It's an injury that's as unique as a snowflake yet as ordinary as a drop of rain. Concussions are most often talked about in sports, but they're extremely common and not just an issue for athletes.
A University of Victoria lab dedicated to the study of concussions is advancing research to improve treatment and the lives of the injured thanks to mentorship, partnership and a video game.
This is an everyone problem. It's just so common. In Canada, I read a stat that came out this year that there are over a quarter of a million concussions each year and people don't really talk about it that much. We do hear about it in terms of [professional] sports, but it's not just happening in sports. It's happening to kids and parents, and it's really commonly happening to our grandparents."
Taylor Snowden, a PhD candidate in neuroscience who works in the UVic Concussion Lab headed by Brian Christie
At the same time, Christie, a neuroscientist and her mentor, says they're known as "snowflake injuries" because each person afflicted with a concussion experiences it differently, with unique sets of symptoms and even durations of symptoms like a group of people filling their plates from a buffet and each coming away with a different combination of foods.
All of which presents tremendous challenges and opportunities to researchers in his lab studying moderate to severe traumatic brain injuries, or TBIs.
Exploring links between concussions and dementia
Snowden's primary PhD dissertation project examines the long-term effects of concussions which can include memory loss and difficulty focusing and included a meta-analysis that found adults who have a diagnosed history of concussion are nearly two times more likely to be diagnosed with dementia later on in life.
That prompted the question "Is there some interaction between a concussion and the natural aging process that it is then causing this increased risk of dementia later on?" And that led to a variety of assessments of patients, from memory and attention testing to advanced neuro imaging that might be able to show signs of an early relationship between concussion and dementia.
Researchers also took blood samples from patients that Snowden brought with her for analysis on a recent working trip to Australia, funded by a Michael Smith Foreign Study Supplement from the Canadian Institutes for Health Research. She notes that protein markers in the blood show effects of brain injuries and can remain present in a patient even 10 or 20 years after they were hurt.
Another component of the research is looking at interventions for adults who've suffered concussions. That's where the video game comes in.
3D game tests and helps concussion patients
Participants in the research, conducted with the support of the Victoria Brain Injury Society (VBIS) an ongoing partnership that informs researchers' work and provides society members access to testing "play" a 3D video game called NeuroTracker.
For my [research] participants, I tell them they're taking their brain to the gym."
Taylor Snowden, PhD candidate in neuroscience at UVic Concussion Lab
While previous research has shown NeuroTracker's promise as a cognitive training tool for healthy older adults, Snowden is working to find out if it could have similar benefits for people with TBI.
Created by Jocelyn Faubert, a professor in the School of Optometry at Université de Montréal, NeuroTracker is designed to stimulate all four lobes of the brain at the same time because players must visually track multiple moving 3D objects. It used to be available only with special 3D TVs in a lab but now can be played on a standard computer screen by a patient wearing 3D glasses they can get, for free, from the UVic Concussion Lab.
"It's causing you to plan and think, working with your frontal lobe," Snowden explains. "You have to predict things in 3D space coming into that temporal lobe. It's a visual task, so you're engaging on your occipital lobe. And it gets harder on an individual basis.
"It's designed to optimally engage everybody at a specific level," she says. "It lets everyone do the same task but everyone is getting it tailored to them and their unique cognitive potential."
Thus, "If you're really good at the task, it's going to go faster."
Just as going to the gym produces results in physical fitness, going to the NeuroTracker gym appears to improve brain fitness in some patients, including working memory and word generation, says the former UVic competitive swimmer who now competes recreationally in Half Ironman races six so far and learned about the lab because it's in the McKinnon Pool complex where she practised.
Snowden notes that blood tests of patients with histories of concussion who participated in NeuroTracker exercises show a spike in a measure called brain derived neurotrophic factor, which is a marker of neuroplasticity or a sign that the brain is working and able to reorganize its functions and connections after injury.
Work with brain injury society aids student researcher
Jamie Morrison, Brian Christie and Taylor Snowden. UVic Photo Services
"For the pilot research, we found some exciting improvements in cognition and reduction in symptoms, yet we don't really understand, at the biological level, what the reasons are for these cognitive improvements," says Jamie Morrison, a master's student in the UVic neuroscience graduate program who works in the concussion lab with Snowden and Christie.
Her part of the study, partnered with the VBIS, is conducting assessments and collecting blood and saliva from patients who play NeuroTracker twice a week for five weeks, then looking at various markers "to help better understand the tool itself and understand how it's helping improve outcomes for survivors."
She says the game "tries to engage that working memory attention and visual processing, and ideally by doing that, we hypothesize that these cognitive improvements are probably due to neuroplasticity, which is really exciting."
Morrison notes the game is not suitable for every concussion patient, including those whose symptoms are still too severe for this type of rehabilitation, but it shows promise.
She also runs the cognitive training program the UVic lab offers for free to people at the VBIS and says working with the group and its community has been a productive collaboration.
"I've gained a lot of valuable hands-on experience in the community working with the brain injury society learning from their staff and their clients," she says.
"They taught me so much about how I can be a better researcher, how I can better support TBI survivors," she says. "They have been a great partner to help educate me and make our research more applicable to those who we're actually trying to help."
Morrison, who has a family history with TBIs and joined the lab after volunteering with the VBIS, also credits Snowden for sharing her knowledge. She was in second year, studying sciences and interested in a career in health care when they met, and Snowden made sure the more junior student was well prepared for research and working in a lab.
Morrison says she's thankful for the mentorship of Snowden and Christie, and hopeful their work will lead to more accessible interventions for concussion patients.
Lab head lauds trainees Snowden and Morrison
"I've got this amazing cohort of trainees who have really done a fantastic job at helping create and conduct this unique research program," says Christie.
The head of the lab raves about Snowden's work as a researcher and mentor as well as Morrison's experience and empathy working with people with neurological deficits.
He's also proud of their results, saying, "Taylor and Jamie are nearing the end of their theses," he says, "and the work that they've been doing will show for the first time, both in people who have had severe traumatic brain injuries as well as people who have a history of concussions, that programs like NeuroTracker can have positive benefits by increasing the production of neurotrophins that can enhance brain plasticity."
Their work has also shown NeuroTracker's potential as a diagnostic tool, he says.
The goal of he and his team is to provide hope for people living with brain injuries while advancing knowledge about concussions.
Brain health conference in April 2025
Christie, Snowden, Morrison and the UVic Concussion Lab will be hosting a Brain Health Summit, an initiative of Toronto-based Brain Changes, in April in nearby Sidney.
