Cornering concussion

US researchers have developed a new device to detect brain injuries right on the sidelines of a football game.

Michelle LaPlaca, an assistant professor at Georgia Tech and Emory University, and David Wright, assistant director of Emory University’s Emergency Medicine Research Center, have developed a new device to detect brain injuries right on the sidelines of a football game, on a battlefield or in the emergency room.

Called DETECT (Display Enhanced Testing for Concussions and mTBI system), the device is a fast, easy to administer and sensitive system for assessing problems associated with concussions. The DETECT device is an integrated system that includes software applications, a portable computer and an LCD display in the headgear.

While a typical mild traumatic brain injury (mTBI) test requires a quiet room and one or two hours of testing, DETECT performs neuropsychological tests in an immersive environment in about seven minutes, regardless of surrounding noise and movement. So, a football player or soldier who just took a hard hit to the head can take the test and either be safely cleared to get back on the pitch or sent to receive medical attention.

The device blocks external stimuli that could interfere with testing, such as light and sound. This allows the test to be given in virtually any setting, even a bright football field with a roaring crowd.

When suffering from mTBI, a person will have difficulty with certain types of thinking controlled by a different areas of the brain, such as working memory, complex reaction and multi-tasking. DETECT runs the wearer through three types of neuropsychological tests that measure the function of several parts of the brain as it attempts to perform the tests.

For example, the first shows the wearer a series of shapes with different colours and textures and gives voice instructions. The wearer uses a simple controller similar to a video game controller to respond to the commands. The device then measures the wearer’s response times and answer selections. If the response time is too slow or the incorrect answers were provided, it indicates impairment.

Biomedical Engineering Assistant Professor Michelle LaPlaca demonstrates DETECT with the help of Bryan Williams. The device helps quickly detect mild concussions in virtually any setting.

The DETECT system includes a laptop to run the software, a head-mounted display, earmuffs that also act as headphones and an input device (controller). The display projects the visual aspect of the test, the headphones provide the verbal instructions and the controller records the wearer’s response.

In addition to the advantages of its speed and portability, DETECT can also be administered by a non-medical personnel such as a coach or parent rather than a trained neurophysiologist.

While the device has already been tested in the lab and in a hospital emergency room, the Georgia Tech football program recognises the need for improved concussion assessment and plans to test this new technology.

DETECT may have other potential cognitive testing applications, such as helping assess cognitive impairment related to Alzheimer’s disease or drug use. The test would be brief and could be performed in a general physician’s office.

DETECT is expected to be commercially available in the next three to five years.