Frequently asked questions
Yes. Cognitive Health Assessments™ measure the health and performance of the brain. This information is beneficial for any type of brain injury.
For concussion and mild traumatic brain injury, Cognitive Health Assessments™ inform if cognitive rehabilitation is required, and if a full neuropsychological assessment may be recommended.
For acquired (ex. stroke, heart attack) and traumatic injuries (ex. car accidents, falls, victims of violence), Cognitive Health Assessments™ indicate potential for treatment.
Yes. Cognitive Health Assessments™ are valuable to anyone in need of reliable, trackable objective data on brain function. For example, understanding the effects of pharmaceuticals on brain function in clinical trials, monitoring the effects of aging, monitoring the brain health of athletes, to name a few.
Cognitive Health Assessments™ do not provide a diagnosis. Diagnoses can be provided by primary care providers, nurse practitioners, and clinical specialists in brain injury.
Cognitive Health Assessments™ are a tool for clinicians to use to objectively inform their clinical decision making, which can include making an initial diagnosis, or to corroborate an existing diagnosis.
- Centers for Disease Control & Prevention: HEADS UP Resource Center (https://www.cdc.gov/headsup/resources/index.html)
- Centers for Disease Control & Prevention:
Traumatic Brain Injury & Concussion resources (https://www.cdc.gov/traumaticbraininjury/index.html)
- 5th International Consensus on Concussion in Sport available through the British Journal of Sports Medicine (bjsm.bmj.com)
- Guideline for Concussion/Mild Traumatic Brain Injury & Persistent Symptoms – 3rd Edition, For Adults over 18 Years of Age, created by the Ontario Neurotrauma Foundation (braininjuryguidelines.org)
- Ontario.ca’s Rowan’s Law: Concussion Safety resources: (https://www.ontario.ca/page/rowans-law-concussion-safety)
- Concussions Ontario’s resources – sponsored and led by the Ontario Neurotrauma Foundation (concussionontario.org)
- Canadian Guideline on Concussion in Sport available through Parachute Canada (https://parachute.ca/en/injury-topic/concussion/)
- Concussion ED app created by Parachute Canada, available for download to your mobile on Apple and iOS devices (http://www.parachutecanada.org/injury-topics/item/2587)
- Brain Injury Canada: Links to brain injury associations across Canada that provide support support, information, education, advocacy, and a variety of programs and services to those affected by acquired brain injury.(https://www.braininjurycanada.ca/abi-associations/)
For more detailed information, visit The Science page.
Standard assessments for the brain include physical, behavioural or neurological testing, CT or MRI scans. What’s missing from these standard assessments is a full objective assessment of cognitive brain function – the root of any functional impairments a patient may experience.
With VoxNeuro’s Cognitive Health Assessments™, you are armed with objective data to customize your treatment strategies quickly and efficiently. VoxNeuro’s reports aid healthcare professionals in eliminating the subjectivity involved in current cognitive assessment methods. Read morechevron_right
Patient reports include objective data from measured brain activity for the following cognitive functions: Executive function, language comprehension, working memory, automatic attention, reactive attention, concentration, information processing, auditory processing, and visual processing.
Reports are available 2-5 business days following an assessment.
In the case of a concussion and mild traumatic brain injuries, an initial assessment is recommended within the first 6 months post-injury. Follow-ups are recommended mid-rehabilitation to confirm if the therapies selected are effective for that patient & inform if other methods should be tried, and post-rehabilitation to confirm if a patient has returned to a healthy norm, requires further rehabilitation or if long-term accommodations are to be implemented.
For athletes, more frequent follow-ups are recommended throughout their recovery to assist in informing return-to-play timelines, and most importantly to ensure a patient does not return to play before symptoms and cognitive performance have returned to normal – avoiding risk of second impact syndrome.
For acquired brain injury patients, the initial assessment is recommended within the first month, or first few months post-injury. If rehabilitation is identified as a potential, follow-ups are recommended every 3-6 months to confirm if the therapies selected are effective for that patient & inform if other methods should be tried.
See Get Started and complete an inquiry form. A member of VoxNeuro’s team will reach out to understand your utility and discuss integration.
VoxNeuro’s Cognitive Health Assessments™ are backed by 25+ years of globally funded research. See Foundational Research for publications and peer reviewed journals that document the research behind the methods performed in VoxNeuro’s Cognitive Health Assessments™.
VoxNeuro’s assessments help streamline the patient care pathway and are best utilized as part of a multidisciplinary approach. For neuropsychology specifically, the results of a Cognitive Health Assessment™ can be used as a screening tool to confirm the need for a neuropsychological assessment to assess the impact of any functional deficits on emotional health. Additionally, they can be used to assist in validating and supporting neuropsychological assessment results with objective data.
