By Richard Knox
Doctors use expensive CT scanners and MRI machines thousands of times every day to look for brain damage. But sometimes cheap and simple is definitely better.
Take the hockey-puck-on-a-rod test a Michigan high school kid cobbled together to help figure out if a knock on the head has caused a concussion. Sports medicine specialists are increasingly worried about the long-term implications of mild, repeated head trauma.
The test is the idea of Ian Richardson. The teenager devised it as a quick and simple way to test reaction time for a science fair project.
Richardson's device looks like something out of a 19th-century medical text. It's a hockey puck, with a long rod embedded in the middle. The stick is marked off in centimeter increments.
Turns out Ian Richardson's father, James, is on the faculty of the University of Michigan Medical School. He thought Ian's idea might be a pretty cool on-the-spot way to screen for concussions among athletes.
It works like this: Tester suspends the device while injured athlete sits with forearm on table, fingers loosely circling the stick. Without warning, tester drops stick. Athlete grabs stick as fast as possible. Place where athlete grabs gives an instant readout of reaction time.
It all happens in milliseconds--too fast to measure with a stopwatch. In a pilot study of the test, athletes with concussions had reaction times that were 15 percent slower.
"Sometimes reaction time may be the only sign of a concussion -- an indication we shouldn't be sending an athlete back to play," says Dr. James T. Eckner, who's working with Richardson to validate the test. A separate study tests whether slowed reaction times makes an injured athlete less quick to protect his face and head if they see a blow coming.
They'll present their results in April at the annual meeting of the American Academy of Neurology.
There are computer algorithms to measure reaction time, using game-like programs. But they're not so good for use at the sidelines, and they involve licensing fees.
But it remains to be seen if anyone will go to the trouble of standardizing and making the puck-on-a-stick test, if it pans out in future studies. "Our technology transfer people say it's too simple to patent," Eckner says.
So the Michigan researchers are working on a fancier device they call the Quick Stick. "It has some sensors inside and a light on it," Eckner says. "We program it to light up on some drops and not others. The person has to make a quick choice to catch it or not depending on whether the light comes on. That makes it quite a bit more challenging."
Of course the Quick Stick will cost more.
So Eckner and his colleagues are hoping somebody will make and sell the puck-on-a-stick device even without patent protection. If so, it might join other time-tested quick-and-simple neurological tests, like that little triangular rubber hammer the doctor uses to test your reflexes.