Diagnostic screening for conscious awareness in brain injury and disease: Visual component
Since the mid 1970s, medical personnel have used the Glasgow Coma Scale (GCS) as an important tool to rate and describe levels of consciousness. This scale is rudimentary and subjective, often resulting in misdiagnoses in cases where people lack the capacity to communicate. In some unfortunate situations, severe neurological damage can render people unable to move. Inevitably, these people are deemed vegetative when in actuality; many are simply ‘locked in’. Family members and professionals alike are left wondering…are they in there?
For years researchers have used cognitive event related potentials (ERPs) with modified EEG to assess receptive language capacity. However, the testing is typically laborious and clinicians are not able to access it in order to assess their clients; which eliminates the technology’s utility to working professionals. Acknowledging this, an innovative research team out of Halifax lead by neuroscientist, Dr. Ryan D’Arcy developed the Halifax Consciousness Scanner (HCS). The HCS is a portable, easy to operate modified EEG/ERP system complete with a specially designed 5 minute protocol which can be implemented in almost any setting by frontline health care professionals. It is anticipated that the HCS will improve our ability to objectively evaluate conscious awareness following brain injury/stroke in emergency rooms, evaluate candidacy for rehabilitation, measure outcomes of intervention when subtle progress is not yet outwardly observable, and identify those patients who are trapped in their bodies so we can intervene. Carolyn Fleck-Prediger is a veteran Speech-Language Pathologist specializing in complex brain injury and stroke. She is completing her graduate work at the University of Alberta. Carolyn is working with Mindful Scientific to develop a HCS that uses visual stimuli so that the conscious awareness of people with hearing or English language barriers can also be evaluated with this new and practical device.
