Complete Mental Counts for Patients Recovering from Brain Injury

Abstract Complete Mental Counts for Patients Recovering from Brain Injury The ultimate vision is ubiquitous use of Complete Mental Counts (CMC)—akin to complete blood counts, but based on behavioral measures of mental functioning versus biochemical measures of physiological health. This project is focused on a particularly receptive market segment—“beachhead”—recovery monitoring for patients with traumatic brain injury (TBI). Blast shockwaves and coup-contrecoup motion during TBI can cause diffuse axonal injury throughout the brain, harming the networks that control mental functioning and resulting in persistent symptoms. TBI symptoms tend to be heterogeneous and non-specific, undermining the discovery and implementation of effective interventions while highlighting the need for objective measures of recovery. Mental functioning is conceptualized along cross-diagnostic domains and dimensions that are grounded in objective measures, from Movement Initiation, Dynamics, and Termination in the Reflexive domain to Inhibition, Prediction, Attention, Memory, and Planning in the Cognitive Domain. The goal of this project is to provide exceptionally sensitive and accessible measures of mental functioning packaged as a software-as-a-service solution (SaaS) that is delivered to users via standard touchscreen devices. This computerized assessment aid—MindCount, CMC precursor—can address unmet needs in clinical practice and trials as well as support basic and translational research about the root causes of mental dysfunction, etc. MindCount reports can have independent but synergistic uses: manage expectations based on prognosis, motivate patients to engage in treatments that work, and inform clinicians if a change in treatment is warranted. The key innovation is dynamic visuotactile measures to assess cross-dimensional mental functioning needed for everyday life. A recent NSF SBIR Phase I project resulted in a tablet-based battery prototype and findings of expected mappings between trial difficulty and performance (ex: faster-moving targets => larger tracking errors). A subsequent pilot study found large case-control differences for cross-dimensional MindCount measures. This project aims to expand, refine, productize, and validate the MindCount battery as a cross-dimensional monitoring tool rather than a disease-specific diagnostic tool. This project aims to validate marketing claims that MindCount can assess and track changes in mental dysfunction. Phase I will focus on inpatients and Phase II will follow their recovery journey as they transition from inpatient to outpatient care. The primary success metric is large effect sizes for MindCount measures. Secondary success metrics: high usability, good test-retest reliability, significant correlations with symptoms and outcomes, smaller effect sizes for state-of-the-art behavioral tests. Achieving the aims and publishing scientific papers will facilitate distributing MindCount to users and buyers. Thought leaders—including target users and buyers—have expressed enthusiastic interest in MindCount.