{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:03:59Z","timestamp":1789985039422,"version":"4.0.1"},"reference-count":326,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p>The transition to fifth- and sixth-generation fighter aircraft is increasing the psychophysiological demands placed on military aircrew. Next-generation fast-jet operations combine sustained and repetitive high-G loading; intermittent hypoxia, hyperoxia, and hypobaria associated with unexplained physiological episodes; prolonged single-seat missions; advanced helmet-mounted displays; acoustic and thermal stress; and high cognitive load from sensor fusion, automation, and manned-unmanned teaming. These exposures challenge autonomic regulation, cerebral and respiratory physiology, neurocognitive performance, sensory integration, and central nervous system resilience. This narrative review synthesizes evidence across cardiovascular-autonomic and hemodynamic function; respiratory physiology and unexplained physiological episodes in the on-board oxygen generating system era; cognitive workload, fatigue, and pilot experience; visual-oculomotor, vestibular, auditory, thermal, and musculoskeletal stress; biological markers of neural strain; and aircrew surveillance and countermeasures. The organizing construct is psychophysiological readiness: the integrated capacity to meet mission demands without disproportionate physiological cost or degraded decision quality. Evidence from direct fifth-generation studies, other fast-jet operations, simulators, and controlled aerospace analogues shows measurable changes in heart rate variability, cerebral oxygenation and perfusion, cortical activity, sensory function, and neurostructural biomarkers, but direct fifth-generation evidence remains limited and responses are strongly individualized and context dependent. Current surveillance remains largely episodic and domain-siloed. We therefore propose a staged monitoring framework combining validated cardiovascular-autonomic and hemodynamic measures with neurocognitive, sensory, wearable, and biomarker data, while treating AI\/ML as an experimental analytic layer requiring prospective validation. Longitudinal, career-spanning monitoring could ultimately support earlier identification of vulnerability and evidence-based optimization of training, recovery, and countermeasures while preserving human aeromedical oversight.<\/jats:p>","DOI":"10.3389\/fphys.2026.1920799","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:29:56Z","timestamp":1789982996000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Human limits in next-generation fighter aviation: psychophysiological stressors, readiness, health, performance, and countermeasures"],"prefix":"10.3389","volume":"17","author":[{"given":"Jennifer F.","family":"Chan","sequence":"first","affiliation":[{"name":"Defence Research and Development \u2013 Toronto Research Centre","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Defence Research and Development \u2013 Toronto Research Centre","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Y.","family":"Shiu","sequence":"additional","affiliation":[{"name":"Defence Research and Development \u2013 Toronto Research Centre","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fethi","family":"Bouak","sequence":"additional","affiliation":[{"name":"Defence Research and Development \u2013 Toronto Research Centre","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaela","family":"Shea","sequence":"additional","affiliation":[{"name":"Defence Research and Development \u2013 Toronto Research Centre","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Saary","sequence":"additional","affiliation":[{"name":"Canadian Forces Environmental Medicine Establishment","place":["Toronto, ON, Canada"]},{"name":"Department of Medicine, Division of Occupational Medicine, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oshin","family":"Vartanian","sequence":"additional","affiliation":[{"name":"Defence Research and Development \u2013 Toronto Research Centre","place":["Toronto, ON, Canada"]},{"name":"Department of Psychology, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn G.","family":"Rhind","sequence":"additional","affiliation":[{"name":"Defence Research and Development \u2013 Toronto Research Centre","place":["Toronto, ON, Canada"]},{"name":"Faculty of Kinesiology and Physical Education, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"243","DOI":"10.31392\/UDU-nc.series15.2025.10(197).46","article-title":"Mechanisms of stress impact on psychophysiological indicators of military personnel and ways for correcting their effects","author":"\u042f\u043a\u043e\u0432\u0435\u043d\u043a\u043e","year":"2025","journal-title":"\u041d\u0430\u0443\u043a\u043e\u0432\u0438\u0439 \u0447\u0430\u0441\u043e\u043f\u0438\u0441 \u0423\u043a\u0440\u0430\u0457\u043d\u0441\u044c\u043a\u043e\u0433\u043e \u0434\u0435\u0440\u0436\u0430\u0432\u043d\u043e\u0433\u043e \u0443\u043d\u0456\u0432\u0435\u0440\u0441\u0438\u0442\u0435\u0442\u0443 \u0456\u043c\u0435\u043d\u0456 \u041c\u0438\u0445\u0430\u0439\u043b\u0430 \u0414\u0440\u0430\u0433\u043e\u043c\u0430\u043d\u043e\u0432\u0430. \u0421\u0435\u0440\u0456\u044f 15"},{"key":"B2","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1080\/15287394.2013.765369","article-title":"Autoantibodies to nervous system-specific proteins are elevated in sera of flight crew members: biomarkers for nervous system injury","volume":"76","author":"Abou-Donia","year":"2013","journal-title":"J. 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