White Paper: Red Oak Instruments, LLC
December 2008
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mTBI Literature Overview: State of the Art for mTBI Detection/Diagnosis
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William C. Paske, PhD, Red Oak Instruments, LLC, Katy, TX
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Abstract:
Most mTBI assessment tests and review articles are directed at the effects of psychosis, depression, mania, posttraumatic stress disorder, agitation and aggression. Many of these problems may be due to a lack of detection of mTBI before complications set in, or appear to be due to other concurrent trauma events. Very few objective tests for physiological symptoms are made when making an assessment for mTBI. While balance, coordination, strength, posture and gait are discussed in some of the screening assessments, any assessments made on these physiological symptoms are subjective, with no objective, repeatable and reproducible screening assessments currently available. CT and PET scans can be run in cases when deemed necessary… but they are usually conducted only after symptoms have persisted for weeks or even months.
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Sports medicine has taken the lead in mTBI research, and even the military looks to sports medicine for multiple and cumulative mTBI research. Measurable physiological changes occur in sports related mTBI events and may be used to develop objective screening criteria which could then lead to applications for military/combat related mTBI events.
The physiological symptoms observed in sports related mTBI events appear very quickly, and the recovery rates for these physiological symptoms have been reported as equivalent to the recovery rates for the cognitive symptoms presently being screened. These measurable physiological symptoms can be interpreted before cognitive and behavioral symptoms become chronic.
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This suggests that studying mTBI in sports related events, would allow the development of an objective, rapid, non-invasive mTBI screen which could then be used by coaches, EMTs, corpsmen, etc. Beyond the military field and medical applications, an objective screening device would allow accurate and less expensive triage of the 1.5 million head injuries presented annually in hospital trauma rooms, ambulances, schools, and other sports venues.
