Revolutionizing Traumatic Brain Injury Detection & Management

Blink technology provides low-cost, objective assessments of a patient’s spontaneous and stimulated blinking, facilitating quicker and more precise evaluations crucial for TBI/complete concussion diagnosis and management.

Understanding the Challenges of Traumatic Brain Injury

Traumatic Brain Injury (TBI) is a brain dysfunction caused by an outside force, most commonly a blow to the head. It can range from mild (concussion) to severe, depending on the force and location of the impact. The largest cause of TBI is a traumatic event such as a road collision, with sports-related TBIs a focal and visible segment of the incidents.

While some treatment options are available to help people recover from TBI, it’s crucial to have accurate and objective traumatic brain injury testing to provide medical experts with the data they need to recommend the best course of action.

Challenges associated with traumatic brain injury detection include:
  • Symptoms can be subtle and easily overlooked especially in mild TBI

  • Delayed onset of symptoms makes diagnosis more challenging

  • Some diagnostic tests for traumatic brain injury may be used but cannot definitively diagnose it

For patients experiencing post-concussion syndrome, managing symptoms can involve cognitive rehabilitation and medication. Complete concussion management aims to provide a holistic approach that addresses the physical, cognitive, and emotional aspects of recovery, leading to a faster and more complete return to normal functioning. Physical therapy for concussion treatment focuses on retraining the body's systems affected by the injury, promoting healing, and ultimately helping patients regain optimal physical function and confidence in their daily lives.

The Facts

According to the Centers for Disease Control and Prevention (CDC), approximately 2.87 million TBI-related emergency department visits, hospitalizations, and deaths occurred in the United States in 2014. TBI is a significant public health concern worldwide.

Although SRC are considered the mildest form of TBI, they are the most problematic from a public health perspective due to their sheer volume and patients waiting for symptoms to resolve spontaneously and not getting treatment.

Sports-related concussions (SRC) are the most prevalent form of TBI in the military and civilian populations.

It is estimated that there are between 1.6 and 3.8 million sport-related brain injuries a year, the vast majority being concussions with the actual number likely higher due to underreporting.

Of the 1.5 million TBI occurring annually in the US, only 15% are moderate or greater, whereas 85% (~1.27 million) are mild TBI (mTBI). mTBI research in both military and athletic populations cite that those diagnosed with mTBI range from 5-6% percent in collegiate football, 8-20% in a military-related deployment, and up to 10% of adolescents who play sport.

Within the civilian population, roughly 250,000 individuals age 19 and younger visit a US emergency medical department for SRCs annually. For NCAA sports, it is estimated that there are 4.47 SRCs per 10,000 athlete exposures, including practice and competitions.

Typical recovery from post-concussion symptoms is within 4 weeks since the injury. Still, approximately 30% of athletes experience persistent post-concussion symptoms (PPCS) for far longer, which is associated with poor academic and work performance and mood disorders.

TBI imposes a significant economic burden on individuals, families, and society as a whole. The lifetime costs associated with TBI-related medical care and lost productivity are estimated to be in the billions of dollars annually in the United States alone.

The updated VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF CONCUSSION-MILD TRAUMATIC BRAIN INJURY  states "Conceptually, a confirmatory objective test that .... could be used to direct treatment and/or predict outcomes would be desirable" This is very important in forward areas that need to make rapid triage/evacuation decisions.

From the Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022: In the research setting, the employment of  modalities assessing autonomic dysfunction show promising sensitivity to acute neurobiological effects and changes over the course of SRC recovery.

Obstacles to consistent care involve delay in initial treatment, lack of follow-up, and access to care. The main predictor for delayed recovery, out of all clinical measures of concussion, is time to initial assessment. The research also identifies the effect of insufficiencies in post-concussion care, citing that of those who experience persisting symptoms, only 1/5th of individuals with such symptoms receive outpatient rehabilitation. Finally, there are several causes for delays, such as access to health care and the urgency of the patient, which are amplified in rural and underserved areas.

The Facts

44%

of subjects do not receive follow up within 3 months

4.17

TBIs per 10k high school athlete exposure / 4.47 per 10k collegiate

2.87

million TBIs in USA per year

150

million TBIs per year (81% are TBI)

2.5

million TBIs in Europe per year

The Blink Research

Blinkcns was established in 2017 to develop a rapid and quantitative method for utilizing a person’s eye blink and blink reflex for the assessment of concussion/traumatic brain injury (TBI), based on research conducted at the MUSC (Medical University of South Carolina). Our EyeStat 3 device was developed, and subsequently FDA 510K cleared, to provide this capability.

Our foundational research supports EyeStat's initial application intended to promptly and objectively test for and identify abnormal blink patterns associated with traumatic brain injury.

