We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
GLOBETECH PUBLISHING LLC

Download Mobile App




Portable Optical Imaging Tool Designed for Concussion Evaluation

By MedImaging International staff writers
Posted on 14 Jul 2014
Print article
Image: Participant fitted with fNIRS headgear (Photo courtesy of University of Pittsburgh Schools of the Health Sciences).
Image: Participant fitted with fNIRS headgear (Photo courtesy of University of Pittsburgh Schools of the Health Sciences).
Researchers have demonstrated that a portable, low-cost optical imaging application is useful in evaluation of concussions.

Two separate research projects, published recently, represent important steps toward demonstrating on patients the utility of portable, optical brain imaging for concussion and substantiating--via a large-scale statistical analysis—computed neurocognitive testing for concussion.

The findings from the optical-imaging research, employing functional near infrared spectroscopy (fNIRS), provided early support for the tool as a low-cost, portable device for imaging sports and military related concussions, researchers said. That report, published in the July 2014 issue of the journal Brain Imaging and Behavior, led to additional research out of University of Pittsburgh (Pitt) Medical Center (UPMC; PA, USA) that examined the brain during dual cognitive-balance performance in children following concussion.

The fNIRS unit works similar to a pulse oximeter for the brain. It gauges blood flow to the brain by sending light signals from sensors mounted in a 3-pound head-cap, and then producing images of blood oxygen changes representing brain activity by recording the absorption of light at different colors. The fNIRS generated readouts while participants wearing the head-cap took a computerized neurocognitive test and matched the test in revealing the brain's struggles to complete specific cognitive tasks.

“We hypothesize that cerebral blood flow is affected post-injury, and brain processing is going to be less efficient,” explained Anthony Kontos, PhD, assistant research director, UPMC Sports Medicine Concussion Program and assistant professor, Pitt department of orthopedic surgery. “If you’re performing a memory task or reaction-time task, it would require activation—more blood flow, more oxygen needed—in certain areas of the brain specific to that task. However, we found decreased and more spread out activation in the concussed group. In other words, their injured brains were less efficient and strained to get from elsewhere in the brain the resources necessary to perform cognitive tasks.”

“We knew what brain areas normally should light up,” added Theodore Huppert, PhD, assistant professor, Magnetic Resonance Research Center, Pitt department of radiology and Swanson School of Engineering. “From our data set, we had on average decreased brain activity and more diffuse brain activity, where more areas of the brain were needed to accomplish the task because the usual areas weren’t as efficient.”

This preliminary study included nine people between ages 18 and 45 who were symptomatic within 15 days to 1½ months of a sports-related concussion. Researchers compared them to five people who were uninjured. The fNIRS scans indicated that the concussed brain activated at a lower threshold and drew from a wider area—a distinct contrast from earlier functional magnetic resonance imaging (fMRI) studies using concussion patients. Furthermore, the decrease in oxygenated blood flow and lower test performance were detected during certain, more cognitively strenuous aspects of neurocognitive testing: word memory, design memory, and symbol matching.

“It’s a portable and fairly inexpensive imaging device compared to MRI; and most important, it allows us to combine both spatial and temporal information, meaning what is going on in a specific area of the brain and when the activation is occurring,” Dr. Kontos said. “It’s not just location. It’s not just timing. It’s both.”

A wireless fNIRS device is expected on the market soon, availing it for further research in a clinical and possibly even a sideline concussion setting, according to the investigators. However, Dr. Kontos emphasized the utility of the current iteration, “You can wear this while doing neurocognitive testing, you can wear this during balance-testing, you can even wear it while doing exertional testing, like on a treadmill. It’s useable in an environment for sports-related concussion.”

“In the past decade and a half, many in the field of concussion science have tried to find an imaging tool that could help us in a clinical setting, and failed to find anything with consistency,” stated Michael Collins, PhD, director, UPMC Sports Medicine Concussion Program. “This preliminary study, although small, showed us where in the brain a patient is affected and to what cognitive extent. It was enough evidence for us to keep pushing further with this potential tool.”

