- Okay, we promise not to do that to you, Chance.
- [Chance] What?
- [Tanner] I told him it was like a microwave
and he told me that we should set you to popcorn.
- [Chance] Please don't.
(air whooshing)
- I'm here at Cognitive FX in Provo, Utah this week,
to try and fix the concussion
I've had for the past six months.
They're a specialty concussion clinic
that shows some great results.
I've already seen some pretty amazing results this week.
And one of their big tools is their MRI machine.
It's an fMRI machine,
which means not only can it do
the standard structural images of your brain,
where all the tissue is,
it can do fMRI,
which means that it can get images
while your brain is working,
about where there's blood flow.
We're gonna try it out.
I'm gonna get to sit at the console.
Chance reached out to me.
He's a fan of the channel.
You saw the video of me saying that I had the concussion
and reached out and said,
"Hey, we're the perfect solution.
You should come check us out."
So, I'm really thankful to you.
Thanks for getting me in here
and getting me in here so quickly.
- Yeah, of course.
I'm glad we could actually help.
- So, we're gonna make you the guinea pig-
- [Chance] Okay.
- We're gonna hook you up.
You haven't had a concussion recently-
- [Chance] No.
- So you've got a,
in theory, a normal brain.
- [Chance] Yeah.
- So we've got Tanner here, who's the MRI tech.
You're gonna show me how to work the controls.
- [Tanner] We'll show you the ropes.
- [Scotty] We need to pull all the metal off, right?
- Correct.
- So giant magnet in there,
really scary and dangerous.
If anything metal goes past the doorway,
it can fly towards the machine
and wreak all sorts of havoc.
- [Chance] Let's switch Chance for some scrub bottoms.
- You wanna do that on camera?
- [Tanner] Yeah.
- [Chance] No, thank you.
- Give us a minute.
- [Tanner] Chance wears glasses.
- Okay.
- [Tanner] Glasses you can't take them into an MRI
'cause you've got metal screws and lots of metal parts.
So, this is a specialty set-
- [Scotty] Wow!
- [Tanner] Of MediGoggles
- Oh, I like the Comic Sans font.
- [Tanner] Very expensive for Comic Sans.
(Scotty laughs)
I'll just screw then on. This is actually plastic.
- [Scotty] Oh, that's-
- [Tanner] And then these lenses
are actually different powers
so that we can build the glasses for patients.
Like five-
- [Scotty] You've got some pretty wild ones here.
- [Tanner] All the way.
You gotta be- - Don't smudge 'em.
- [Tanner] Pretty dang blind-
- Yeah. - To need these guys.
- [Scotty] For like, look at that thing.
- [Chance] First one's E, the next one's LT.
- [Scotty] Stylish.
- [Chance] Yep.
- [Tanner] Okay, well, let's get you in there, my friends.
- [Chance] Okay.
- [Tanner] Couple safety checks.
Pockets, jewelry, zippers, wristband.
We are good.
Chance, you can leave your mask just here.
- So you can walk all the way up to the metal frame here.
- [Tanner] All the way to the metal frame,
just don't go past it.
Or else you won't keep your camera.
Some ear plugs for you, there.
- This is a super loud machine.
Remind me,
I think I know where the noise comes from.
It's from the coils in the machine slapping together-
- [Tanner] Yep.
- As they energize the inner drives?
- Correct.
So two major parts of the MRI.
The big circle tube is actually the MRI coil
that generates the magnetic field.
So if you could see the magnetic lines,
they'd be shooting out,
wrapping around the machine,
wrapping back in around and behind the machine,
just like a giant electromagnet.
Then, down on the lower side of the machine,
you've got gradient coils that are generating,
you know what?
Let me pull this guy off.
So, gradient coils
that are generating radio frequency pulses.
So how an MRI works,
is the giant magnet
lines up all the water molecules in your body.
And then the gradient coils are pulsating,
knocking them off course and then recording
how fast and how strongly they knock back into alignment.
The gradient coils,
lots of power going through them,
expanding, contracting, making them-
- Very, very, quickly.
- Really, really quickly.
So, for example,
when we're taking his fMRI images,
we're actually taking images of the whole brain,
24 slices, in about two or three seconds.
So it's (imitates coils clicking).
And that's why sounds really horrible.
So, this one, giant squeeze ball.
This one is the emergency let me out ball.
(Tanner chuckles)
So you'll notice this is pneumatic tubing?
