/ Modified jun 4, 2014 3:20 p.m.

UA Research Aims to Improve Concussion Diagnosis

Drive for study is to develop tools that can be more sensitive at catching low-grade injury; technology records brain activity along scalp.



There is research under way at the University of Arizona focusing on the hot-button issue of athletes suffering concussions. The emphasis is on early detection and treatment.

Jarret Bunnin is a recent graduate of the UA. In school, he played rugby, after growing up playing football. He's had his bumps, bruises along the way, and had even felt woozy after a big hit.

But Bunnin had never experienced anything like what happened to him earlier this year, after he suffered a concussion in a rugby match.

"It's unlike any injury I've ever had before. With other injuries like breaks, strains, pulls you can kind of get over them in a week or two, or you can still play with it, and it's something you can fight through," he said. "With a concussion, that's not the case at all. You can't just jump back into things after being out a week. It's all a process and a time sensitive process."

Bunnin was upended and landed on his head, causing the concussion. He was out of action for five weeks.

Knowing the severity of a concussion, and when it's safe for a player to return to the field are diagnoses that vary from person to person, and it can be difficult to be accurate.

That's where the UA research comes in.

"The drive for the study and the research that we are doing is to develop tools that are going to be more sensitive at catching these low-grade concussions," said Ezra Smith, a UA graduate student, researching ways to better diagnose concussions. He is studying for his Ph.D. in psychology. "It's more sensitive than a neurological exam and can be applied more quickly to clear players in the case where it would be safe for them to go."

The technology uses an electroencephalography test, or EEG, to record electrical brain activity along the scalp. Patients wear caps that look similar to swimming or shower caps filled with sensors that pick up brain activity. The cap is connected to a computer that amplifies the brain waves, and they appear on a computer screen looking like a polygraph test.

The EEG works well for the type of research that Smith is doing: looking at lower grade concussions.

"The tool we use, the EEG, has excellent time resolution. It can detect down to a millisecond changes in brain activity. Why is that important?" he said. "Well, it might be important to know how offset in time two parts of the brain are in talking to each other are."

Smith said the EEG is also more sensitive than the standard neurological exam, which involves CT or MRI scans. And, he said it provides quicker results and is more mobile, and eventually could be used on the sidelines of sports events.

That could help Dianne Goodridge. She’s an athletic trainer for UA club sports including rugby. She has seen how dealing with concussions has changed over the course of her 29-year career.

“Earlier on when we did not have as much evidence to back us up. If it was a borderline case and the athlete said, 'I’m fine. I’m ready to go,' and we didn’t have any other conclusive reason that we could hold them out we would let them go," she said. "Now we have more tools in our toolbox to say, 'You’re not ready.'"

She said diagnosing a concussion is difficult.

“We error on the side of caution, in most sports you can pull a kid out 10 minutes and that gives you enough time to diagnose a concussion," Goodridge said. "When they have a big hit you have to do you evaluation and diagnosis on the field. So we error on the side of caution and pull them out if we have any suspicion of a concussion but they can’t do back in the game. That’s just the rules of rugby.”

Smith stressed it will take some time, possibly five to ten years, before there are any real world advancements for players from his technology.

While the technology exists, what is needed for his research is time for testing and validation that the EEG is a faster, more accurate course of action than what is in place. If the study that Smith and others are working on becomes reality, it could change the way concussion diagnoses are treated.

Through diagnosis, treatment and recovery, Bunnin said his thoughts have changed on dealing with concussions and their long-term effects.

“When I first got mine I was thinking 'Oh great, now I’ve got a concussion. I‘m just getting in the flow of things. I’ve been working really hard but now I’ve got to sit out for four to five weeks,'" he said. "At the same time, you do hear all these things going on with the NFL about having concussions and past brain damage, and brain trauma being linked to suicide and dementia. When you look at things like that it does make you take a step back from whatever other ideas that have been floating around in your head of rushing back.”

Some of Bunnin’s teammates take the same deliberate view while others do try to rush back.

“I’ve probably played with more guys that have gotten a concussion, and they have tried to push it as fast as they can, they try and cheat the process to get back because it is a competition," he said.

Injured athletes will always fight to get back on the playing field. It’s their nature. This study could help make their return to action more deliberate and safer.

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