Concussion - a class of traumatic brain injury (TBI) - is caused by strong forces applied directly or indirectly to the head and is marked by a range of neurological and cognitive deficits in both the short and long term. These head injuries impact a large segment of the population with 1.7 million Americans suffering from TBI every year - 75-85 percent of which are classified as concussion or mild TBI (mTBI). Growing numbers of concussions in contact sports (across all ages) along with an escalation of mTBI as the "signature injury of war" in returning veterans have led to a full scale "Concussion Crisis". In addition to causing a range of short- and intermediate-term deficits, concussion has also been shown to be the root cause of chronic traumatic encephalopathy (CTE), a neurodegenerative disorder leading to premature dementia in individuals with moderate to extensive concussion histories. A large void in current concussion management is the absence of interventions that can help facilitate recovery at the neural level and improve the short and long term outcomes for concussion patients at all stages post-injury. The goal of this multi-phase research and commercialization program (beginning with this Phase I application) is to evaluate the feasibility and efficacy of a neuroplasticity-based videogame platform that targets the brain networks underlying deficits in executive function (EF) in patients following concussion. At the core of these new technologies are a measure-then- train approach that first 'breaks down'EF to separately analyze and train each patient's subcomponent EF systems and then uses these analytics to 'build up'a unified training experience that more closely approximates how EF is deployed in the real-world. The end result is a training experience that is hyper- individualized t each patient and driven by adaptive algorithms developed by NeuroScouting to maximally drive neural plasticity. Over the past five years, these BrainAnalytics (BA) and NeuroEnhance (NE) technologies have been implemented with elite athletes in MLB, NFL, NBA and the US Olympics to optimize visuomotor systems in the brain and have been empirically validated to transfer into real-world performance improvements on the field. This application evaluates technology that has been developed specifically for EF deficits in concussion and rigorously tests the transfer of training to multiple behavioral and neurophysiological measures of EF outcome measures in adult PPCS patients. This Phase I work will lay the empirical foundation to expand subsequent Phase II work to youth populations and other age groups across the lifespan. These technologies would transform concussion management from a passive 'wait and track'approach into an active 'train and measure'recovery process and could improve EF-related recovery as well as serve a neuroprotective role by strengthening vulnerable EF systems in those patients at risk of developing CTE.
The current application examines the feasibility of neuroplasticity-based training interventions to target executive function deficits in patients following concussion and mild traumatic brain injury (mTBI). These individualized training platforms would fill a major gap in concussion rehabilitation and offer a transformative new approach to improve short- and long-term recovery outcomes by directly targeting impacted neural systems in these patients.