Nothing even metal on the connector here.
It actually just runs in through pneumatic tubing
and runs all the way to the back room.
You squeeze it.
(faint signal beeping)
I'm gonna turn that guy off so it doesn't drive me nuts.
- Okay. Great, yeah.
(Tanner laughs)
(signal beeping)
- So, we wouldn't be able to hear him in there at all
while the machine is running
and we can't even hear him through this speaker
that we'll show you here in a minute.
So, we have to have that loud emergency squeeze ball
so that we can know to go in and get 'em out.
This one, the button box,
again, pneumatic tubing,
where this is actually just registering
the pressure of these buttons being pressed.
- So, I did a bit of research
and this thing is called an FORP,
or a Fiber Optic Response Pad.
And the buttons actually intercept the path of light
from a strand of fiber optics, one per button.
And, it's crazy expensive,
it's like $4,000,
but the company that makes this
makes a bunch of MRI Safe devices,
including a steering wheel.
And so,
the reason we're using this,
is, let's discuss the next piece.
- [Tanner] Okay.
- This is to give answers-
- [Tanner] Right.
- To a quiz-
- [Tanner] Right.
- That you are being given,
via another very cool piece of technology,
because again,
you can't just put a computer screen in here, right?
- Right.
If we scoot out around here,
we'll look through,
well actually, like, right past Chance, there,
and if you look right through that,
you can actually see that TV screen
right at the back of the room.
It's actually an MRI Safe TV screen.
Don't actually know how it works.
Crazy expensive though.
Again, about $10,000.
- Oh my god.
- Yeah.
You're gonna have a hard time seeing that
'cause you're looking at the ceiling, right?
- Right.
- So, let's show you how that works.
So, this guy is a head coil for an MRI,
and your head just goes right in the center of it.
These arms around the outside
are actually gradient coils that are putting off
their own radio frequency as part of it.
- No way! - Yep.
- I thought this was just for holding you still.
- Nope. It does hold you still, too.
But, it's actually a necessary part of the machinery.
If you look at this guy,
feels like you're plugging in like, a nuclear power plant.
- Does the machine actually energize these coils?
- Yep.
So the machine energizes these coils
and then is transmitting in this coil
and receiving in coils in the actual machine.
Typically, right?
This whole apparatus wouldn't be here
if you were doing a normal brain MRI.
We want you to be able to see that TV screen at the end-
- Yeah.
- So you've got mirrors here,
that you're actually looking at this mirror at the top,
which is bouncing the image off of this mirror here,
and then viewing the image-
- [Scotty] Off the back.
- Now the tape.
It looks super redneck.
(Tanner laughs)
- It's not great. - It's not good.
The tricky thing is,
that for a GE MRI,
they actually only manufacture this to point forward.
We wanted to use the TV at the other end,
so, we had to literally flip it and tape it.
So let's go put this on Chance.
- Yeah, let's get him loaded up.
- [Tanner] So. Let's get his head coil on here.
- [Chance] It's your average (indistinct).
- [Tanner] Your noggin fits. I love it.
- Excellent.
- So, giant plug,
plugs into that guy.
Okay, we'll get some padding in here by your ears.
So typically for a brain MRI,
we want you to be really, really still, right?
Because we're taking lots of pictures really quickly
and we don't want the pictures to smudge.
So we put not one,
but two giant pads right along side.
As comfy as it gets?
- [Chance] What?
(Scotty and Tanner laugh)
- Your earplugs have expanded, haven't they?
- [Chance] Yes.
- It normally takes a minute
and I can talk a little quieter.
(Scotty laughs)
So the machine,
it's interesting,
actually needs to know where he's at in physical space.
- [Scotty] Yep.
- So, we turn on this handy dandy crosshair laser.
- [Scotty] Oh, nice.
- We're actually looking to put that
directly over a line on this head coil
that tells the machine where his brain is.
Because, we want the machine to know
where he is a physical space,
and we want it to be dead center in the machine
so that he's experiencing
as much of the magnetic field as possible.
So, we'll slide him back just a little bit.
(gear clunks)
Just close your eyes.
And then we'll actually hit the zeroing button.
- Just like zeroing out a CNC machine-
- Yep.
- Or a 3D printer.
- Exactly the same.
- You got your DRO up here.
- [Tanner] Yep, exactly. Same thing.
(Scotty laughing)
Your elbows are touching the sides just a bit,
so let's get some padding in there for you.
