stimulation (tDCS) applied to a scalp location over the left dorsolateral prefrontal cortex (lDLPFC) to improve information processing capabilities during a multitasking environment. Methods: The study consisted of 20 participants from Wright-Patterson Air Force Base (16 male and 4 female) with an average age of 31.1 (SD = 4.5). Participants were randomly assigned into two groups, each consisting of eight males and two females. Group one received 2 mA of anodal tDCS and group two received sham tDCS over the lDLPFC on their testing day. Results: The findings indicate that anodal tDCS significantly improves the participants' information processing capability resulting in improved performance compared to sham tDCS. For example, the multitasking throughput capacity for the sham tDCS group plateaued near 1.0 bits/s at the higher baud input (2.0 bits/s) whereas the anodal tDCS group plateaued near 1.3 bits/s. Conclusion: The findings provided new evidence that tDCS has the ability to augment and enhance multitasking capability in a human operator. Future research should be conducted to determine the longevity of the enhancement of transcranial direct current stimulation on multitasking performance, which has yet to be accomplished.

Individual differences in biophysiological toughness: sustaining working memory during physical exhaustion.

Recent evidence suggests that increased dehydroepiandrosterone sulfate (DHEAS), in combination with decreased cortisol levels have been correlated with enhanced performance outcomes in stressful military environments. This study was implemented to replicate these findings in a group of active duty Air Force members to provide information on the usefulness of these biomarkers indices in the training and operational environment. Seventeen active duty males participated in the 4 sessions of this study. Sessions 1 and 2 were training days for the cognitive testing. Session 3 was a baseline measure of physical fitness, utilizing the VO2 Maximal Treadmill test. Session 4 was centered around a modified-Astrand treadmill protocol designed to induce physical exhaustion. Blood draws for biomarker analysis, cognitive testing (NovaScan), psychomotor vigilance, and physiological measures were collected before, during, and following the treadmill protocol. Results showed that prolonged increases in cortisol negatively correlate with working memory performance. DHEAS release from baseline to poststress was negatively related to the changes in cortisol for 20 minutes following stress. These results indicate that the ratio of DHEAS to cortisol buffers, the effect of cortisol increases that are related to poor working memory performance because of physical exhaustion.

Sex differences in whole body gait kinematics at preferred speeds.

Studies on human perception have identified pelvis and torso motion as key discriminators between male and female gaits. However, while most observers would advocate that men and women walk differently, consistent findings and explanations of sex differences in gait kinematics across modern empirical studies are rare. In the present study we evaluated sex differences in whole body gait kinematics from a large sample of subjects (55 men, 36 women) walking at self selected speeds. We analyzed the data through comparisons of discrete metrics and whole curve analyses. Results showed that in the frontal plane, women walked with greater pelvic obliquity than men, but exhibited a more stable torso and head. Women had greater transverse plane pelvis and torso rotation as well as greater arm swing. Additional sex differences were noted at the hip and ankle. These kinematic results are in line with anectdotal observations and qualitative studies. In order to understand these observations and substantiate some of the explanations previously set forth in the biomechanics literature, we also explored possible reasons for dynamic sex effects, and suggested applications that may benefit from their consideration.

A comparison of the effects of transcranial direct current stimulation and caffeine on vigilance and cognitive performance during extended wakefulness.

BACKGROUND: Sleep deprivation from extended duty hours is a common complaint for many occupations. Caffeine is one of the most common countermeasures used to combat fatigue. However, the benefits of caffeine decline over time and with chronic use. OBJECTIVE: Our objective was to evaluate the efficacy of anodal transcranial direct current stimulation (tDCS) applied to the pre-frontal cortex at 2 mA for 30 min to remediate the effects of sleep deprivation and to compare the behavioral effects of tDCS with those of caffeine. METHODS: Three groups of 10 participants each received either active tDCS with placebo gum, caffeine gum with sham tDCS, or sham tDCS with placebo gum during 30 h of extended wakefulness. RESULTS: Our results show that tDCS prevented a decrement in vigilance and led to better subjective ratings for fatigue, drowsiness, energy, and composite mood compared to caffeine and control in sleep-deprived individuals. Both the tDCS and caffeine produced similar improvements in latencies on a short-term memory task and faster reaction times in a psychomotor task when compared to the placebo group. Interestingly, changes in accuracy for the tDCS group were not correlated to changes in mood; whereas, there was a relationship for the caffeine and sham groups. CONCLUSION: Our data suggest that tDCS could be a useful fatigue countermeasure and may be more beneficial than caffeine since boosts in performance and mood last several hours.

