Study finds new information about firefighters' brains that could help ‘train’ rescue decisions in critical wildfire situations.

A study led by the University of Coimbra (UC) has revealed new information about the neural response of firefighters to critical firefighting situations. In particular, the scientists sought to identify the brain processes involved in decision-making under extreme firefighting conditions.

The study monitored the brain responses of 47 people while they played virtual rescue games. The research team believes that using tasks such as visualizing life-threatening scenarios involving rescue decisions could be instrumental in improving and training decision-making in high-risk situations.

"By analysing how the brain solves life-saving dilemmas, we were able to study the role of expertise and the use of coping mechanisms - a set of cognitive and behavioural strategies people use to manage stressful situations under high emotional overload - in firefighters," says Miguel Castelo-Branco, Professor at the Faculty of Medicine of the University of Coimbra (FMUC) and Scientific Coordinator of the Centre for Biomedical Imaging and Translational Research (CIBIT) at the UC Institute of Nuclear Sciences Applied to Health (ICNAS).

The 'critical decision games' we developed for this study can be used as a decision-making training tool for firefighters. Miguel Castelo-Branco

In this study, whose first author is Isabel Catarina Duarte of CIBIT/ICNAS, "we found that decision dilemmas led to the activation of neural networks involved in emotional reward management and other networks related to ethical and deontological dilemmas," adds the study co-leader.

The research team - which included the Centre for the Prevention and Treatment of Psychological Trauma of the Integrated Psychiatry Centre of the Coimbra Local Health Unit, coordinated by João Redondo - was actually able to demonstrate that "neural activity related to the decision to rescue decreases in certain brain regions the greater the ability to use coping strategies, suggesting compensatory learning acquired with practice," says the neuroscientist. Examples of coping strategies used by firefighters include explicitly seeking external advice or emotional support.

Thus, this study shows that 'experience increases the activation of neural networks according to these emotional coping strategies, and that using the critical decision games we developed for this study can serve as decision-making training for firefighters,' explains Miguel Castelo-Branco.

The firefighters who took part in the study - many of them from departments involved in fighting the wildfire in Pedrógão Grande - "visualised realistic scenarios involving life-threatening situations for themselves and potential victims, where they had to make a rescue decision," explains the researcher. To this end, we chose a scenario in which previous training and expertise play an important role: firefighting in life-threatening situations, such as houses on fire with people inside. The brains of the participating firefighters were examined using functional magnetic resonance imaging.

"We also found that brain activity in regions associated with memory and decision-making - such as the hippocampus and insula - increased concurrently with the increase in risk," he adds. This means that "we have been able to identify brain areas whose activity is directly related to estimating the likelihood of adverse events, such as the collapse of a burning house or loss of life," he explains.

Additionally, it was observed that people who are not firefighters, and who were subjected to the same decision-making tasks, "showed a greater directed influence of the insula on circuits related to the selection of appropriate actions", in other words, "the way the brain controls decision-making depends on experience and training", explains Miguel Castelo-Branco.

The study Neural underpinnings of ethical decisions in life and death dilemmas in naïve and expert firefighters, published in the journal Scientific Reports, (by Nature) – was carried out in the framework of the DECFIRE project - Training Critical Decision-Making and Post-Traumatic Stress Management in Firefighting Experts, led by the University of Coimbra, with partners including the Centre for the Prevention and Treatment of Psychogenic Trauma, the Regional Health Administration of the Central Region and the Coimbra District Firefighters Association.

The scientific article also included contributions from other CIBIT/ICNAS researchers: Ana Dionísio, Joana Oliveira, Joana A. Dias, Marco Simões, and Rita Correia (the latter two are also researchers at the UC Centre for Informatics and Systems). Salomé Caldeira and João Redondo from the Centre for the Prevention and Treatment of Psychological Trauma also participated in the study.

The paper is available here.