Various medications and psychoactive substances may cause the results of the assessment to deviate from ‘normal’ values. To ensure this is taken into consideration during the clinical examination of their report, patients are screened for this information during the patient intake process.
Owing to decades of research preceding the commercial launch of VoxNeuro’s Cognitive Health Assessments™, as well as continuous expansion of the normative database, VoxNeuro has a rich collection of data from patients of different genders spanning 7 years of age to 70+. With this database to compare a patient’s results to, a baseline is not required.
The sooner you can get a full understanding of your patient’s cognitive function, the faster you can start rehabilitating any areas of dysfunction identified in a VoxNeuro Cognitive Health Assessment™ report.
First, please see the question and answer directly above. VoxNeuro’s assessments can be run anytime post-injury – from days following through years after the injury to assess cognitive effects.
Standard practice advises primary care providers monitor symptoms & provide patients’ with education on how to manage their symptoms through gradual return to activity, and to seek medical attention immediately if symptoms worsen for the first 4 weeks post-injury.
When symptoms do not resolve in the initial 4 weeks of an injury, multidisciplinary examinations for a patient’s cognitive, physical and emotional complications are required. VoxNeuro’s Cognitive Health Assessments™ inform if the patient requires cognitive rehabilitation, and can identify if a full neuropsychological assessment is of benefit to the patient.
No, the Cognitive Health Assessments™ offered are extremely sensitive measurements and as a result can be useful in both the acute and chronic phases of injury. You can explore more on how our assessments benefit individuals years removed from their injuries in the publication Disruption of Function: Neurophysiological markers of cognitive deficits in retired football players and in the award winning series Collision Course.
A Cognitive Health Assessment™ report summarizes the health of a brain’s performance. It breaks this performance into core and base functions, so each can be examined individually. This ability to assess each individual function is unique to VoxNeuro’s Cognitive Health Assessments™. The data provided allows healthcare professionals to objectively review each cognitive function, and provide treatment plans specific to a patient’s unique needs as indicated by any sub-normal responses.
Yes. Coverage may be provided through workplace insurance and through motor-vehicle accident (MVA) insurance. Coverage may also be possible through personal extended benefits.
All coverage options are dependent on the nature of the patient’s injury and the coverage provided by the insurer. Granting funding is up to the insurer, on a case by case basis and is not guaranteed.
Appointments run between 1.5 – 2 hours. This includes the patient completing self-report inventories prior to the EEG portion of the assessment, which takes 45 minutes to complete.
EEG differs from neuroimaging techniques like MRI or CT scans in the following ways:
- EEG is non-invasive and does not give off any radiation. Unlike CT & MRI, it does not take images of the brain, but instead measures the electrical activity that is naturally emitted from the brain. This is done by inserting conductive gel between the scalp and the EEG cap, similar to what is used in an ultrasound
- EEG does not restrict patients who have metal components in their bodies such as metal plates or implants, unlike MRIs
- EEG does not require any tight spaces to complete
- EEG can be done in a relatively comfortable set up, with the patient seated in a chair and the EEG cap placed over their head – similar to a shower cap
There are a number of ways EEG can be utilized in clinical testing. Visit How Cognitive Health Assessments™ are different from traditional EEG, to learn more.
No, patients will not feel anything happening to their brain or body during the Cognitive Health Assessment™ that they would not otherwise feel during regular daily life. No part of the assessment should cause any physical pain or discomfort whatsoever. Patients may experience mental fatigue from concentrating on completing the tasks.
Prior to completing the EEG portion of the assessment, patients are screened for if they experience epileptic seizures, hearing or visual impairments. Alternate test formats may be used to accommodate.
Yes, VoxNeuro Certified Clinics are equipped to offer accommodations to the testing protocol to allow patients with auditory and visual impairments to complete the testing. This should be noted at time of booking.
VoxNeuro currently only offers assessments in English. If English is not the patient’s first language, accommodations may be made to facilitate the assessment. Ask your VoxNeuro Certified Clinic for more details.
No. Patients seeking to book a Cognitive Health Assessment™ may reach out to a VoxNeuro Certified Clinic directly.
Review results & prepare next steps:
Reports are ready 2-5 days post-assessment. Using your report, healthcare professionals can create a customized plan based on the specific areas of cognitive function identified as performing below healthy norms.
If interventions are pursued, VoxNeuro recommends retesting throughout the intervention to quantify progress and improvements in cognitive functioning.
No, VoxNeuro is a private outsourced lab developed service.
See Q: Are Cognitive Health Assessments™ eligible for coverage from any types of insurance? for more details.
No, VoxNeuro does not facilitate funding coverage.
If you are eligible, assistance in funding coverage may be pursued with VoxNeuro Certified Clinics.
See Q: Are Cognitive Health Assessments™ eligible for coverage from any types of insurance? for more details.
