Dr. David Wright talks about a heads-up display unit that, with active white noise reduction, takes the neurotesting room to the sidelines or to combat.
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DETECT came out of this real need
for a sideline assessment tool for concussion,
and I'll tell you, this all started
well before
the OEF, OIF,
well before the NFL was being carted in front of
Congress to explain the issues with concussions.
We recognized, as did many other, frankly, people
in the country that concussions were a problem,
that there was no good way
on the sidelines to
discriminate between who had a concussion and who didn't,
who could go back into play and who should not,
and, again, this was well before people
were being held out.
Most players were being sent right back in
even if they were diagnosed with a concussion.
Just, "You clear?" "Yeah, I got it, I'm good, let's go,"
and that was the mentality at the time.
This was around 2000-2001,
not that long ago but light years
with where we are with concussion today,
at least, our thinking of the importance
of concussion.
So, what we did was
we looked out there
and tried to decide,
What's the gold standard currently,
back in 2001,
for determining whether someone
was concussed or not,
and at the time, and actually still
today, was neuropsychological testing
and testing function of the brain.
The problem is
that neuropsychological testing requires
an examiner,
someone knowledgeable.
It's a pen and paper test, or it was at that time.
It took anywhere from
an hour to 4 hours worth of testing,
and it needed to be done in a very quiet room,
so that there weren't distractions
in this testing.
Well, of course, none of those applied to the sidelines,
especially not during a game
where you get up to 100 decibels,
the game's going on, the coach is saying something
and the athletic trainer's saying something,
so it's quite a chaotic environment,
and I and my colleague,
Michelle LaPlaca at Georgia Tech,
which is a fantastic engineering school, sat down and said,
"Okay. Here's our design criteria,
how do we overcome these issues?"
And so, what we did was,
over a series of years, working,
we designed a neuropsychological test
that essentially took
the best of each test that's already being used
and reprogrammed it to be very short,
very pithy,
and be able to identify dysfunction quickly.
So, we were able to reduce
the neuropsychological testing period
down to less than 10 minutes.
We then said, "Okay, now we've got a problem
with all the noise."
Nobody can take anything on the sidelines too well.
So, we created an immersive platform,
and that's the device that we have.
It is essentially a heads-up display unit
with active noise reduction
that takes the testing room to the field.
So, it's got white noise in it,
it's got a whole variety of other technology in it
to create this immersive environment,
and then we run the subjects through
this testing paradigm
and can fairly quickly say
they're functioning at normal level,
or not.
So, our device doesn't diagnose
traumatic brain injury.
What it diagnoses is,
or what it tells you is,
they're not functioning at the level they should be functioning
which is really what you want to know.
You want to know, are they impaired enough that
they shouldn't be going back out?
I'll say 1 other important and relevant issue
with this is,
we think this is really important
for the military.
Maybe even more so than
football and sports,
because in football and sports
there are probably microscopic things happening,
axons, like increasing ion channels, and things like that
after each repetitive concussion
or each repetitive hit,
and it's probably important in a young athlete,
if they're exposed to that, to pull them out
and let that quiet up
even if their brain function was back to normal,
but in the military,
there's a whole different set of rules,
and so, if you have a soldier out in the field,
and I have a biomarker for brain injury
and I can test him after exposure to a blast
and I can say "Okay, so he was exposed to blast,
he has a brain injury."
Really, as a colonel who's wanting to send this guy back out,
that doesn't tell me the information that I need.
What I really want to know is,
can that soldier, when he goes back out,
think, and can he perform?
Will he walk out in front of a
dangerous situation?
Will he make good decisions while he's in harm's way,
and you need a functional test for that,
and there's no other biomarker test
that's going to provide that information,
and that's why this functional testing
is really still critically important
in that kind of paradigm and that
kind of setting.
Yeah, it'd be nice to know that they were exposed to
a brain injury or to a blast,
but, again, the really important information
is, are they functioning right?
So, the device is essentially a heads-up display,
very much like the immersive
gaming systems that you may have seen
that are available out there,
or what military night vision goggles
would look like,
and there's headphones that have noise reduction
capabilities,
and the information is displayed up through the headphones
and through the heads-up display,
and so it's like a helmet, essentially,
and indeed we can actually even place it
in a football helmet
if we needed to, if that was so desired.
Produced by Victoria Tilney McDonough, Ashley Gilleland, Justin Rhodes, and Erica Queen, BrainLine.
David Wright, MD, FACEP is a tenured associate professor in the Department of Emergency Medicine at Emory University, and the director of the division of Emergency Neurosciences. The Emergency Neurosciences program is dedicated to finding novel therapies for the treatment of rapidly evolving neurological conditions, including traumatic brain injury, stroke, status epilepticus, spinal cord injury and others.
The contents of Brainline (the “Web Site”), such as text, graphics, images, information obtained from the Web Site’s licensors and/or consultants, and other material contained on the Web Site (collectively, the “Content”) are for informational purposes only. The Content is not intended to be a substitute for medical, legal, or other professional advice, diagnosis, or treatment.
Specifically, with regards to medical issues, always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Web Site. If you think you may have a medical emergency, call your doctor or 911 immediately. The Web Site does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Web Site. Reliance on any information provided by the Web Site or by employees, volunteers or contractors or others associated with the Web Site and/or other visitors to the Web Site is solely at your own risk.
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