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February 1, 2008

Dr. McCoy To The Sidelines, Please

Star Trek fans remember the tricorder, the handy medical and scientific device that allowed both Dr. McCoy and Mr. Spock to make instant evaluations of injured crew members, hostile environments, and hurt Hortas. They were one of the ways in which plot lines could get speeded along without too much exposition, along with the "universal translator" that allowed everyone to speak in California English -- well, everyone! except! William! Shatner!

In a development that ST fans might appreciate, sports physicians may be able to use something similar now to check for concussions. A new hand-held brain-scan device promises to make a clear diagnosis that will eliminate guesswork and prevent permanent damage:

A startup called BrainScope is developing a tool that may help inform doctors about which injured players should stay on the sidelines—or be taken to a hospital. The Chesterfield (Mo.) company's handheld device determines the severity of concussions by reading the brain's electrical signals. The National Collegiate Athletic Assn. is planning a clinical trial later this year. Ira Casson, co-chair of the NFL's Mild Traumatic Brain Injury Committee, is eyeing the technology. "Today, you often have to use only your judgment" to gauge how serious a concussion is, Casson says. "If there were something more objective, that would be very useful." ...

The result was a tool that's cheap and simple enough to be used on the sidelines. Rather than producing hard-to-decipher squiggly lines, the BrainScope device displays a meter, which shows whether brain activity after an injury falls in or out of the danger zone. Built-in signal-processing technology picks up abnormal brain signals, while simultaneously canceling out electrical noise from blinking, breathing, and the like. The device calculates the severity of each injury by comparing brain wave readings to a database of 15,000 scans compiled at New York University's Brain Research Lab. "We're going about it exactly the way many doctors told us to go about it," says Causevic.

On Jan. 15, Causevic met with brain experts for the NCAA to design a pilot program. Before they roll out BrainScope, they'll measure the brain activity of 750 high school and college players. That will provide an additional comparison to validate BrainScope's accuracy after an on-field collision.

The device has applications outside of sports as well. If the price gets low enough, EMTs could carry this as a diagnostic device. Emergency rooms could use it in place of a more expensive EEG for triage. Most importantly, as Business Week notes, the military could use it in the wake of bomb attacks to determine whether troops need to be rotated out of combat assignments for recovery.

The technology still has to prove itself. It uses a scanning technique that has not had much validation in the past, despite 70 years of experimentation. The technique suffers from a reputation garnered by quacks using it for New Age enlightenment and for diagnostic purposes for which it was never intended or tested. BrainScope intends to provide the real-world test for the product that will prove the technology a boon or a bust in short order.

It's not quite the tricorder that Star Trek predicted, but it's a good start if it works. Does the device come with the lighted salt shaker accessory Dr. McCoy used, too?

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