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Detection of Concussion Using Cranial Accelerometry

Auerbach, Paul S. MD, MS*; Baine, Jennifer G. MD; Schott, Megan L. MD; Greenhaw, Amy MA, ATC§; Acharya, Monika G.§; Smith, Wade S. MD, PhD

Clinical Journal of Sport Medicine: March 2015 - Volume 25 - Issue 2 - p 126–132
doi: 10.1097/JSM.0000000000000117
Original Research
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Objective: To determine whether skull motion produced by pulsatile cerebral blood flow, as measured by cranial accelerometry, is altered during concussion.

Design: In phase 1, to identify a specific pattern indicative of concussion, cranial accelerometry of subjects who sustained a concussion underwent analysis of waveforms, which was compared with accelerometry from subjects without a concussion (baseline). In phase 2, this concussion pattern was tested against prospectively acquired, blinded data.

Setting: High school tackle football practice and game play.

Participants: Eighty-four football players.

Interventions: Subjects had accelerometry measurements and concurrent 2-lead electrocardiograms. In players with a concussion, multiple sequential measurements were obtained. Sport Concussion Assessment Tool 2 was used to assist clinical determination of concussion.

Main Outcome Measures: Whether a characteristic waveform pattern of cranial accelerometry occurs in subjects with concussion.

Results: Phase 1 demonstrated a consistent pattern correlated to concussion. Phase 2 found this pattern in 10 of 13 subjects with concussion (76.9% sensitivity). Seventy-nine of 82 baseline plus nine postseason (total = 91) recordings from nonconcussed subjects did not show the concussion pattern (87% specificity).

Conclusions: In subjects with concussion, we observed a unique pattern determined by cranial accelerometry. This may provide a method to noninvasively detect and longitudinally observe concussion.

Clinical Relevance: There is no objective, real-time, noninvasive, and easily accessible measure for concussion. If accelerometry is validated, it could provide a critical diagnostic tool for sports medicine physicians.

*Division of Emergency Medicine, Department of Surgery, Stanford University School of Medicine, Stanford, California;

Department of Orthopedic Surgery, Stanford University School of Medicine, Stanford, California;

Stanford-Kaiser Affiliated Residency in Emergency Medicine, Stanford University School of Medicine, Stanford, California;

§Los Altos High School, Los Altos, California; and

Department of Neurology, School of Medicine, University of California, San Francisco, San Francisco, California.

Corresponding Author: Paul S. Auerbach, MD, MS, Division of Emergency Medicine, Stanford University School of Medicine, Alway Building M121, 300 Pasteur Drive, Stanford, CA 94305-2200 (auerbach@stanford.edu).

W. Smith has received grant support from Jan Medical, Inc for another research study unrelated to this research study. The other authors report no conflicts of interest.

Received August 25, 2013

Accepted April 27, 2014

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