Feb 12, 2019
Detecting Impairments

Upon the conclusion of a multi-year, peer-reviewed hockey concussion study, a brain research team discovered undetected brain impairments in hockey players. They used a new brainwave monitoring method dubbed “brain vital signs” to do so.

According to a release from Canada’s Simon Fraser University, the findings were the fruits of an ongoing relationship between neuroscientists from the Health and Technology District in Surrey, British Columbia, and Mayo Clinic Sports Medicine Center in Rochester, Minn.

“We recognized the need to move beyond subjective concussion diagnoses that relied on questions—that players could deny or exaggerate—to more objective measurements,” said Aynsley Smith, PhD, Sport and Exercise Psychologist and Concussion Investigator for Mayo Clinic Sports Medicine.

Over the course of two seasons, the team tracked the brain function of a combined 47 junior ice hockey players—all male—from Canada’s Junior A division and America’s Tier III level. Researchers divided players into two groups—those diagnosed with concussions and those who were not—and assessed the baseline, post-injury, return-to-play, and postseason time points of each. To do so, the team utilized a new brainwave monitoring method known as “brain vital signs,” which translates complex brain waves from portable electroencephalography (EEG) devices into event-related potentials (ERPs) within minutes.

The study’s brain vital signs measured three “core, well-established ERP brain responses.” Those included the N100 for auditory sensation, P300 for basic attention, and N400 for cognitive processing.

“The research team found that brain vital signs detected neurophysiological impairments, such as attention and cognitive processing deficits, in players who had been diagnosed with concussions and were cleared for return-to-play,” according to the SFU release.

“What’s even more surprising is that not only did we find undetected physiological impairments in players diagnosed with concussions who were cleared to play, we also found that players who were not diagnosed with concussions showed decreased cognitive processing speed post season—thought to be the result of repetitive ‘sub-concussive impacts,’” said Shaun Fickling, lead author of the study and a PhD student at SFU.

The results even point to brain vital signs being “a breakthrough for analyzing complex brainwave data,” and that the method is “more sensitive in detecting brain function changes related to concussion than existing clinical tests.” The study also proved the effectiveness of brain vital signs as a fast, user-friendly, and intuitive producer of measurable results, which can conveniently be conducted rinkside.

Michael Stuart, MD, Co-Director of Mayo Clinic Sports Medicine and Chief Medical and Safety Officer for USA Hockey, thinks this advancement could combat what he describes as a “global public health issue” surrounding concussions in sports.

“There is a growing urgency to develop practical approaches that use objective, physiological measures, which are also rapidly and easily deployable in sport and clinical settings so medical staff can better diagnose and treat concussions,” said Dr. Stuart.

Ryan D’Arcy, PhD, Co-Founder of the Health and Technology District, SFU professor, and the study’s senior author, agrees that the discovery of brain vital signs as an indicator of undetected brain impairments is a vital step forward in concussion evaluation and treatment.

“Sports-related concussion is a major topic of discussion amongst scientists, clinicians, the medical community, the sports industry and various government agencies,” Dr. D’Arcy said. “There is growing concern that concussions may be associated with an increased risk of persistent cognitive and mental health impairments later in life.” 

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