Point-of-care brain wave monitoring can help improve concussion care

Despite the brain being one of the most important organs of the body, breakthroughs in brain health, specifically the way we measure cognition, have been largely unchanged in decades.

Advanced neuroimaging devices like MRI exist; however, these are embedded within hospitals and inaccessible research labs, largely inaccessible to the people who need them.

Concussion has been making headlines for decades, with an ever-increasing need for tangible signs of progress with respect to accurate assessment and effective treatments. Previously considered a minor injury, the concept of concussion is becoming increasingly well-established as a brain injury, with the potential for serious consequences.

From athletes on the field to children on the playground to adults involved in motor vehicle accidents and/or falls, concussions affect us all. Prompt and accurate assessment is crucial for ensuring proper management and reducing the risk of future complications. However, traditional methods of concussion assessment often rely on subjective and error-prone evaluations, leading to challenges in treatment. This is where the emergence of objective brain wave measures is quickly becoming a priority.

Brain wave activity can be easily and safely recorded from electroencephalography (EEG), which is one of the oldest neurophysiological measures in neurology. For more than 100 years, EEG has been used in clinical and research settings to assess neurological function by measuring the electrical activity arising from neural activity in the brain. While traditionally confined to acute hospitals and specialized clinics, recent technological advancements have made portable EEG devices increasingly accessible. These devices, coupled with innovative software algorithms, have the potential to revolutionize concussion assessment by bringing point-of-care testing directly to where the impact happens: on the field, in the gym or even on the battlefield.

One key advantage of point-of-care EEG is its ability to provide real-time insights into cognitive brain function following a potential concussive impact. Unlike traditional neuroimaging techniques such as MRI, which may not detect subtle changes in brain activity, EEG offers a direct window into immediate changes in the brain activity. By analyzing specific brain wave responses, called cognitive evoked potentials (EPs), clinicians can quickly assess the presence and severity of concussive impacts in conjunction with other clinical assessments to better inform diagnostic evaluation and treatment decisions. These EPs are increasingly utilized as “vital signs” for cognitive brain function.

Point-of-care cognitive EPs have the potential to enhance sideline assessment in sports, where timely decisions about player safety are paramount. By equipping medical professionals with portable EEG devices, teams can quickly assess athletes for signs of concussion immediately following a suspected head injury. This rapid EP assessment can help prevent further injury and ensure that athletes receive appropriate care without delay.

Beyond the sidelines, point-of-care EPs holds promise for improving concussion management in a variety of settings. In outpatient clinical settings, where accurate diagnosis is critical, portable EEG devices can help expedite recovery for patients dealing with long-term concussion symptoms. Similarly, in military settings, where concussions are common among service members, point-of-care EPs can aid in the rapid assessment of head injuries and accurate return-to-activity, enabling prompt medical intervention and reducing the risk of long-term complications.

The widespread adoption of point-of-care EPs face several challenges and only recently has become increasingly incorporated within a “vital signs” framework. Challenges have included portability, time and skillset required to analyze reports, and sensitivity. Despite these challenges, the potential benefits of point-of-care EPs for concussion assessment are clear: By bringing EEG technology out of the lab and into the hands of frontline health care providers, we can revolutionize the way we diagnose and manage concussions, ultimately improving outcomes for patients and drastically reducing the burden of this serious public health issue. The days of reliance on subjective clinical guesswork are over. The medical community can now harness objective and accessible sensitive cognitive brain data for individual evaluations.

In medicine, you can’t treat what you can’t measure. The integration of point-of-care brain wave monitoring into concussion assessment represents a significant step forward in our efforts to improve the assessment and management of concussions. By providing real-time insights into brain function, portable EEG devices have the potential to revolutionize concussion assessment in a variety of settings, from the sports field to the battlefield. While challenges remain, the promise of point-of-care EPs for concussion assessment is too great to ignore. It is time to embrace this innovative technology and harness its potential to improve outcomes for individuals affected by concussion.

For more information:

Ryan C.N. D’Arcy, PhD, PlEng, can be reached at https://ca.linkedin.com/in/ryan-c-n-d-arcy-79109513 or neurocatch@havasformula.com.