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Charleston Business

The Brain Game

Sep 24, 2018 01:43PM ● By Emily Stevenson
By Chris Haire

Football—it’s long been viewed as the most dangerous mainstream team sport. In fact, you can go back to its earliest days and find evidence of criticism of the much-beloved fall pastime.

During the first five years of the 20th Century, “at least 45 football players died,” the Washington Post reported in 1905, “many from internal injuries, broken necks, concussions, or broken backs.” At the time, there were calls to ban the game, but thanks to then-President Theodore Roosevelt, the game was changed to make it safer—forward passes were introduced, play would stop when the ball or player was down.

However, more than 100 years after that initial public outcry, football may be facing its most damaging PR crisis yet.

In the midst of a string of tragedies—assaults, suicides, murders—scientists have confirmed a link between concussions and a devastating degenerative disease, chronic traumatic encephalopathy (CTE). It’s a connection that some believe will radically affect the nature of the game and may even bring about its demise.

Misgivings about the sport arising from its association with CTE may already be having an impact.

According to an August report from the National Federation of State High School Associations, the number of students playing traditional football has fallen for the second year in a row, with the numbers dropping 20,565 from 2016 to 2017 and 27,865 from 2015 to 2016.

But what if there was a way to make it certain that a player suffering from a concussion would not be able to return to play until they had recovered, thereby further damaging the brain?

Thanks to the Charleston-based startup Blinktbi, Inc., that scenario may soon be a reality: The company’s product, EyeStat, a portable device that tests athletes for concussions on the sidelines.

EyeStat looks very much like a virtual reality headset, albeit one that fires five random puffs of air at the eyelashes over a 20-second period. The eyes respond by blinking, which EyeStat records. In under a minute, the device delivers its result: Red for a concussion, green for the all-clear.

“It’s different from the other types of technology that use the eye as an indication for what happens in the brain,” says Dr. Doug Carnes, CEO and board member of Blinktbi. Current tests, Carnes says, observe eye movement.

“The athlete is asked to to follow a ball or some picture of something as it moves around a screen in a design or pattern,” Carnes says. The problem: players can willingly perform poorly on their baseline tests so that if and when they receive a major blow to the head in a game, their baseline is poorer. In other words, a player can game it.

EyeStat, on the other hand, focuses on blinks. And in the case of non-injured and concussed players, the blinks are quite different.

“Our technology is an autonomic nervous system reaction. You are going to blink. There is no way you are going to not blink,” says Carnes. “There is no way you can cheat it.”

For Dr. Dena Garner, professor in the Department of Health and Human Performance at The Citadel, this simple fact alone is one of the reasons to applaud EyeStat.

“This, to me, is really exciting,” Garner says. “One of the reasons I really love it is you can’t fake a blink. A reflex is a reflex.”

Garner and her team began conducting tests of Blinktbi’s device in 2015, and their findings showed that the new tech appeared to deliver as promised. “Our research showed there were huge differences between active play, baseline, and concussion,” she says.

Following that first year of testing, researchers took the product to the home field of The Citadel Bulldogs. The device proved effective at identifying concussions.

For Garner, EyeStat is particularly useful because it eliminates the subjective nature of prior tests and in effect, gives athletic trainers, doctors, and coaches the confidence they are making the right call to pull a player out of a game or keep them in.

Equally as important, the data EyeStat collects about each player is saved, over time providing a record of an athlete’s health. Following any concussion, the device can be used again to determine whether an athlete can return to play. However, Carnes says, Blinktbi is still conducting research regarding recovery times for players.

The idea for what was then being called the Blink Reflexometer was hatched by Dr. Nancey Tsai, clinical associate professor of neurosurgery at the Medical University of South Carolina (MUSC). Tsai then introduced her idea to Mark Semler, CEO of the Zucker Institute for Applied Neurosciences, a nonprofit R&D lab of sorts at MUSC. Together, Tsai and Semler further developed the device. 

As an organization that houses clinicians, scientists, engineers, intellectual property experts, and business developers under one roof, ZIAN was uniquely qualified to bring the Blink Reflexometer to market.

Not only does ZIAN put all these professionals in close contact with each other, allowing them to share ideas face to face and giving them the opportunity to strike while the iron is hot, the organization offers researchers and engineers an outlet to be creative while the business side of the operation is tasked with attracting would-be investors.

Take Blinktbi, for instance. It wasn’t a cheap product to create, Semler says. Building prototypes, writing software, and conducting clinical trials are expensive, and those costs are best paid for by angel investors.

“We have to pitch to them, each technology, every single one, and they write the checks for each project,” Semler says. “They have skin in the game.”

Currently, ZIAN has developed seven products. Several, like the EyeStat, have been licensed out to companies.

In July, Blinktbi announced a partnership with the biopharmaceutical company Prevacus, Inc., to conduct further tests of EyeStat. Meanwhile, Carolina Panthers great Steve Smith recently joined the Blinktbi advisory board.

Garner, for one, sees a bright future for this new piece of technology, and not just for athletes. “I absolutely believe that it will be a device that will become commonplace,” Garner says. “Not only does it have applications for concussion for sports, but also disease models for Parkinson’s and multiple sclerosis.”