Doctoral candidate Carolyn Fleck-Prediger is delving into the world of neuroscience and how the brain can repair itself from trauma.
Fleck-Prediger took her 25 years of experience as a speech language pathologist at the Centennial Centre for Mental Health and Brain Injury and brought it into the world of neuroscience.
The challenge was in finding ways to help patients improve despite severe stroke or brain trauma.
As it happened there were two neuroscientists specializing in conscious awareness who were developing a portable device, which reads brain waves on the scalp. Those neuroscientists are Ryan D’Arcy and Adrian Owen who are big in the world of consciousness.
It was D’Arcy who was working on studying patients’ brains and their levels of consciousness using the scanner, called the Halifax Consciousness Scanner (HCS). “We met and tested this patient and it became very obvious that I needed to test more patients.”
Her evaluations pointed out there were gaps of information from patients’ responses and results. They both wanted to study more patients.
“He realized I was the missing clinical link. I knew how to relate to families. I knew how to talk to patients. I knew risk factors and so he said, ‘We really need you on our research team,’” explained Fleck-Prediger.
She subsequently stepped into her PhD studies, but this time with a focus on neuroscience.
Dr. D’Arcy was testing auditory awareness in patients and checking the reactions from certain stimuli. The initial version of the Halifax Consciousness Scanner used tones and spoken words to test auditory awareness in patients. The problem with the auditory testing of the HCS unit is she was turning away as many people as she tested.
This is where Fleck-Prediger stepped in and she developed a visual version of the scanner.
It’s quite predictable to when a person sees specific faces or in tests using different sounds there is also a reaction, however, it’s slightly slower than the visual stimuli. The more severe the brain injury, the longer the delay in reactions.
“That’s how we figure out whether a patient is actually taking in sensory information,” said Fleck-Prediger.
“The benefit of this is it doesn’t require any behavioral movement.”
The unit first determines if a patient can react to stimuli in a predictable way. Where this benefits patients — especially those in a minimal conscious state — is seeing improvements in someone who has suffered mental trauma such as a coma or concussion. This test does not require specific behaviour or movement and determines if a patient needs to be placed into an environment that promotes neuroplasticity.
What is neuroplasticity?
This is the brain’s ability to form new neural connections as the nerve cells compensate for an injury or disease.
“We are just coming to realize how much the brain can change,” explained Fleck-Prediger. “We’ve always thought once brain damage happens then it’s permanent.”
Studies are showing more and more patients are coming out of years of comas and they are able to recount what they heard around them. “We have one patient, for instance, who said that she attended her own funeral.”
Sometimes there’s a disconnect in the brain networks, said Fleck-Prediger. The HCS may be able to determine if those networks can recover through specific therapy. “We want to identify that population who are in a minimally conscious state who have the potential for rehabilitation.”
From there they need to be monitored over time. One of the benefits of the HCS is in its ability to have patients tested periodically. The scanner is able to detect reactions before they can be outwardly seen.
“We often see the brainwaves change before the new behavioural capacity develops,” said Fleck-Prediger.
A large team of neuroscientists have been working on the HCS. One case study has been published in medical journals and another is nearing completion with eight authors attached to its findings.
The goal is to make the HCS user-friendly while also gathering accurate information on patients’ consciousness. “They’re using it for autism testing. They’re using it for dementias and determining how that disease is progressing.”
Constructing the visual protocols of the HCS is part of Fleck-Prediger’s doctoral studies.
She recently presented some of her findings at the Ponoka Legion as the group helped sponsor her studies. The Legion knows one of the patients in the study and Fleck-Prediger suggests the HCS has applications in a variety of brain injury situations as well.