Office-based Neurophysiological Assessments for Diagnosis and Prognosis of Concussion

Patients with concussion often receive insufficient and/or ineffective diagnostic workups. A limiting factor for prompt and accurate diagnosis is the scarcity of practical and effective concussion diagnostics that can be used by private-practice physicians. This gap in the diagnostic process can delay the implementation of crucial interventions. The absence of an affirmative concussion diagnosis leaves patients with few options when follow-up treatment would otherwise be indicated, potentially leading to worsening symptoms, prolonged recovery, and a higher likelihood of developing long-term complications. Neurophysiological assessments such as electroencephalography (EEG) and event-related potentials (ERPs) offer an opportunity for an objective evaluation of brain deficits that can occur after a concussion. By detecting abnormalities in brain patterns that are often associated with concussive injuries, these tests can help provide timely diagnosis and treatment of the disorder, thus reducing the likelihood of chronification of post-concussive symptoms. We reviewed a battery of neurophysiological assessments that have been scientifically validated to detect the pathophysiological effects of concussion and can be performed in office settings by nonspecialist technicians. These assessments are designed to help with diagnosis and prognosis of concussion, while also being accessible and practical to administer for private-practice physicians who can incorporate them into routine evaluations of patients with traumatic brain injury (TBI). The implementation of neurophysiological tools in primary care and outpatient settings has the potential to bridge the gap between symptom presentation and definitive diagnosis, thus mitigating the risk for long-term adverse outcomes.