A new brain-scanning technology from Nova Scotia startup Mindful Scientific could change the way concussions are handled in professional sports—and revolutionize care for people with catastrophic brain injuries in the process.
The company's approach uses a lightweight EEG scanner to take brain activity readings while subjecting patients to various neurological pokes and prods. These pokes and prods aren't literal, but take the form of simple verbal and visual tests designed to evoke telltale neurological signals of consciousness in anyone capable of processing them. "For instance, we present [the patient] a pattern, and then we violate the pattern and see how the brain responds," Mindful Scientific CEO Ying Tam told Motherboard. The offending pattern can be everything from a nonsensical sentence to a broken series of musical tones. "Or we present them with their name, then a similar stimuli but with someone else's name," Tam added.
The Halifax scanner attempts to assess three neurological indices—sensation, attention, and perception—as well as memory and language, two higher cognitive indices. In all cases, the intent in Tam's testing is to capture the brain "popping" in response to these stimuli.
"If I say to you, 'The pizza is much too… sing.' You're thinking, 'Hot.' If your brain is working properly at all, your brain's going to pop," Tam explained.
The scanner averages out the scores on more than 350 such readings to prepare an aggregate score of a person's level of consciousness; it's not yet clear where, precisely, the cut-offs lie between various levels of consciousness, but Tam says that's ultimately a decision for the practitioners who make use of their tech.
"Right now what people do is a self-test called the SCAT3, where they sit down and assess themselves along a number of indices," Tam said. This means that the patient must be conscious during administration of the test, and the results can be skewed by all the confounding variables associated with intellectual testing in any context. "We think our device will replace all of that."
At present, EEG is the scanner's primary neuro-imaging technology, due to its low cost and portability. But Mindful Scientific hopes that in a hospital setting, their prod-and-check approach could be applied with even higher resolution imaging techniques for even more precise results.
The most stark example of how improved consciousness-testing could be useful comes from so-called Locked-In Syndrome, in which patients can be partially or even fully conscious without any ability to express that fact to those around them. These people have often been mistakenly categorized as vegetative—and according to the National Research Council of Canada the traditional method of assessing consciousness fails in this context nearly half the time. The Halifax scanner could help doctors and family members determine the true level of consciousness of a seemingly comatose patient.
However, it's the Halifax scanner's ability to assess less catastrophic brain injuries that is getting the most attention. Still reeling from the enormous legal payout to former NFL players in 2013, professional sports teams are eager to reduce liability for what seems to be a long-standing (though until recently, little-known) health crisis.
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"We've talked to professional sports teams who say they want the test to last no longer than 5 minutes, they want to use it at the sidelines," Tam said. That's a lofty goal, but Tam explained they have a compressed sequence of stimuli, part of their "secret sauce," that generates 330 neurological pokes and prods within that short period of time.
The beauty of the Halifax Consciousness Scanner is that it requires little work on the part of the participant; its various stimuli trigger the neurological equivalent of muscle reflexes, rather than tasking the patient with solving verbal or logic problems. It attempts to assay consciousness while only indirectly engaging the conscious mind—meaning it could work despite a patient's fatigue, disinterest, or distraction. It would also require little or no localization across cultures.
Tam is confident that his company's scanner will eventually be used widely. "Maybe it'll be driven by sports teams, maybe it'll be driven by the military. But there will definitely be pressure to deploy, in hospitals, all over," Tam said. "You can't ignore concussions these days."