Citation

Hanley D, Prichep LS, Badjatia N, Bazarian J, Chiacchierini RP, Curley KC, Garrett JS, Jones EB, Naunheim R, O'Neil BJ, O'Neill J, David W, Huff JS. J. Neurotrauma 2018; 35(1): 41-47.

Affiliation

University of Virginia Health System, 12350, Charlottesville, Virginia, United States ; jshuff@virginia.edu.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5004

PMID

28599608

Abstract

The potential clinical utility of a novel quantitative EEG-based Brain Function Index (BFI) as a measure of the presence and severity of functional brain injury was studied as part of an independent prospective validation trial. The BFI was derived using EEG features associated with functional brain impairment reflecting current consensus on the physiology of concussive injury. 720 adult patients (18-85 years) evaluated within 72 hours of sustaining a closed head injury were enrolled at 11 US Emergency Departments. Glasgow Coma Scale was 15 in 97%. Standard clinical evaluations were conducted and 5-10 minutes of EEG acquired from frontal locations. Clinical utility of the BFI was assessed for raw scores and percentile values. A multinomial logistic regression analysis demonstrated that both the odds ratio of mild functionally impaired group compared to uninjured as well as the odds ratio of the moderate functionally impaired group compared to uninjured, were significantly different from the CT+ (structural injury visible on CT) TBI group (p=0.0009 and p=0.0026, respectively). However, no significance differences in odds (ratios compared to uninjured) of the mild and moderately functionally impaired groups were obtained. ANOVAs demonstrated significant differences in BFI among normal (16.8%), mTBI/concussed (61.3%), and CT+ (21.9%) patients (p<0.0001). Regression slopes of the odds ratios for likelihood of group membership suggest a relationship between the BFI and severity of impairment.

FINDINGS support the BFI as a quantitative marker of brain function impairment, which scaled with severity of functional impairment in mTBI patients. When integrated into the clinical assessment, the BFI has the potential to aid in the early diagnosis and thereby potential to impact the sequelae of TBI by providing an objective marker available at the point of care, hand-held, non-invasive and rapid to obtain.

Language: en

Keywords

ASSESSMENT TOOLS; BIOMARKERS; CLINICAL TRIAL; EEG; TRAUMATIC BRAIN INJURY