New software shows ‘sub-concussive impacts’ likely alter brain function

A season long study of youth hockey players resulted in some interesting findings regarding concussions and sub-concussive impacts.

Dr. Ryan D’Arcy, a neuroscientist in Surrey, British Columbia, has developed a new brainwave monitoring method called ‘Brain Vital Signs’ (BVS). D’Arcy told The North Delta Reporter that his software is, “the first objective yardstick for brain function.”

To develop BVS D’Arcy and his team worked with the U.S.’ Mayo Clinic Sports Medicine Centre, Health and Technology District, and Simon Fraser University. Together those groups studied Junior A male hockey players over an entire season of play.

To study players, scientists used a portable electroencephalography (EEG) cap to read their brain activity before and after games and analyzed the data with the BVS software.

The resulting peer-reviewed study showed that, “existing concussion protocol tests may not be detecting brain function changes in young ice hockey players diagnosed with concussions.”

Existing concussion protocols involve a series of baseline questions being asked to an athlete prior to competition. The questions are designed to assess brain function and include having the athlete rate their own light/noise sensitivity, neck pain, irritability, as well as their understanding of space and time; with questions like “what month is it?”

Other questions that could feature in baseline testing include immediate memory tests (“repeat these five words in any order”), concentration tests (“repeat these numbers back to me in reverse order”), balance tests, and delayed recall tests — where the patient is asked to recall their answer from the earlier immediate memory test.

If a medical professional suspects an athlete has suffered a concussion, they will ask these same questions and cross-reference the answers with the baseline answers. It is believed the variations in the two sets of answers show that the patient’s brain function has been altered.

Most medical professionals will also use the Glasgow Coma Scale (GCS) when assessing an athlete after a suspected concussion. GCS, which is widely used in boxing, tests eye, verbal, and motor responses.

These traditional methods are problematic because they are often unable to diagnose physiological changes that are occurring in the brain which do not have any noticeable symptoms. These methods are also susceptible to athletes ‘gaming the system’, by training themselves to remember the answers they gave during baseline testing and repeating them during an actual concussion test.

BVS does not use any questioning or physical examinations when determining if brain functions have been altered. It just reads the electrical activity in the brain. These results are then compared to baseline readings to determine any changes.

D’Arcy told the Surrey Now-Leader that his multi-year study had three key findings. First, that BVS was very sensitive in detecting significant changes in brain function in players who had suffered a concussion. Second, BVS detected brain function deficits in players who returned to play after being cleared with existing concussion tests.

The third finding of note was that BVS, “detected changes in cognitive processing speeds at the end of the season for players who did not receive any concussion diagnoses, implicating sub-concussive effects.”

Dr. Shaun Fickling of SFU, the lead author on the study, said that players who had not been diagnosed with concussions showed “decreased cognitive processing speed post season — thought to be the result of ‘sub-concussive impacts.’” Fickling did also suggest that these readings could be the result of concussions which were not diagnosed.

This is not the first study to link sub-concussive blows to changes in brain function. In January 2018, Boston University School of Medicine released a study that showed repeated sub-concussive blows can, like concussions, cause chronic traumatic encephalopathy (CTE).

In addition to BVS being sensitive enough to detect brain changes from concussions, and possibly sub-concussive blows, the software is also able to create something similar to a “fingerprint” for concussion.

D’Arcy explained that in the future BVS will not require baseline testing from an athlete in order to search for a concussion, that it has instead discovered a unique pattern of brain activity consistent with concussion.

Future applications for combat sports could include baseline testing for athletes and then post-fight tests to determine whether or not they had suffered brain impairments regardless if they had been knocked out or ‘rocked’ with blows to the head.