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Better detection of concussions using vital signs

As a father of a young ice hockey player, I’m all too familiar with every parent’s concern about concussions. As a neuroscientist, I chose not to accept that it was okay to rely on subjective and error-prone tests to understand how best to care for our brains after concussion. We dared ourselves to think bigger, and to devise a solution that was larger than concussions – to ask the question: “Why don’t we have objective vital signs for brain function?”

We have vital signs for our body like heart rate, body temperature, respiratory rate, and blood pressure. Why not for our brain? You can’t treat what you can’t measure, bottom line. Therefore, we must first know if brain injuries, like concussions, have significantly affected brain function. We must also know whether our treatments are helping to promote improved recovery. In essence, we must have an objective measuring stick for brain function.

The laboratory research that underpins the emerging brain vital signs framework began more than 20 years ago, with applications in concussion evaluation now moving into its 6th year. Brain vital signs uses portable brain wave recording technologies (called electroencephalography, or EEG) to automatically translate complex brain functions into a simple and intuitive vital sign framework. It provides an objective, physiological evaluation of brain function.

It’s possible to measure brain vital signs reliably in all people across age ranges. Like blood pressure, the brain’s vital signs tend to have common ranges. Each person has his  own unique results that can be monitored over time. Brain vital sign monitoring is currently in validation trials for aging, brain injury, and dementia applications. However, the most remarkable results so far have come from the applications in concussion research across the United States and Canada.

We have vital signs for our body like heart rate, body temperature, respiratory rate, and blood pressure. Why not for our brain?

In the Editor’s Choice study published in Brain: A Journal of Neurology, we reported the initial results of a multi-year collaboration with Mayo Clinic Sports Medicine Center in Rochester, Minnesota to deploy brain vital signs in youth ice-hockey players (Junior A, Division III). The study is part of an on-going research collaboration to deploy brain vital sign monitoring in athletes.

So, what next? It is possible to have vital signs for brain function and that these appear to have tremendous promise to improve brain health. Consider, for a moment, the global impacts that vital signs have for heart health. Our hearts are much healthier due to our ability to monitor vital signs like blood pressure. There is no reason now not to move toward a similar situation for brain health. Immediate next steps are underway. For instance, applications in concussion have since been expanded to youth football, with preliminary results showing very similar outcomes.

The science beyond brain vital signs is not new. Over the last century researchers around the world have been investigating brain vital signs. What is new is the translation of that science into a simple, practical framework to objectively monitor healthy brain functions – such as sensory processing, attention processing, and cognitive processing.

Most encouragingly, particularly as a hockey dad, this objective measuring stick is quickly helping to identify effective treatments of concussion. In the years to come, we hope that improved protective equipment and increased awareness for preventative regulations will continue to advance the concept of safe sports. If a picture is worth a 1,000 words, it may well be that an objective medical imaging picture is worth much more in terms of brain health. Concussion remains a global concern, but optimized brains working together can find quick solutions to concussion and other problems just like it.

Featured image credit:  “SFU Ph.D student and brain researcher Shaun Fickling uses ‘brain vital signs’ to monitor brain function” by Simon Fraser University. Used with permission. 

 

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