Invention offers game plan for concussions

When the Carolina Panthers take on the Denver Broncos this Sunday in the Super Bowl, there will be more at stake for the players than bragging rights and money. As the recent movie “Concussion” showed, they may run the risk of brain damage in what a PBS Frontline report called a “concussion crisis” for the National Football League.

But highly paid athletes aren’t the only people who risk brain injury during practices and games. More than 400,000 children and teenagers suffer a sports-related concussion each year, as MUSC pediatric neurologist Thomas Koch, M.D., recently noted in an South Carolina Public Radio podcast. Some of those kids, like the pro athletes they admire, try to keep playing, even though doing that can cause more serious or even deadly problems.

That’s where a device being developed at the Zucker Institute for Applied Neurosciences at the Medical University of South Carolina comes in. Co-inventor Mark Semler said the Blink Reflexometer is designed to measure the way an athlete blinks after a head injury to see if he or she has a concussion. “We think it may be a good way to check neurological function that can be really useful to a trainer trying to make a call on the sidelines.”

The patent was filed in 2013, and the team at ZIAN is looking for commercial partners while it refines the technology and prepares it for commercialization.

Semler said Nancey Tsai, M.D., a physical medicine and rehabilitation doctor, came up the idea while affiliated with MUSC’s Neuroscience Department. She brought it to ZIAN, where Semler serves as chief technology officer. She knew blink reflexometers were out there, but they were, in Semler’s words, “pretty crude, kind of do-it-yourself research tools.”

Tsai had something different in mind: a high-quality but relatively low-cost device that could be used right on the sidelines of games. It would need to be put through rigorous testing to see how well it worked and whether any changes were needed.

The technology was new, but it relied on a primitive reflex: the blink. “There are several characteristics of the blink that change with different neurological states,” Semler said. “For instance, the way Parkinson’s patients blink is different.”

So a concussion, which is a disturbance of brain function due to a head injury, may change the way a person blinks as well. “When something triggers your blink reflex, the electrical pathways go through your brain stem,” Semler said. “If you have damage to your brain stem from a concussion, even a mild concussion, it might be picked up on our Blink Reflexometer.”

The device, which is being tested at MUSC and on athletes at The Citadel, has a few different ways of triggering the blink reflex: bright lights, loud noises and a puff of air. “Then it measures movements of your eye.”

Semler said the Blink Reflexometer may give team trainers an objective way to help them judge whether a player has had a concussion. “Right now, trainers just use guidelines put out by various organizations. They have other diagnostic equipment too, but in talking to them, we learned it doesn’t fit their needs.”

Unfortunately, he said, many of today’s concussion diagnostics can allow some players to “game” the system. They intentionally do badly on baseline tests measuring their memory and balance, taken before they play. That way, if they have a concussion and have to retake the tests, their scores should still look okay and they can keep playing.

“We aren’t calling the Blink Reflexometer a concussion detector. It’s an aid for trainers,” Semler said. An aid designed to be rugged, portable and fast. “So you don’t have to take them off the field. It’s Friday night lights, it’s raining and the crowd is screaming. You want to know if they have an issue so you can move them somewhere else for treatment or they can go back in.”