A pilot study conducted by the Canadian Concussion Centre has shown that using a non-LCD screen for computer tasks may decrease the risk of exacerbating symptoms in sufferers of post-concussion syndrome (PCS).
The findings provide a potential option for earlier return to work or return to school for those suffering from light sensitivity and computer or cell phone screen intolerance – common, persistent concussion symptoms.
The data, presented this month at the American Academy of Neurology’s 2017 Sports Concussion Conference, reported that 26 participants who read a narrative on non-LCD screens for 30 minutes or until their symptoms worsened, experienced less symptom exacerbation compared with doing the same exercise on an LCD screen.
“These results are very encouraging as they indicate there may be a technology that allows PCS sufferers with photophobia and screen intolerance to return to work or school faster,” said Dr. Charles Tator, neurosurgeon and director of the Canadian Concussion Centre. “We’ve observed that photophobia occurs in up to 43 per cent of individuals with PCS and, in severe cases, can last several years or even permanently. In a society more and more reliant on working and learning on screens, PCS sufferers can experience the added suffering of being unable to return to their academic or professional routine which can be frustrating.”
Photophobia – also known as photosensitivity – is an abnormal sensitivity to light. The majority of screens on computers, televisions, phones and other technology are liquid crystal displays (LCD) using a backlight or reflector to produce light in colour.
For someone suffering from photophobia, the backlight is aggravating as well as the “flicker rate” of an LCD screen which refreshes approximately 60 times per second. PCS sufferers are often advised by their health-care team to avoid using LCD screens if the screen exacerbates their symptoms.
For this research, the CCC team used a non-LCD computer monitor based on “e-paper” technology provided through a research partnership with Iris Technologies, a company with the Biomedical Zone – a physician-led incubator for health technology companies that is a partnership between St. Michael’s Hospital and Ryerson University. E-paper screens use a magnetized polymer to create shapes on its display, unlike the light modulating liquid crystals with backlighting used for LCD screens. These screens also only refresh when content on the screen changes, holding a static image for the viewer that is easier to look at.
Participants in the research were diagnosed with PCS, which persisted for at least three months since their last concussion, and reported suffering from screen intolerance. The participants were randomized into two groups each reading a narrative on either an LCD screen or a non-LCD screen for 30 minutes or until their symptoms worsened. After completing the Sport Concussion Assessment Tool 3rd edition (SCAT3) and a reading comprehension test utilizing one of the computers, participants then repeated the evaluation using the other screen. They then completed a questionnaire about the experience.
The majority of the participants reported fewer exacerbated symptoms and a significant difference in the amount of time they were able to spend reading when using the non-LCD screen. They also reported an increased ability to focus and that the non-LCD computer screen was easier on the eyes.
“The findings certainly warrant further investigation to determine how helpful non-LCD screens could be to specific PCS patient populations,” Tator said. “We are already planning other research projects to evaluate this further.”
The study was made possible with funding from the Queen’s University Entrepreneurship Competition, the Ontario Brain Institute, and the Toronto General and Western Hospital Foundation.
Commentary: Non-LCD screens may have an even broader application for our headache patients who we are treating with Active Release Therapy. Switching to a non-LCD screen would be worth exploring for patients who have screen sensitivities.