{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T19:43:11Z","timestamp":1776109391976,"version":"3.50.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Traumatic brain injury (TBI) is a significant health concern, particularly in military and sports settings. This study investigated the use of functional near-infrared spectroscopy (fNIRS) to identify TBI in Role of Care (ROC) 1 and 2 environments. This initial study aimed to begin the development of a rapid, noninvasive neuroimaging technique for assessing brain injuries in field settings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Material and Methods<\/jats:title>\n                  <jats:p>Twelve participants, who were all Division 1 athletes, volunteered for this study (age: 21.1\u2009\u00b1\u20092.7\u2009years). A 4\u2009\u00d7\u20091 optode to receiver fNIRS grid was placed over the injured and un-injured region of the brain (control) while performing a 60-second simple reaction time test. These assessments were collected within the first 24 \u2009hours of injury, when the team\u2019s physician cleared the participant for return to activity (RTA) and return to play (RTP). All testing were performed in ROC 1 or 2 environments. A Morlet wavelet fNIRS analysis approach was then used to rapidly interpret data in field-based environments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The Morlet wavelet fNIRS analysis identified the injured brain region. The injured region exhibited 72% greater tHb (P\u2009=\u2009.013), 2.6-fold increase in O2Hb (P\u2009=\u2009.018), and 1.3-fold increase in hHb compared to the control region (P\u2009=\u2009.006). The average time from the initial point of injury to being cleared for RTP was 4.3\u2009\u00b1\u20092.7 weeks. The average of the simple reaction time test exhibited a decrease in reaction time from initial and RTA at the RTP timepoint (P\u2009=\u2009.016).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The Morlet wavelet fNIRS analysis identified the injured region of the brain at initial, RTA, and RTP timepoints in ROC 1 and 2 environments. It did not detect differences in recovery, but there was an improvement in simple reaction time. Thus, the fNIRS analysis detected TBI\u2019s in ROC 1 and 2, but further development is needed to increase its sensitivity to tracking TBI\u2019s over time.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaf047","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T22:19:37Z","timestamp":1758320377000},"page":"13-19","source":"Crossref","is-referenced-by-count":1,"title":["Identifying Traumatic Brain Injuries Using a Morlet Wavelet fNIRS Analysis in Role of Care 1 and 2 Environments: A Feasibility Study"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9581-1225","authenticated-orcid":false,"given":"Cory M","family":"Smith","sequence":"first","affiliation":[{"name":"Robbins College of Health and Human Sciences, Human & Environmental Physiology Laboratory, Baylor University , Waco, TX 76710,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8109-5498","authenticated-orcid":false,"given":"Cierra B","family":"Ugale","sequence":"additional","affiliation":[{"name":"Robbins College of Health and Human Sciences, Human & Environmental Physiology Laboratory, Baylor University , Waco, TX 76710,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-2432","authenticated-orcid":false,"given":"Matt D","family":"Segovia","sequence":"additional","affiliation":[{"name":"Robbins College of Health and Human Sciences, Human & Environmental Physiology Laboratory, Baylor University , Waco, TX 76710,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8211-3863","authenticated-orcid":false,"given":"Owen F","family":"Salmon","sequence":"additional","affiliation":[{"name":"Robbins College of Health and Human Sciences, Human & Environmental Physiology Laboratory, Baylor University , Waco, TX 76710,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie M","family":"Lee","sequence":"additional","affiliation":[{"name":"Robbins College of Health and Human Sciences, Human & Environmental Physiology Laboratory, Baylor University , Waco, TX 76710,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6827-302X","authenticated-orcid":false,"given":"Andrew R","family":"Gallucci","sequence":"additional","affiliation":[{"name":"Robbins College of Health and Human Sciences, Human & Environmental Physiology Laboratory, Baylor University , Waco, TX 76710,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"issue":"3","key":"2025092002190757800_R1","article-title":"Perceptions of traumatic brain injury (TBI) among professionals providing drug and alcohol addiction treatment","volume":"4","author":"Brown","year":"2019","journal-title":"J Neurol Amp Neuromed"},{"issue":"7","key":"2025092002190757800_R2","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1093\/arclin\/acac031","article-title":"An initial psychometric analysis of the brain gauge tactile-based test battery and its potential for clinical use assessing patients with acute mild traumatic brain injury","volume":"37","author":"Ivins","year":"2022","journal-title":"Arch Clin Neuropsychol"},{"issue":"1","key":"2025092002190757800_R3","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12010319","article-title":"Psychometric properties of the German version of the Rivermead Post-Concussion Symptoms Questionnaire