Our Experts

TBI Scientific Advisors

Aaron Yengo-Kahn, MD, Ph.D.
Resident in Dept. of Neurological Surgery at Vanderbilt University
Aaron Yengo-Kahn, MD, Ph.D.
Resident in Dept. of Neurological Surgery at Vanderbilt University

Aaron Yengo-Kahn, MD, PhD was born in Pittsburgh, PA and grew up near Boston, MA in Lexington, MA. He attended Boston University where he graduated in 2011 with a degree in Human Physiology earning summa cum laude honors. He spent a year before medical school teaching anatomy to undergraduate students as well as working as a research coordinator at New England Baptist Hospital. He received his medical degree from Vanderbilt University School of Medicine in 2016. At the end of his 3rd year he was inducted into both the Alpha Omega Alpha medical honor society and Gold Humanism Honor Society. While a medical student, he pursued interests in medical education, serving as the Co-Chair of the Student Curriculum Committee during his fourth and receiving the Geoffrey David Chazen Award for contributions to Vanderbilt’s education program. He remains interested in medical student and resident education contributing to medical student clinical skills evaluations, developing and coordinating resident anatomy sessions and mentoring medical students in clinical outcomes research and neurosurgery.


His main research interests include sport-related concussion, specifically novel diagnostic methods, outcomes prediction and cost-benefit analyses. He has served as the Co-Director for Research at the Vanderbilt Sport Concussion Center since July 2019. He has additional research interests in pediatric neurosurgery, adult neurotrauma and systems-of-care.

Dena Garner, Ph.D.
Principal Investigator
Dena Garner, Ph.D.
Principal Investigator

Dr. Dena Garner is a full professor in the Department of Health and Human Performance, the Director of Undergraduate Research, and the Assistant Provost for Research and Policy at The Citadel in Charleston, South Carolina. She started working at The Citadel in 2004 while completing her post-doctoral fellowship in the Department of Neurology at the Medical University of South Carolina, also located in Charleston. Before her move to Charleston, she worked at Oregon State University in Corvallis, Oregon, where she also received her doctoral degree in exercise physiology. She received her Master’s degree from the University of South Carolina in exercise physiology and an undergraduate degree from Furman University in Greenville, South Carolina.

She has been working in the area of mouthpiece use and its effect on human performance since 2005, with studies that have focused on reaction time, lactate, and cortisol and the effect of mouthpiece use on these parameters. In addition, her research has focused on mouthpiece use during steady-state exercise and effects on oxygen and carbon dioxide exchange as well as the proposed mechanisms for positive effects on airway dynamics in a healthy population. 

In addition to research in the area of mouthpiece use and its effect on human performance, Dr. Garner is involved in a research study that encompasses testing and evaluating physiologic neuro-assessment devices in healthy versus traumatic brain injury populations. Related to this research, she was awarded a multi-year grant from the Henry Jackson Foundation to assess neurologic assessment devices in healthy populations.

In her roles as Director of Undergraduate Research and Assistant Provost for Research and Policy, she works with The Citadel campus to promote research and scholarly activity in all departments.  In addition, she promotes external grants to support faculty research, specifically to improve the faculty/student mentoring within these research grants.  During the first year of directing undergraduate research, she worked closely with the Provost and the departments to implement the inaugural Citadel SURE (Summer Undergraduate Research Experience) program.  

Mohammad Haider MD, Ph.D.
Assistant Director of Research, Concussion Research Center, University at Buffalo
Mohammad Haider MD, Ph.D.
Assistant Director of Research, Concussion Research Center, University at Buffalo

Dr. Haider has been a volunteer intern, graduate assistant, post-doctoral research fellow, research coordinator and research assistant professor at the Concussion Management Clinic and Research Center at The University of Buffalo. His clinical research focuses on standardizing clinical assessment of concussions, methods of exercise tolerance/heart rate threshold assessment post-concussion, identifying clinical biomarkers of delayed recovery, cervicogenic headaches and treating concussions with sub-symptomatic aerobic exercise. His pre-clinical research focuses on identifying autonomic nervous system impairments and cerebral blood flow regulation after concussion, with an interest in cerebrovasoreactivity. His research also includes salivary and serum biomarkers of neuroinflammation and neurodegeneration, traumatic encephalopathy syndrome and sub-clinical oculomotor dysfunction.

Education:

  • 2020: PhD in Neuroscience, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, SUNY
  • 2020: Advanced Graduate Certification in Biostatistics, School of Public Health and Health Professions, University at Buffalo, SUNY
  • 2017: Post-Doctoral Research Fellowship, Concussion Management Clinic and Research Center, University at Buffalo, SUNY
  • 2015: MD Equivalence, Education Commission for Foreign Medical Graduates
  • 2014: MBBS, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan

TBI Sports Advisors

Dan "Beaker" Stuck
Manager of Wellness & Team Affairs at NHL Hershey Bears
Dan "Beaker" Stuck
Manager of Wellness & Team Affairs at NHL Hershey Bears

Dan “Beaker” Stuck served as the head athletic trainer of the AHL hockey team, Hershey Bears, since 1985 before being appointed as the club’s Manager of Wellness and Team Affairs. Stuck won five Calder Cups during his tenure as the team’s head trainer. Dan’s affiliation with the team dates back to 1977, when at the age of 13 he served as one of the team’s locker room assistants. Dan became Hershey’s assistant trainer in 1982, and then took a year away to become the assistant equipment manager for the NHL’s Philadelphia Flyers. The following season, in 1985-86, he was named Hershey’s head trainer, a position he has held ever since.

