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Published on: September 20, 2018
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Clinical Manifestations
Joel Ramirez1,2, Vincent N Marraffino3, Oshin Vartanian4,5
1Dr. Sandra E. Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
Summary
Canadian military aircrew exhibit higher white matter hyperintensities (WMH) compared to controls, linked to subtle cognitive deficits. These findings suggest occupational stressors may impact aircrew brain health.
Area of Science:
- Neuroscience
- Aerospace Medicine
- Radiology
Background:
- Military aircrew face extreme physiological stressors (G-forces, hypoxia) potentially causing cognitive dysfunction.
- Previous studies linked white matter hyperintensities (WMH) to cognitive decline in U.S. Air Force pilots.
- This study investigated WMH prevalence and cognitive correlates in Royal Canadian Air Force (RCAF) aircrew.
Purpose of the Study:
- To determine the prevalence of WMH in RCAF fighter pilots and aircrew.
- To examine the relationship between WMH and enlarged perivascular spaces (PVS) with neurocognitive performance.
- To assess the impact of occupational stressors on brain health in military aircrew.
Main Methods:
- Brain MRI (3T) and comprehensive neurocognitive assessments were performed on RCAF personnel.
- A validated algorithm quantified WMH and PVS volumes.
- WMH and PVS volumes were compared to controls, and associations with cognitive function were analyzed using regression models.
Main Results:
- RCAF aircrew showed significantly higher WMH volumes than normal controls (497.62mm³ vs. 158.58mm³).
- High performance flight hours correlated with increased PVS volumes (r=0.352, p=0.022).
- WMH were associated with lower scores in vocabulary, short-term visual memory, and working memory updating.
Conclusions:
- RCAF aircrew present a greater WMH burden than controls, indicating potential cerebrovascular changes.
- Increased WMH volumes, possibly from flight stressors, correlate with subtle neurocognitive impairments.
- Future research will explore blood biomarkers for neurological injury to understand these effects.
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