in adolescents after traumatic brain injury and their proxies","volume":"12","author":"Bockhop","year":"2023","journal-title":"J Clin Med"},{"issue":"1","key":"2025092002190757800_R4","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1177\/1094428116658959","article-title":"Functional near-infrared spectroscopy (fNIRS) for assessing cerebral cortex function during human behavior in natural\/social situations: a concise review","volume":"22","author":"Quaresima","year":"2019","journal-title":"Organizational Res Methods"},{"issue":"5","key":"2025092002190757800_R5","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1007\/s10278-020-00387-1","article-title":"A narrative review on clinical applications of fNIRS","volume":"33","author":"Rahman","year":"2020","journal-title":"J Digit Imaging"},{"key":"2025092002190757800_R6","first-page":"1279","article-title":"Tracking the recovery of a patient with a mild traumatic brain injury utilizing a 60-s combined functional near-infrared spectroscopy and psychomotor testing: case study","volume":"7","author":"Smith","year":"2023","journal-title":"J Clin Case Rep Med Images Health Sci"},{"issue":"5","key":"2025092002190757800_R7","doi-asserted-by":"crossref","DOI":"10.3390\/s21051586","article-title":"Near-infrared spectroscopy (NIRS) in traumatic brain injury (TBI)","volume":"21","author":"Rold\u00e1n","year":"2021","journal-title":"Sensors"},{"key":"2025092002190757800_R8","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2021.719501","article-title":"Near infrared spectroscopy for high-temporal resolution cerebral physiome characterization in TBI: a narrative review of techniques, applications, and future directions","volume":"12","author":"Gomez","year":"2021","journal-title":"Front Pharmacol"},{"key":"2025092002190757800_R9","article-title":"Cerebral multimodality monitoring in adult neurocritical care patients with acute brain injury: a narrative review","volume":"13(1)","author":"Tas","year":"2022","journal-title":"Front Physiol"},{"issue":"5","key":"2025092002190757800_R10","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s10548-016-0507-1","article-title":"Effective connectivity of cortical sensorimotor networks during finger movement tasks: a simultaneous fNIRS, fMRI, EEG study","volume":"29","author":"Anwar","year":"2016","journal-title":"Brain Topogr"},{"issue":"15","key":"2025092002190757800_R11","doi-asserted-by":"crossref","DOI":"10.3390\/s22155865","article-title":"Concurrent fNIRS and EEG for brain function investigation: a systematic, methodology-focused review","volume":"22","author":"Li","year":"2022","journal-title":"Sensors"},{"issue":"10","key":"2025092002190757800_R12","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1109\/TBME.2020.2971679","article-title":"Enhancing fNIRS analysis using EEG rhythmic signatures: an EEG-informed fNIRS analysis study","volume":"67","author":"Li","year":"2020","journal-title":"IEEE Trans Biomed Eng"},{"key":"2025092002190757800_R13","doi-asserted-by":"crossref","DOI":"10.1016\/j.nicl.2019.102086","article-title":"Assessment of cerebrovascular dysfunction after traumatic brain injury with fMRI and fNIRS","volume":"25","author":"Amyot","year":"2020","journal-title":"NeuroImage Clin"},{"issue":"1","key":"2025092002190757800_R14","doi-asserted-by":"crossref","DOI":"10.1088\/1741-2552\/ac542c","article-title":"Removal of movement-induced EEG artifacts: current state of the art and guidelines","volume":"19","author":"Gorjan","year":"2022","journal-title":"J Neural Eng"},{"issue":"5","key":"2025092002190757800_R15","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1152\/japplphysiol.00166.2018","article-title":"Understanding near infrared spectroscopy and its application to skeletal muscle research","volume":"126","author":"Barstow","year":"2019","journal-title":"J Appl Physiol (1985)"},{"issue":"15","key":"2025092002190757800_R16","doi-asserted-by":"crossref","DOI":"10.3390\/s21155117","article-title":"A motion artifact correction procedure for fNIRS signals based on wavelet transform and infrared thermography video tracking","volume":"21","author":"Perpetuini","year":"2021","journal-title":"Sensors (Basel)"},{"issue":"5","key":"2025092002190757800_R17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0304356","article-title":"Opening the dialogue: a preliminary exploration of hair color, hair cleanliness, light, and motion effects on fNIRS signal quality","volume":"19","author":"Holmes","year":"2024","journal-title":"PLoS One"},{"issue":"1","key":"2025092002190757800_R18","doi-asserted-by":"crossref","DOI":"10.3390\/app12010316","article-title":"Assessment of fNIRS signal processing pipelines: towards clinical applications","volume":"12","author":"Bonilauri","year":"2021","journal-title":"Appl Sci"},{"issue":"1286586","key":"2025092002190757800_R19","article-title":"Optimizing spatial specificity and signal quality in fNIRS: an overview of potential challenges and possible options for improving the reliability of real-time applications","volume":"5","author":"Klein","year":"2024","journal-title":"Front Neuroergonom"},{"key":"2025092002190757800_R20","first-page":"0613","article-title":"Using EEG and fNIRS measurements for analysis on the effects of heat stress on short-term memory performance","author":"De La