Dan’s main responsibilities with the team include working with team doctors and physical therapists to decide the best course of action and treatment for the players, as well as assisting Bears management with travel accommodations away from Hershey. Dan lives in Palmyra with his wife Janice. He has a son, Dustin, who is an assistant athletic trainer for the AHL’s Providence Bruins, and a daughter, Alexis.

Danny Morrison
Former President of the NFL Carolina Panthers
Danny Morrison
Former President of the NFL Carolina Panthers

Danny Morrison is Professor of Practice in the Department of Sport and Entertainment Management at the University of South Carolina. Prior to joining the faculty, he was President of the Carolina Panthers and worked extensively in college sports administration.

Danny was the athletic director at Wofford College from 1985 to 1997 and a Senior Vice President until 2001. It was during this time the Panthers began holding training camp there. He served as Commissioner of the Southern Conference from 2001 to 2005. From 2005 until September 2009, he was the athletic director of Texas Christian University. He was named President of the Panthers in September 2009. In 2015, after three consecutive NFC South Division Championships, the Panthers set a franchise record with a 15-1 regular season mark and participated in Super Bowl 50. Danny resigned from his position in February 2017 to pursue interests on the college level.

Luke Kuechly
Retired linebacker for NFL Carolina Panthers
Luke Kuechly
Retired linebacker for NFL Carolina Panthers

Luke August Kuechly is a former American football middle linebacker who played all eight seasons of his professional career with the Carolina Panthers of the NFL. He was drafted by the Panthers ninth overall in the 2012 NFL Draft. Kuechly played college football at Boston College where he was recognized twice as a consensus All-American. Kuechly had an immediate impact his rookie season, as he led the NFL in tackles and won the Associated Press 2012 NFL Defensive Rookie of the Year award, becoming the third youngest recipient in its history. In 2013, Kuechly became the youngest recipient of the AP NFL Defensive Player of the Year Award in its history.

Rick Carlisle
Head Coach of NBA Indiana Pacers
Rick Carlisle
Head Coach of NBA Indiana Pacers

Rick Carlisle is the new Head Coach of the Indiana Pacers. He just finished his 13th and final season as the head coach of the Dallas Mavericks. He was hired by Dallas in May 2008, and is the third-longest tenured head coach in the league. Carlisle became the winningest coach in Mavericks history with a 103-93 victory at the L.A. Lakers on Nov. 1, 2015.

Carlisle has led his team to the playoffs 12 times in his 16 seasons as a head coach. He guided the Mavericks to their first-ever world championship in 2011, while posting an impressive 16-5 mark during the 2011 postseason. Carlisle, who won a title as a player with Boston in 1986, is one of only 14 individuals to win an NBA championship as both a player and a head coach. He moved into 17th place on the NBA’s all-time wins list in 2017-18. Named the ninth Dallas coach in franchise history, he led the Mavericks to the postseason in seven of his first eight seasons with the team. Carlisle joined the Mavericks after spending six seasons, with Detroit and Indiana, as a head coach. He served as an ESPN studio analyst during the 2007-08 NBA season before coming to Dallas. He also serves as the President of the NBA Coaches Association.

Steve Smith Sr.
Retired Wide Receiver for NFL Carolina Panthers
Steve Smith Sr.
Retired Wide Receiver for NFL Carolina Panthers

A 16-year NFL veteran, Steve Smith Sr. is a five-time Pro Bowl selection, three-time All-Pro, and is considered one of the NFL’s most productive wide receivers of the 21st century. Steve led the league in catches, receiving yards, and touchdowns in 2005 (Jerry Rice and Sterling Sharpe are the only other NFL players ever to have recorded a “triple crown”). He spent his entire career with the Carolina Panthers until signing with the Baltimore Ravens in March 2014. He is the Panthers’ all-time leader in total touchdowns (67), receptions (836), and receiving yards (12,197). In 2011, he became the 35th player in NFL history to amass 10,000 receiving yards. Steve also won the Ed Block Courage Award, was twice named the Baltimore Ravens Man of the Year, and was a nominee for the Walter Payton Man of the Year Award.

In 2013, Steve and his wife, Angie, founded the Steve Smith Family Foundation, which champions for families affected by domestic violence and promotes child health and wellness. Since its inception, the foundation’s efforts have provided children from the Safe Alliance Domestic Violence Shelter the opportunity to attend summer camps. In November 2016, Smith pledged over $350,000 to establish the Smith Family Wellness Center in collaboration with Project 658.

Annually, Steve hosts numerous youth football camps nationwide. This past April, he took that concept internationally, hosting a camp at Vogelweh Air Base in Kaiserslautern, Germany, for children of active-duty and retired U.S. military members. Since retirement, Steve has worked as an analyst for the NFL Network.