A team of researchers led by Jeffrey J. Bazarian, M.D., M.P.H. found that a portable, handheld EEG device can help diagnose sport-related concussion at the time of injury. The study results, published on February 15, 2020 in JAMA Open Network, were used to support the submission of the device to the FDA for commercialization, which was granted in September 2019.
Concussion is a diagnosis based largely on a patient's own report of signs and symptoms. The lack of an accurate, objective way to identify the presence and severity of concussion presents challenges to health care providers and patients, especially around decisions about rest and recovery time and readiness to return to play. If a patient returns to play too early, they risk further brain injury that could have long-term consequences.
Bazarian led a team of researchers who tested the multimodal "Concussion Index," which includes the use of a handheld EEG device to assess changes in the brain following a head hit. Past studies show that disruptions in brain electrical activity (EEG) occur in concussion, including the disorganization of communication between different parts of the brain. Use of the EEG device is coupled with cognitive testing and symptom reporting from patients to arrive at the Concussion Index for a given patient.
Athletes from 10 universities and high schools across the country participated in the study between 2017 and 2019. Athletes who experienced a concussion were assessed with the Concussion Index within 72 hours of injury, when they returned to play and 45 days after they returned to play. Athletes who did not suffer a concussion served as controls. The team found that the Concussion Index was able to distinguish between athletes with a concussion and those without on the day of injury with high accuracy. Read the full study results here.
Professor of Emergency Medicine, Neurology, Neurosurgery, and Public Health Sciences at the University of Rochester Medical Center, Bazarian has spent the past 25 years studying how to better diagnose and treat concussions. He is particularly interested in neuroimaging and blood-based biomarkers of brain injury after concussion and repetitive head hits. He also treats children and teens with concussion at the University of Rochester Child Neurology Concussion Clinic.
Though the Concussion Index and associated EEG device, developed by BrainScope, is approved for use in the U.S., many questions need to be answered before it is deployed at URMC, including: who administers the test; how test results get from the EEG device to a health care provider and then into the patient's electronic medical record; and will insurance provide reimbursement for the use of the test. Bazarian is working with a small group of researchers who hope to study these and other implementation issues in the future.