Neurophysiological Outcomes of mTBI

It is understood that over time warfighters are often exposed to many, sometimes dozens, of blastrelated incidents over a wide spectrum from very mild to very severe, and that physiological damage to the central nervous system (CNS) appears to accumulate over time as exposures increase for each individual, but currently no dosimetric tools exist to identify warfighters who have accumulated levels of damage that put them at risk for permanent irreversible damage and/or disability. For current and future asymmetric military action, it is essential to develop clinical tools for the early pre-clinical diagnosis, quantitative assessment, and tracking of treatment efficacy for mTBI and TBI. Such tools will allow commanders to identify warfighters with detectable levels of mTBI exposure and will allow them to set standards for allowable exposure levels and thresholds for removal of warfighters from combat conditions, while also allowing recovery and assessment prior to re-entry into combat or other at-risk assignments. These tools must be field deployable, reliable, easily used, resistant to bias or 'cheating', with readily interpreted results. We are in the early stages of development of an innovative, low-cost sensory testing device that non-invasively assesses the CNS health status in minutes for numerous patient populations that are currently difficult to diagnose or assess (including TBI). The diagnostic system delivers a battery of sensory based (tactile) tests that are conducted rapidly – much like an eye exam with verbal feedback – and are designed around the concept of measuring how much the CNS is impacted by a particular injury or neurological disorder. An important feature that needs to be integrated into these sensory based metrics is their neurophysiological significance, and this can be achieved by combining an extensive literature review of neurophysiological outcome measures obtained from individuals with mTBI with the development of a neuro-computational model.