Cruz","year":"2021"},{"issue":"2","key":"2025092002190757800_R21","doi-asserted-by":"crossref","DOI":"10.1088\/0967-3334\/33\/2\/259","article-title":"Wavelet-based motion artifact removal for functional near-infrared spectroscopy","volume":"33","author":"Molavi","year":"2012","journal-title":"Physiol Meas"},{"issue":"2","key":"2025092002190757800_R22","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1002\/jbmr.2613","article-title":"Evaluation of skull cortical thickness changes with age and sex from computed tomography scans","volume":"31","author":"Lillie","year":"2016","journal-title":"J Bone Miner Res"},{"issue":"11","key":"2025092002190757800_R23","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1089\/neu.2010.1388","article-title":"Noninvasive monitoring of cerebrovascular reactivity with near infrared spectroscopy in head-injured patients","volume":"27","author":"Zweifel","year":"2010","journal-title":"J Neurotrauma"},{"issue":"4","key":"2025092002190757800_R24","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.bja.2019.11.031","article-title":"Continuous cerebrovascular reactivity monitoring in moderate\/severe traumatic brain injury: a narrative review of advances in neurocritical care","volume":"124","author":"Zeiler","year":"2020","journal-title":"Br J Anaesth"},{"key":"2025092002190757800_R25","article-title":"Cerebrovascular pressure reactivity and brain tissue oxygen monitoring provide complementary information regarding the lower and upper limits of cerebral blood flow control in traumatic brain injury: a CAnadian High Resolution-TBI (CAHR-TBI) cohort study","volume":"10(1)","author":"Gomez","year":"2022","journal-title":"Intensive Care Med Exp"},{"issue":"2","key":"2025092002190757800_R26","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1007\/s12028-011-9630-8","article-title":"Critical thresholds for cerebrovascular reactivity after traumatic brain injury","volume":"16","author":"Sorrentino","year":"2012","journal-title":"Neurocrit Care"},{"issue":"5","key":"2025092002190757800_R27","doi-asserted-by":"crossref","first-page":"607","DOI":"10.3109\/02699052.2015.1004558","article-title":"Higher haemoglobin levels and dedicated trauma admission are associated with survival after severe traumatic brain injury","volume":"29","author":"Baltazar","year":"2015","journal-title":"Brain Inj"},{"issue":"9","key":"2025092002190757800_R28","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1177\/0885066620944097","article-title":"Arterial oxygenation in traumatic brain injury\u2014relation to cerebral energy metabolism, autoregulation, and clinical outcome","volume":"36","author":"Wettervik","year":"2021","journal-title":"J Intensive Care Med"},{"issue":"6","key":"2025092002190757800_R29","doi-asserted-by":"crossref","first-page":"40","DOI":"10.29245\/2572.942X\/2016\/6.1067","article-title":"Cerebral microvascular injury in traumatic brain injury","volume":"1","author":"Kenney","year":"2016","journal-title":"J Neurol Neuromed"},{"key":"2025092002190757800_R30","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.expneurol.2015.05.019","article-title":"Cerebral vascular injury in traumatic brain injury","volume":"275","author":"Kenney","year":"2016","journal-title":"Exp Neurol"},{"issue":"9","key":"2025092002190757800_R31","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1080\/02699052.2019.1632487","article-title":"Reaction time and cognitive-linguistic performance in adults with mild traumatic brain injury","volume":"33","author":"Norman","year":"2019","journal-title":"Brain Inj"},{"issue":"1","key":"2025092002190757800_R32","article-title":"Long-term effects of mild traumatic brain injuries to oculomotor tracking performances and reaction times to simple environmental stimuli","volume":"8","author":"Danna-Dos-Santos","year":"2018","journal-title":"Sci Rep"},{"issue":"5 Suppl","key":"2025092002190757800_R33","doi-asserted-by":"crossref","first-page":"40","DOI":"10.7205\/MILMED-D-15-00148","article-title":"Simple and procedural reaction time for mild traumatic brain injury in a hyperbaric oxygen clinical trial","volume":"181","author":"Churchill","year":"2016","journal-title":"Mil Med"},{"key":"2025092002190757800_R34","doi-asserted-by":"crossref","first-page":"2989","DOI":"10.2147\/NDT.S125620","article-title":"Biomarkers in traumatic brain injury (TBI): a review","volume":"14","author":"Dadas","year":"2018","journal-title":"Neuropsychiatr Dis Treat"},{"issue":"2","key":"2025092002190757800_R35","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1177\/03635465211053869","article-title":"The minimal clinically important difference: a review of clinical significance","volume":"51","author":"Bloom","year":"2023","journal-title":"Am J Sports Med"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/Supplement_2\/13\/64287900\/usaf047.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/Supplement_2\/13\/64287900\/usaf047.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T06:19:43Z","timestamp":1758349183000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/190\/Supplement_2\/13\/8256251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":35,"journal-issue":{"issue":"Supplement_2","published-online":{"date-parts":[[2025,9,16]]},"published-print":{"date-parts":[[2025,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf047","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,9]]},"published":{"date-parts":[[2025,9,1]]}}}