Cerebrovascular Reactivity in Special Operations Forces Combat Soldiers

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 (F_1,5092 = 0.19, p = 0.66) or during the hyperventilation task (F_1,5092 = 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.