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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.

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Summary
This summary is machine-generated.

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.

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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.