I-Corps: Translation potential of a monitoring tool to measure and track levels of consciousness

This I-Corps project is based on the development of a medical device that measures the level of consciousness. Currently, doctors and nurses often struggle to accurately determine the level of consciousness in approximately 30–40% of the most serious cases of brain injury, and around 70% die after families decide to stop life support. This is a problem, in part, because doctors lack sufficiently reliable tools to measure consciousness and predict recovery. This technology addresses this problem by providing a tool to track a patient’s brain and motor activity patterns, which indicate the level of responsiveness. The goal is to better track how the brain “wakes up” and use the information to guide treatment decisions and recovery plans. This technology may serve as a confirmatory method for neuro-evaluation and help to detect deviations from the expected recovery trajectory in hospitals, emergency services, and nursing homes. In addition, this technology may enable healthcare teams to determine the effects of oversedation or undersedation, and may provide better outcomes and save lives for patients with brain injury. This I-Corps project utilizes experiential learning coupled with a first-hand investigation of the industry ecosystem to assess the translation potential of a medical device monitoring tool that measures and tracks consciousness levels and their fluctuations. This technology is based on a repeated, temporally discrete, dynamic cortical pattern that aligns with autonomic tone and is reliably associated with single motor changes evident in the recovery of consciousness from anesthesia and brain injury coma models in rodents. This dynamic pattern, termed arousal units (AUs), contains distinctive cortical patterns that reliably synchronize with transient shifts of breathing frequency and single motor behavioral changes that evolve as rodents and humans reach a state of wakefulness. Oscillatory patterns within AUs may be transformed into indices, making it possible to quantify consciousness levels in minutes, and can be used to distinguish voluntary from erratic behaviors. In addition, this technology reveals fluctuations that can quantitatively track the transition from a reflexive state to a state of awareness and the transition from one state of consciousness to another. This device may benefit physicians and nurses that currently perform neuro-evaluations using qualitative methods to make informed decisions about the need for additional tests or treatments. A monitoring tool that measures and tracks consciousness may reduce the risk of patient mortality and improve patient recovery and outcomes. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.