Hypoxia and Flight Performance of Military Instructor Pilots in a Flight Simulator

Temme, Leonard A.; Still, David L.; Acromite, Michael T.

doi:10.3357/asem.2690.2010

Cited by 44 publications

(34 citation statements)

References 2 publications

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“…NH may be particularly useful as a stress paradigm for mTBI assessment for several reasons. Most of the literature investigating the hypoxia-induced effects on sensoryintegrative function has been limited to normally functioning individuals, however, our work [60,61] and that of others [59], demonstrate that, when challenged with hypoxic stress, individuals with mTBI show a statistically significant and disproportionate cognitive impairment as compared with healthy individuals, consistent with the BRC model. Furthermore, Temme et al found that the peripheral oxygenation (SpO 2 ) response to hypoxia differed between healthy individuals and asymptomatic individuals with a history of mTBI, suggesting that the assessment of additional functional modalities (i.e., oculo motor, pupillometric, vestibular, auditory, etc.)…”

Section: Hypoxia and Cerebral Resource Depletionsupporting

confidence: 69%

“…The hypothesis that a physiologic stress challenge, such as NH, can uncover latent, hidden or subclinical symptoms of concussion was corroborated by the current group during an experiment evaluating the simulated flight performance of highly skilled, active duty military instructor pilots undergoing NH exposure approximating 18,000 ft. above MSL [60]. Under the control condition of breathing MSL air, the flight performance of all pilots was consistent with their highlevel expertise.…”

Section: Using Hypoxia In Mtbi Assessmentmentioning

confidence: 54%

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Feasibility of using normobaric hypoxic stress in mTBI research

et al. 2017

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Studies of mild traumatic brain injury (mTBI) recovery generally assess patients in unstressed conditions that permit compensation for impairments through increased effort expenditure. This possibility may explain why a subgroup of individuals report persistent mTBI symptoms yet perform normally on objective assessment. Accordingly, the development and utilization of stress paradigms may be effective for enhancing the sensitivity of mTBI assessment. Previous studies, discussed here, indirectly but plausibly support the use of normobaric hypoxia as a stressor in uncovering latent mTBI symptoms due to the overlapping symptomatology induced by both normobaric hypoxia and mTBI. Limited studies by our group and others further support this plausibility through proof-of-concept demonstrations that hypoxia reversibly induces disproportionately severe impairments of oculomotor, pupillometric, cognitive and autonomic function in mTBI individuals.

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Section: Hypoxia and Cerebral Resource Depletionsupporting

confidence: 69%

Section: Using Hypoxia In Mtbi Assessmentmentioning

confidence: 54%

Feasibility of using normobaric hypoxic stress in mTBI research

et al. 2017

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“…The regular administration of melatonin under hypoxic conditions partially ameliorated the destructive actions of the low-oxygen environment. These findings have implications for not only ground-based individuals who move to high altitudes, but also to pilots who experience hypoxia when they fly at high altitudes [177]. …”

Section: Melatonin: Male Reproductive Healthmentioning

confidence: 99%

Peripheral Reproductive Organ Health and Melatonin: Ready for Prime Time

Reíter

Rosales-Corral

Manchester

et al. 2013

IJMS

190

120

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Melatonin has a wide variety of beneficial actions at the level of the gonads and their adnexa. Some actions are mediated via its classic membrane melatonin receptors while others seem to be receptor-independent. This review summarizes many of the published reports which confirm that melatonin, which is produced in the ovary, aids in advancing follicular maturation and preserving the integrity of the ovum prior to and at the time of ovulation. Likewise, when ova are collected for in vitro fertilization-embryo transfer, treating them with melatonin improves implantation and pregnancy rates. Melatonin synthesis as well as its receptors have also been identified in the placenta. In this organ, melatonin seems to be of particular importance for the maintenance of the optimal turnover of cells in the villous trophoblast via its ability to regulate apoptosis. For male gametes, melatonin has also proven useful in protecting them from oxidative damage and preserving their viability. Incubation of ejaculated animal sperm improves their motility and prolongs their viability. For human sperm as well, melatonin is also a valuable agent for protecting them from free radical damage. In general, the direct actions of melatonin on the gonads and adnexa of mammals indicate it is an important agent for maintaining optimal reproductive physiology.

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“…The hypothesis that physiologic or psychological stress might uncover latent or subclinical mTBI symptoms was suggested by an incidental observation made in a flight simulator during a study of instrument flight by highly skilled, military instructor pilots who were exposed to a normobaric hypoxic condition that approximated conditions encountered at 18,000 feet above mean sea level (MSL) (Temme et al, 2010). Under the control condition of breathing MSL air, which contains about 21% oxygen (O 2 ) and 78% nitrogen (N), the flight performance of all pilots was essentially indistinguishable and consistent with their extraordinary expertise; however, when the pilots were breathing a normobaric simulation of air 18,000 feet above MSL, which contained about 9.98% O 2 and 89% N, one pilot not only lost control of the aircraft but did not realize that fact.…”

Section: Introductionmentioning

confidence: 99%

Uncovering Latent Deficits Due to Mild Traumatic Brain Injury by Using Normobaric Hypoxia Stress

Temme¹,

Bleiberg²,

Reeves³

et al. 2013

Front. Neurol.

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Memory deficits and other cognitive symptoms frequently associated with mTBI are commonly thought to resolve within 7–10 days. This generalization is based principally on observations made in individuals who are in the unstressed environmental conditions typical of a clinic and so does not consider the impact of physiologic, environmental, or psychological stress. Normobaric hypoxic stress can be generated with normal mean sea level (MSL) air, which is about 21% oxygen (O2) and 78% nitrogen (N), by reducing the percentage of O2 and increasing the percentage of N so that the resultant mixed-gas has a partial pressure of O2 approximating that of specified altitudes. This technique was used to generate normobaric hypoxic equivalents of 8,000, 12,000, and 14,000 feet above MSL in a group of 36 volunteers with a mTBI history and an equal number of controls matched on the basis of age, gender, tobacco smoking consumption, weight, height, and body mass index. Short-term visual memory was tested using the Matching to Sample (M2S) subtest of the BrainCheckers analog of the Automated Neuropsychological Assessment Metrics. Although there were no significant differences in M2S performance between the two groups of subjects at MSL, with increased altitude, the mTBI group performance was significantly worse than that of the control group. When the subjects were returned to MSL, the difference disappeared. This finding suggests that the “hypoxic challenge” paradigm developed here has potential clinical utility for assessing the effects of mTBI in individuals who appear asymptomatic under normal conditions.

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Hypoxia and Flight Performance of Military Instructor Pilots in a Flight Simulator

Abstract: Moderate levels of hypoxia degraded the ability of military instructor pilots to perform a precision slow flight task. This is one of a small number of studies to quantify an effect of hypoxia on primary flight performance.

Cited by 44 publications

References 2 publications

Feasibility of using normobaric hypoxic stress in mTBI research

Feasibility of using normobaric hypoxic stress in mTBI research

Peripheral Reproductive Organ Health and Melatonin: Ready for Prime Time

Uncovering Latent Deficits Due to Mild Traumatic Brain Injury by Using Normobaric Hypoxia Stress

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