To find out more information regarding payment and cancellation policies, please contact the VoxNeuro Certified Clinic where you are getting your Cognitive Health Assessment™.
A concussion is an injury to the brain that results in temporary loss of normal brain function. (Definition by the American Association of Neurological Surgeons).
Concussion are caused by a biomechanical force, meaning any situation that may induce a sudden/dramatic biomechanical force are potential mechanisms of injury. Some of the most common are motor vehicle collisions, falls, assaults, and non-intentional strikes during sport or other recreation.
The observable effects of a concussion or acquired brain injury can be noticeable immediately, or become noticeable over time. Every concussion presents with its own unique cluster of signs and symptoms, however some of the more common categories of signs and symptoms are cognitive-based symptoms (difficulties with various areas of cognition), vestibular and vision dysfunction (persistent vertigo, dizziness, nausea, eye characteristics etc.), mental health (irritability, sadness, anxiety, etc.), post-traumatic headache, sleep-wake disturbances, and fatigue.
The most frequently reported impairments as a result of a concussion and brain injury that prevent individuals from returning to work / regular activity are cognitive difficulties (ONF Brain Injury Guidelines, 3rd Edition – 2018, Pg 5). Some examples include issues with: thinking, concentrating, memory, processing environmental stimuli, and executive function: a complex cognitive process that affects an individual’s ability to multitask, prioritize, organize, and have effective time management.
A full list of noticeable signs and symptoms a patient may experience following a concussion or acquired brain injury may include: (source: Brain Injury Canada (2018)).
- Slowed information processing
- Problems planning, organizing or starting tasks
- Difficulty following conversations, finding the right word, or speaking in complete sentences
- Difficulty making decisions
- Easily distracted
- Easily confused
- Poor memory
- Lowered inhibition (saying or doing something before thinking it through)
- Problems with balance, walking, sitting, bathing, household or everyday tasks
- Slurred speech
- Chronic pain such as headaches
- Sleep difficulties
- Change in vision
- Sensitivity to noise
- Sensitivity to light
- Sensory changes: ringing in the ears, trouble with hand-eye coordination, unpleasant tastes or smells, sensations on the skin like tingling, pain, or itching, difficulty with balance, dizziness
- Lack of emotional responses
- Emotionally vulnerable (ex. Crying without cause, emotional outbursts)
- Engaging in risky behavior, impulsive
- Isolating oneself
- Difficulty with social and work relationships
- Changing/inconsistent sleep patterns
- Change in role – often from being independent to relying on others for care and support
If you believe you have sustained a concussion, you should seek out your primary care physician or an urgent care facility, however if you suspect there may be a more serious injury, present yourself to an emergency department immediately.
Observing one of the following clinical signs constitutes an alteration in brain function and should be a cause for immediate medical attention following an injury (source: Centers for Disease Control and Prevention. (2015)). Report to Congress on Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation. National Center for Injury Prevention and Control; Division of Unintentional Injury Prevention. Atlanta, GA.
- Any period of loss of or decreased consciousness;
- Any loss of memory for events immediately before (retrograde amnesia) or after the injury (post-traumatic amnesia)
- Neurologic deficits such as muscle weakness, loss of balance and coordination, disruption of vision, change in speech and language, or sensory loss
- Any alteration in mental state at the time of the injury such as confusion, disorientation, slowed thinking, or difficulty with concentration.
Symptoms may present immediately, or develop within a few days post injury. With proper guidance on symptom management, the majority of patients will recover within 1-4 weeks.
- ≈ 80% of the adult population recover in 2 weeks
- ≈ 70% of children and adolescents recover within 4 weeks
Action: Consult with your primary care provider immediately if a concussion is suspected. Follow-up with your primary care provider to monitor your symptoms until they resolve.
On average, symptoms that last beyond 3 weeks.
- ≈ 15-20% of the adult population
- ≈ 30% of children and adolescents
Action: Interdisciplinary care required.
Post Concussion Syndrome (PCS)
May be diagnosed when symptoms persist past 2-3 months post injury
Action: Re-evaluation and continued care from interdisciplinary team required.
* Infographic informed by Ontario Neurotrauma Foundation’s Concussion Recovery Pattern and Post-Concussion Care Pathway 2017
The exact rehabilitation strategy will depend on the category of symptoms being addressed, and will be planned by your rehabilitation provider to address your unique injuries needs. The best management strategy is to be treated by a multidisciplinary team, meaning regular visits with your primary care provider to manage your symptoms, and specialist to address cognitive (brain function), physical and emotional issues you may be dealing with as a result of your injury.