Detection of vigilance performance using eye blinks.

Research has shown that sustained attention or vigilance declines over time on task. Sustained attention is necessary in many environments such as air traffic controllers, cyber operators, and imagery analysts. A lapse of attention in any one of these environments can have harmful consequences. The purpose of this study was to determine if eye blink metrics from an eye-tracker are related to changes in vigilance performance and cerebral blood flow velocities. Nineteen participants performed a vigilance task while wearing an eye-tracker on four separate days. Blink frequency and duration changed significantly over time during the task. Both blink frequency and duration increased as performance declined and right cerebral blood flow velocity declined. These results suggest that eye blink information may be an indicator of arousal levels. Using an eye-tracker to detect changes in eye blinks in an operational environment would allow preventative measures to be implemented, perhaps by providing perceptual warning signals or augmenting human cognition through non-invasive brain stimulation techniques.

Sustained acceleration on perception of relative position and motion.

INTRODUCTION: Air-to-air refueling, formation flying, and projectile countermeasures all rely on a pilot's ability to be aware of his position and motion relative to another object. METHODS: Eight subjects participated in the study, all members of the sustained acceleration stress panel at Wright-Patterson AFB, OH. The task consisted of the subject performing a two-dimensional join up task between a KC-135 tanker and an F-16. The objective was to guide the nose of the F-16 to the posterior end of the boom extended from the tanker, and hold this position for 2 s. If the F-16 went past the tanker, or misaligned with the tanker, it would be recorded as an error. These tasks were performed during four G(z) acceleration profiles starting from a baseline acceleration of 1.5 G(z). The plateaus were 3, 5, and 7 G(z). The final acceleration exposure was a simulated aerial combat maneuver (SACM). RESULTS: One subject was an outlier and therefore omitted from analysis. The mean capture time and percent error data were recorded and compared separately. There was a significant difference in error percentage change from baseline among the G(z) profiles, but not capture time. Mean errors were approximately 15% higher in the 7 G profile and 10% higher during the SACM. DISCUSSION: This experiment suggests that the ability to accurately perceive the motion of objects relative to other objects is impeded at acceleration levels of 7 G(z) or higher.

Vibrotactile stimulators and virtual 3-D audio countermeasures, training and motion sickness symptoms with a simulated graveyard spin illusion.

The vestibular system by itself is incapable of effectively compensating for the graveyard spin illusion. We examined two countermeasures, i.e., efficacy of vibrotactile stimulation around the waist and virtual 3-D audio presented independently and jointly for controlling a simulated graveyard spin. We also examined: a) additional training with these countermeasures to improve "intuitiveness;" b) included non-perturbation trials along with perturbation trials; and c) monitored changes in well-being as measured by a motion sickness scale from pre- to post-test and immediately following each trial. Ten volunteers received two training and two test sessions. The somatogyral illusion was generated by accelerating a chair for 24 s until it attained a peak rotation of 120 degrees /s and then stopped. Over the ensuing 40 s the chair rotated in one of two random perturbation patterns or remained stationary. During this period, participants were required to eliminate all movements of the chair by turning a knob in the opposite direction of perceived rotation. For the control trials, participants relied solely on vestibular signals to cancel perceived movements. For the experimental trials, vibrotactile stimulation around the waist, virtual 3-D audio, or both were presented. The mean Cancellation Error (CE) for the control trials was 52 degrees /s. The application of the countermeasures significantly reduced the CE. Additional training and testing did not improve intuitiveness. Perturbations to the chair resulted in a higher CE than no perturbations. Motion sickness symptoms showed no differences from pre- to post-test and very rarely reported after each trial.