The fNIRS study employed ImPACT, a computerized neurocognitive test battery designed to evaluate mild traumatic brain injury. The technology was developed by ImPACT Applications, Inc. (Pittsburgh, PA, USA).

In a separate study, a meta-analysis published in the March 2014 edition of the Journal of the International Neuropsychological Society, Rock Braithwaite, EdD, a professor from the department of kinesiology and recreation administration, Humboldt State University (Arcata, CA, USA), synthesized all existing research using the four major computerized neurocognitive tests for concussion: Headminder, CogSport, Automated Neuropsychological Assessment Metrics (ANAM), and ImPACT.

In what is considered the largest statistical review of published computerized concussion testing to date, involving 37 studies and 3,960 participants all within the first week of sustaining a concussion, the investigators produced two key findings: (1) Middle-school and younger high-school students displayed more pronounced cognitive effects and greater performance deterioration according to neurocognitive testing after a concussion than their senior high-school and college-aged counterparts. (2) ImPACT demonstrated the strongest performance for identifying cognitive impairment because it measured the types of tasks that this meta-analysis analyzed as being most effective in detecting such postconcussion issues: processing speed, verbal memory, visual memory, and recall.

“ImPACT found the largest effects for individuals who had been concussed, across all outcomes,” said Dr. Braithwaite, who initiated the idea for this study. “Memory, processing speed, recall… ImPACT was able to better detect changes compared to the other computerized tests.”

Dr. Kontos, a coauthor on the meta-analysis along with Drs. Elbin and Dakan, concurred with Dr. Braithwaite that their study is an important first step. “There is not a lot of good research out there involving many of these tests, and most of the existing research uses the ImPACT test,” said Dr. Kontos. “We need more research on the effectiveness of these other tests in patients with sports-related concussion.”

Related Links:

University of Pittsburgh Medical Center
ImPACT Applications 
Humboldt State University


Gold Member
Solid State Kv/Dose Multi-Sensor
AGMS-DM+
New
Ultrasound Software
UltraExtend NX
New
Silver Member
Mobile X-Ray Barrier
Lead Acrylic Mobile X-Ray Barriers
Laptop Ultrasound Scanner
PL-3018

Print article

Channels

Ultrasound

view channel
Image: Structure of the proposed transparent ultrasound transducer and its optical transmittance (Photo courtesy of POSTECH)

Ultrasensitive Broadband Transparent Ultrasound Transducer Enhances Medical Diagnosis

The ultrasound-photoacoustic dual-modal imaging system combines molecular imaging contrast with ultrasound imaging. It can display molecular and structural details inside the body in real time without... Read more

Nuclear Medicine

view channel
Image: PET/CT of a 60-year-old male patient with clinical suspicion of lung cancer (Photo courtesy of EJNMMI Physics)

Early 30-Minute Dynamic FDG-PET Acquisition Could Halve Lung Scan Times

F-18 FDG-PET scans are a way to look inside the body using a special dye, and these scans can be either static or dynamic. Static scans happen 60 minutes after the dye is administered into the body, showing... Read more

Imaging IT

view channel
Image: The new Medical Imaging Suite makes healthcare imaging data more accessible, interoperable and useful (Photo courtesy of Google Cloud)

New Google Cloud Medical Imaging Suite Makes Imaging Healthcare Data More Accessible

Medical imaging is a critical tool used to diagnose patients, and there are billions of medical images scanned globally each year. Imaging data accounts for about 90% of all healthcare data1 and, until... Read more

Industry News

view channel
Image: The acquisition will expand IBA’s medical imaging quality assurance offering (Photo courtesy of Radcal)

IBA Acquires Radcal to Expand Medical Imaging Quality Assurance Offering

Ion Beam Applications S.A. (IBA, Louvain-La-Neuve, Belgium), the global leader in particle accelerator technology and a world-leading provider of dosimetry and quality assurance (QA) solutions, has entered... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.