While treatment is a custom fit to the patient based off their unique presentation of symptoms and assessment findings, some of the most prevalent management strategies are presented alongside the most common clinical symptom categories documented. These recommendations follow the latest guidelines published by the Ontario Neurotrauma Foundation.
|Management Strategy / Specialists||Category of Symptoms|
|Neuropsychological Assessment & Rehabilitation of Problem Area of Cognition (e.g., neuropsychologist, occupational therapist, physiotherapist)||Cognitive Dysfunction|
|Neuro-Ophthalmologists||Complex Visual Symptoms|
|Qualified Optometrists||Impairments of Eye Movement and Photosensitivity|
|Healthcare Practitioners Specialized in Coordinating Eye-Head Movements, Balance, and Mobility||Vestibular System|
|Pharmacotherapy||Mental Health Headaches|
Sleep-Wake Disturbances Fatigue
ABI refers to damage to the brain resulting from events incurred after birth.
There are two classifications for ABIs, traumatic and non-traumatic.
Traumatic Brain Injury
ABIs occurring due to an external force such as a bump, blunt force, or jolt to the head are classified as traumatic brain injuries (TBIs). An external force to the head does not always result in a TBI.
TBIs range in severity from “severe”, such as coma or Unresponsive Wakefulness Syndrome (vegetative state), to “mild” (mTBI), commonly referred to as concussion. (Source: Traumatic Brain Injury & Concussion (2017, April 27)).
TBIs can result in temporary injury or more severe, long-term damage to brain cells.
Non-Traumatic Acquired Brain Injury
Non-Traumatic Acquired Brain Injuries are caused by something that happens inside the body or a substance introduced into the body that damages brain tissues. (source: Brain Injury Canada (2018). Brain injury info: Acquired brain injuries (ABI) – the basics).
Causes include: motor vehicle accidents, falls, assault, gunshot wounds, domestic violence, shaken baby syndrome, sports injuries, explosive blasts and combat injuries.
Causes include: (source: Brain Injury Canada (2018). Brain injury info: Acquired brain injuries (ABI) – the basics.)
- Ischemic stroke (stroke from a blocked blood vessel in the brain)
- Hemorrhagic stroke (stroke from a burst blood vessel in the brain)
- Aneurysm (a bulge in a blood vessel in the brain that may leak/rupture)
- Seizure disorders
- Brain tumour
- Substance abuse
- Opioid overdose (heroin, fentanyl, codeine, morphine…)
- Hydrocephalus (fluid accumulates in the brain)
- Vasculitis (inflammation of the blood vessel walls in the brain)
- Hematoma (blood collecting on the surface of the brain)
- Events where the brain has been deprived of oxygen
- Toxic exposures
VoxNeuro’s concussion & traumatic brain injury assessments run advanced electroencephalography (EEG) simultaneous to neuropsychological tests. By pairing widely used and validated neuropsychological assessment methods with EEG, VoxNeuro transforms what would be qualitative results from traditional, subjective testing into objective, quantifiable measurements of brain function. The objective data on the patient’s brain function helps healthcare providers create customized treatment plans specific to the patient’s unique injury, and accelerate & track recovery with unprecedented precision.
Concussions and brain injuries cause disruption in normal brain function. Too often concussions and brain injuries are only treated for their symptoms, not addressing the root-cause of many of the issues the patient may be experiencing – issues in their cognitive function.
The most frequently reported impairments as a result of a concussion and brain injury that prevent individuals from returning to work / regular activity are cognitive difficulties (ONF Brain Injury Guidelines, 3rd Edition – 2018, Pg 5). Some examples include thinking, concentrating, memory, processing environmental stimuli, and executive function: a complex cognitive process that affects an individual’s ability to multitask, prioritize, organize, and have effective time management.
VoxNeuro’s assessments arm clinicians with vital, objective data on a patient’s brain activity in all core functions, including:
- auditory processing (ability to hear a stimulus)
- visual processing (ability to see a stimulus)
- information processing
- language comprehension (ie. ability to follow conversations or reading text)
- automatic attention
- reactive attention
- working memory
- executive function (ie. ability to make decisions, working memory, problem solving, planning & organization)
This objective data allows clinicians to pinpoint and address the root of the cognitive impairments a patient is dealing with, in addition to treating observable/reported symptoms and functional impairments. Knowing areas of cognitive deficit is essential for rehabilitation professionals to facilitate the patient’s return to pre-accident functioning and improve their quality of life.
VoxNeuro’s assessments screen the need for cognitive rehabilitation, and the potential need for a full neuropsychological assessment. Additionally, VoxNeuro’s assessments add value in confirming if a patient’s symptoms are not associated with cognitive deficits, meaning their symptoms may be due to mood disorders, pain, musculoskeletal injuries or other causes. With VoxNeuro, healthcare teams are armed with objective data to customize a patient’s care path and rehabilitation quickly and efficiently with a 60-minute assessment and 2-5 day report turn around (2 for concussions, 5 for ABIs) – helping cut down timelines and streamline paths for specialized care.