Study seeks consistency in concussion data

University of Victoria researchers are part of a Canada-wide effort to dramatically improve diagnosis and treatment of concussion, a complex brain injury gaining increasing attention at all levels of sport.

The issue of mild traumatic brain injury (mTBI or concussion) has been pushed under an intense national spotlight, with Hockey Hall of Fame goalie and former federal cabinet minister Ken Dryden calling on the sports community last spring to get to the bottom of concussions or face catastrophic consequences. Other national icons, such as three-time Olympic hockey gold medallist Hayley Wickenheiser, are also urging action.

"Concussion is an enormous concern in all of sport, not just hockey," says Wickenheiser. "Research into better understanding concussion, and how best to treat and prevent the injury, is vitally important. Increasing the safety of athletes, preventing injury and facilitating recovery when injuries do occur have to be the highest priorities for everyone involved in sport."

Dr. Brian Christie, a professor in the Division of Medical Sciences and director of UVic's new Neuroscience Graduate Program, is part of a team of researchers across Canada recently awarded $1.4 million over five years by the Canada Institutes of Health Research to conduct just that type of research. The goal is to standardize the terms and tools used to describe concussion patients to facilitate data comparisons across sites, and enhance investigations into long-term effects.

"There is enormous interest in concussion, both from a research perspective and from the public, and we've seen our project garner huge community engagement just by word of mouth," says Christie, who was invited to speak on the subject at last fall's Wickfest, an annual women's hockey festival hosted by Wickenheiser.

Standardized data will also help scientists better understand the symptoms that are the best prognostic indicators for poor recovery from concussion, Christie says. That knowledge will provide clinicians across Canada with more confidence in their diagnoses and empower doctors, parents, players and coaches to make better decisions about treatment, including when it is appropriate and safe for a patient to "return to play."

Christie was already working on a similar study, which will now feed into the CIHR-funded project, looking to validate a testing protocol for gathering accurate baseline information on cognitive function in youth hockey players. That effort partnered with the Victoria Racquet Club minor hockey program to test approximately 200 youth players ages 6 to 17 over the past year, using Neurotracker software donated by Quebec-based Cognisens Inc. and evaluating its potential as a low-cost, accessible option to accurately assess concussion symptoms and severity in youth athletes

Once reliable baseline data is established, it's easier to determine if a player has sustained a concussion. Christie says it could also facilitate active recovery, through repeat testing to track cognitive improvements. Because the program involves testing a large group across a wide age range, it will result in year-by-year comparisons and longitudinal data, Christie says, adding that the UVic Vikes rugby team also began testing last year.

Christie, whose research also investigates how developmental disorders affect learning and memory processes, also believes there might be potential for the software to facilitate better perceptual awareness in developmental disorders like autism and fetal alcohol spectrum disorders, as well as having benefits for elderly drivers.

Christie will be speaking to parents, players and coaches about concussions during this week's Ryan O'Byrne Charity Camp hosted at UVic's Ian H. Stewart Complex, where the Toronto Maple Leafs defenceman also played minor hockey. The Neurotracker program will also be demonstrated during O'Byrne's youth camp, with both guest NHL coaches and camp participants given an opportunity to try it.

The CIHR-funded research also involves Dr. Chand Taneja, a pediatric clinical neuropsychologist with the Queen Alexandra Centre for Children's Health/Vancouver Island Health Authority. As the only practising board-certified neuropsychologist on Vancouver Island, Taneja sees most of the Island's children referred due to neurological impairment.

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