Using Virtual Reality to Improve Concussion Diagnosis

Using Virtual Reality to Improve Concussion Diagnosis


A concussion really is loosely defined
as one of a series of symptoms, and it’s a long list of symptoms, and if you have
one of those, then you typically are diagnosed with a concussion following
a head impact or a biomechanical impact that you report that you had. When you
get hit— you can be hit in your body. You can be hit directly in the head—that
causes an acceleration of your body or your head and, because your brain is
inside your skull resting in cerebrospinal fluid, so it’s just sort of
a water like substance that bathes your brain, it’s just floating in there, and so
if you get accelerated then your brain hits the inside of your skull, and then,
when you decelerate, so there’s an acceleration and a deceleration, then
your brain hits the other side of your skull, and it’s causing the brain to kind
of deform during that acceleration and deceleration. That sort of stretching and
shearing motion can have an effect on all the little neurons and axons that
are connecting—that basically make up your brain. So you could certainly have
other injuries occurring that are affecting the other parts of your body,
but the concussion itself is the brain that’s being affected. My area is focused
on balance. We call it posturography, so the study of posture. We use what’s
called a soccer-heading paradigm. You shoot a ball from what’s called a jugs
machine, and the idea is that you’re exposing a person to a controlled bout
of head impacts, and this is well below what you’d experience in a soccer game.
We call this a sub-concussive blow and that means that they won’t show symptoms of a concussion afterwards, but they will maybe show very low level things that we
weren’t able to detect through our standard ways of measuring for
concussion. Right now, our main tests are using virtual reality, and in that test
we’re using a combination of what you might call a veridical representation of
your environment, meaning it’s a real representation of the environment you’re
standing in, and then we alter that environment to be something that is
perturbing. So, if your environment is tilting or spinning, then it’s—you use
that visual information to help you keep your balance,
and, if that’s happening, then you’re more likely to fall over if you change the
visual information that you’re getting. So, we’re using that to test whether or
not if you’ve had a concussion you’re going to be more susceptible to this
dynamic rotating and moving environment than a person who hasn’t been. We’re
doing MRI scans over a the Temple University Brain Research Imaging Center.
That scanner allows us to see movement of blood-oxygenated level of brain
activity in particular parts of the brain, and so basically we’re exposing
them to some of the same virtual environment scenes that we had then look at while they were doing the postural tasks, and we want to see is there some
area of the brain that is either more activated or less activated in the
concussed or sub-concussed subject than the healthy subject. We have so few of these
very accurate and sensitive measures right now that we’re kind of sending
people back into the line of fire without having a really good idea of
whether or not they’re fully recovered so, in 20 years the hope is we have some
really easily accessible tests that you can just basically pull up your
smartphone and be able to take a quick test, and you determine, because you’re
being compared to the normative values, you can tell whether or not you’ve
recovered or whether or not you were actually injured in the first place.
Knowing that people are going to get injured, we want to have good tools for
helping them recover and identify whether or not and how seriously they
were injured.

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