Dr. Matthew Kennedy, Co-Founder & Chief Medical Officer, NeurovineConcussion is often described as an “invisible” injury – it does not appear on MRI scans, CT scans, or other widely used medical imaging devices. Without objective findings on imaging, concussion can only be diagnosed through the signs and symptoms a person with concussion describes. These can be diverse and numerous, and even delayed from the initial head impact, making the correct diagnosis a challenge. Most significantly, this invisibility can cause patients, their colleagues and employers to question the legitimacy of their injury, leading to self-doubt, isolation, and exacerbating mental health.
The risk of concussion is present for people of all ages and can happen in any situation in daily life. The risk of concussion is higher for those who participate in sport, and a rise in youth participation in recreational and contact sports has contributed to an increase in diagnosed concussions in youth. This being said, the large majority of concussions happens in the general population during regular daily activities.
In this blog post, I’ll delve into how portable electroencephalography (EEG) paired with a mobile application can help bring visibility to this invisible injury and help guide patients through successful concussion recovery.
So what happens when a concussion occurs?
Concussion is a type of brain injury that occurs from a traumatic hit to the head or body, causing the brain to move around and hit the inside of the skull. Concussion itself can be classified as an invisible injury that does not appear on medical imaging, but the resulting symptoms can severely affect a person’s day-to-day life.
Common symptoms of concussion include headaches, dizziness, confusion, and sensitivity to light and noise, but many people with concussion may also experience more severe and chronic symptoms, including emotional and cognitive changes, and changes to sleep patterns. Because these symptoms often manifest and progress differently from one individual to another, concussions prove to be a challenging condition to correctly diagnose, assess, and treat.
How is concussion treated today?
The current standard of care for treating concussion is based on a vague and generic graduated return-to-life plan. Patients are advised to start with rest, and gradually increase their physical and mental exertion in a step-wise fashion. If they push too hard and develop symptoms they are advised to take a step back in their activity for a period of time until the symptoms resolve before pushing forward again.
Evidence has shown that activity helps to speed recovery, but that overexertion causes delays in recovery. Furthermore, concussions are very individualized and nuanced with no two concussions being the same. The current guidelines of blindly and gradually pushing forward runs the risk of delaying recovery by overexertion.
There is an important need for an individualized and data-driven recovery plan to optimize this complex path to recovery for each individual patient.
What is EEG and how can it help?
EEG is a passive, non-invasive tool that uses electrodes placed on the scalp to record the activation of neurons in the cerebral cortex. EEG has been shown to effectively measure cognitive exertion during mental tasks such as reading a book or solving a puzzle.
Although EEG cannot give an anatomical view of the brain, such as that from an MRI scan, it does have a high temporal resolution, meaning it is able to monitor real-time changes in brain activity. This real-time brain data allows for continuous monitoring of cognitive effort which can be used to help walk the delicate line of concussion recovery. Allowing patients to optimize their level of cognitive exertion, but avoiding potentially damaging overexertion.
Another advantage of EEG is its portability and accessibility. Recently, EEG headsets have been manufactured for commercial use as a tool for monitoring mental activity in everyday life. This allows the possibility of affordable portable EEG monitoring for concussion patients to help guide them through their recovery in real-life home settings.
EEG is proving to be an optimal tool for real-time monitoring of brain activity in concussion rehabilitation. The use of EEG can be extremely beneficial to understanding the changes that occur in the brain after concussion and make these changes “visible” to patients and their clinicians. This is good news for concussion patients struggling with their “invisible injury” and provides a path to help them heal.
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