Cognitive readiness denotes an individual’s ability to reply and adapt to the changes around them. This includes functions like keeping balance after tripping, or making the correct decision in a difficult situation based on knowledge and past experiences. For military service members, cognitive readiness is crucial for his or her health and safety, in addition to mission success. Injury to the brain is a significant contributor to cognitive impairment, and between 2000 and 2024, greater than 500,000 military service members were diagnosed with traumatic brain injury (TBI) — attributable to anything from a fall during training to blast exposure on the battlefield. While impairment from aspects like sleep deprivation will be treated through rest and recovery, others attributable to injury may require more intense and prolonged medical attention.
“Current cognitive readiness tests administered to service members lack the sensitivity to detect subtle shifts in cognitive performance which will occur in individuals exposed to operational hazards,” says Christopher Smalt, a researcher within the laboratory’s Human Health and Performance Systems Group. “Unfortunately, the cumulative effects of those exposures are sometimes not well-documented during military service or after transition to Veterans Affairs, making it difficult to offer effective support.”
Smalt is a component of a team on the laboratory developing a collection of portable diagnostic tests that provide near-real-time screening for brain injury and cognitive health. One in every of these tools, called READY, is a smartphone or tablet app that helps discover a possible change in cognitive performance in lower than 90 seconds. One other tool, called MINDSCAPE — which is being developed in collaboration with Richard Fletcher, a visiting scientist within the Rapid Prototyping Group who leads the Mobile Technology Lab on the MIT Auto-ID Laboratory, and his students — uses virtual reality (VR) technology for a more in-depth evaluation to pinpoint specific conditions equivalent to TBI, post-traumatic stress disorder, or sleep deprivation. Using these tests, medical personnel on the battlefield could make quick and effective decisions for treatment triage.
Each READY and MINDSCAPE are a response to a series of Congressional laws mandates, military program requirements, and mission-driven health needs to enhance brain health screening capabilities for service members.
Cognitive readiness biomarkers
The READY and MINDSCAPE platforms incorporate greater than a decade of laboratory research on finding the correct indicators of cognitive readiness to construct into rapid testing applications. Thomas Quatieri oversaw this work and identified balance, eye movement, and speech as three reliable biomarkers. He’s leading the hassle at Lincoln Laboratory to develop READY.
“READY stands for Rapid Evaluation of Attention for DutY, and is built on the premise that spotlight is the important thing to being ‘ready’ for a mission,” he says. “In a single view, we will consider attention because the mental state that lets you concentrate on a task.”
For somebody to be attentive, their brain must constantly anticipate and process incoming sensory information after which instruct the body to reply appropriately. For instance, if a friend yells “catch” after which throws a ball in your direction, with the intention to catch that ball, your brain must process the incoming auditory and visual data, predict prematurely what may occur in the subsequent few moments, after which direct your body to reply with an motion that synchronizes those sensory data. The result? You realize from hearing the word “catch” and seeing the moving ball that your friend is throwing the ball to you, and also you reach out a hand to catch it just in time.
“An unhealthy or fatigued brain — attributable to TBI or sleep deprivation, for instance — can have challenges inside a neurosensory feed-forward [prediction] or feedback [error] system, thus hampering the person’s ability to attend,” Quatieri says.
READY’s three tests measure an individual’s ability to trace a moving dot with their eye, balance, and hold a vowel fixed at one pitch. The app then uses the information to calculate a variability or “wobble” indicator, which represents changes from the test taker’s baseline or from expected results based on others with similar demographics, or the final population. The outcomes are exhibited to the user as a sign of the patient’s level of attention.
If the READY screen shows an impairment, the administrator can then direct the topic to follow up with MINDSCAPE, which stands for Mobile Interface for Neurological Diagnostic Situational Cognitive Assessment and Psychological Evaluation. MINDSCAPE uses VR technology to manage additional, in-depth tests to measure cognitive functions equivalent to response time and dealing memory. These standard neurocognitive tests are recorded with multimodal physiological sensors, equivalent to electroencephalography (EEG), photoplethysmography, and pupillometry, to raised pinpoint diagnosis.
MINDSCAPE for brain health screening
Video: MIT Lincoln Laboratory
Holistic and adaptable
A key advantage of READY and MINDSCAPE is their ability to leverage existing technologies, allowing for rapid deployment in the sector. By utilizing sensors and capabilities already integrated into smartphones, tablets, and VR devices, these assessment tools will be easily adapted to be used in operational settings at a significantly reduced cost.
“We will immediately apply our advanced algorithms to the information collected from these devices, without the necessity for costly and time-consuming hardware development,” Smalt says. “By harnessing the capabilities of commercially available technologies, we will quickly provide precious insights and improve upon traditional assessment methods.”
Bringing latest capabilities and AI for brain-health sensing into operational environments is a theme across several projects on the laboratory. One other example is EYEBOOM (Electrooculography and Balance Blast Overpressure Monitoring System), a wearable technology developed for the U.S. Special Forces to observe blast exposure. EYEBOOM constantly monitors a wearer’s eye and body movements as they experience blast energy, and warns of potential harm. For this program, the laboratory developed an algorithm that would discover a possible change in physiology resulting from blast exposure during operations, relatively than waiting for a check-in.
All three technologies are in development to be versatile, in order that they will be adapted for other relevant uses. For instance, a workflow could pair EYEBOOM’s monitoring capabilities with the READY and MINDSCAPE tests: EYEBOOM would constantly monitor for exposure risk after which prompt the wearer to hunt additional assessment.
“A variety of times, research focuses on one specific modality, whereas what we do on the laboratory is seek for a holistic solution that will be applied for many various purposes,” Smalt says.
MINDSCAPE is undergoing testing on the Walter Reed National Military Center this yr. READY might be tested with the U.S. Army Research Institute of Environmental Medicine (USARIEM) in 2026 within the context of sleep deprivation. Smalt and Quatieri also see the technologies finding use in civilian settings — on sporting event sidelines, in doctors’ offices, or wherever else there’s a necessity to evaluate brain readiness.
MINDSCAPE is being developed with clinical validation and support from Stefanie Kuchinsky on the Walter Reed National Military Medical Center. Quatieri and his team are developing the READY tests in collaboration with Jun Maruta and Jam Ghajar from the Brain Trauma Foundation (BTF), and Kristin Heaton from USARIEM. The tests are supported by concurrent evidence-based guidelines lead by the BTF and the Military TBI Initiative at Uniform Services University.