We actually don't want any of your extremities
to be touching the sides of the walls.
Right hand there,
other hand here.
So, with the gradient coils,
it's actually passing radio frequency
through your body enough,
that you can start to heat up on your elbows.
- Wow.
- It's one of the other big reasons
that we don't want you to have metal
and that we actually have several protocol on there
that keep us not scanning too quickly
on certain scan sequences,
because it would pump too full of that radio frequency
and then start to get warm.
- Wow. And then you'd start to cook people like a microwave.
- Yep. Exactly. Yeah.
- [Scotty] Yeah.
Okay, we promise not to do that to you, Chance.
- [Chance] What?
- [Tanner] I told him it was like a microwave
and he told me that we should set you to popcorn.
- [Chance] Please don't.
(Scotty and Tanner chuckling)
- [Tanner] Okay, well let's show you how this guy works.
This is just the control for the MRI technician.
And down here,
you've got your MRI computer,
but that is not the whole computer.
This is basically a glorified desktop
that just records what's going on here
and sends it to the main MRI computer in the back.
All right, Chance,
I'm gonna go ahead and run
a couple of localizer scans here for you.
Go ahead and hang tight
and you'll hear some scanning noise, okay?
- [Chance] Okay.
- So right now the only thing the machine has loaded in
is where that center point is on his head.
So, we'll scan and run what's called a localizer scan.
The localizer scan is a very small amount of images
in not very good image quality,
just to see where the heck his head even is.
- So that we could figure out what area
are we actually gonna run-
- Right.
- A more detailed scan on.
- Right.
So, if we look over at this guy over here,
these are the localizer scans
that we just did of Chance's head.
There's like 20 of them.
- That's pretty high detail, though.
I thought it was gonna be much worse.
- It's not terrible.
It's not bad-
- [Scotty] No.
- If you get quite a bit of good detail,
but then you have to really ramp up the time
and the scanning frequencies-
- Yeah.
- To get better-
- To get stuff that's actually usable, yeah.
- So, we do what's called the three calibration.
And we're choosing a point here.
This one is calibrating the gradients.
- So this is basically setting contrast.
- Yep.
- [Scotty] Oh, that's really interesting.
- [Tanner] So it's gonna run this really loud,
high-pitched, gross scan,
and then these images look like gobbledygook, so-
- But you're dragging this around
to set where you're gonna scan.
Wow, that's cool.
- [Tanner] So if you look down in here,
it's these 24 slices,
at a slice thickness of five millimeters.
- [Scotty] Wow, that's awesome.
- [Tanner] We're essentially setting
what our voxel size is going to be.
- It's basically like a- - So it's a pixel size.
- 3D pixel.
- [Tanner] Now, these guys,
we're dragging where to put those slices
so that we can get the best scan coverage.
And then we'll run what's called a prep scan.
So it's a lower res version of that,
and then it'll actually run the exact sequence
to make sure that the machine can run the sequence.
So you'll hear this like,
beep, beep, beep, beep, beep, beep,
just like that.
All right, Chance.
Do you remember that first test?
- [Chance] Yes.
- You guys have some proprietary tests.
- Correct.
- Some problem solving,
some memory type stuff- - Right.
- That sort of thing.
- [Tanner] Right.
- But, you guys have worked very hard to develop that.
You're not quite ready to share that with the world, so.
- Right. So, a couple-
- So we're gonna keep this off camera.
- We'll keep that pointed that way.
Chance, we're gonna talk a little more,
so we'll be back in a moment, okay?
- [Chance] Okay.
(Scotty chuckling)
- Keep him on ice in there.
So, fMRI is just the protocol to gather functional imaging.
It doesn't refer to anything that you're doing.
The thing that is special about our system,
why it's called functional neurocognitive imaging
rather than functional magnetic resonance imaging,
is the tasks.
- [Scotty] Right.
- So you might have had,
in your course of concussion recovery,
like a neuropsychological testing battery,
that are tests to see what your brain is doing,
when it's doing it,
how fast it's doing it, how much is it doing?
And those tests are all entirely based on performance.
What these are,
is tests that have been adapted for use in the fMRI,
that are well suited to detect the areas
that have experienced damage from a concussion.
- And it's less about what you answer-
- Right.
- And more about what is the brain doing
while you're trying to answer? - Right.
That's one of the tricky things with concussion.
You've got mild TBI all the way up to severe TBI.
Severe TBI, like you can't walk, you can't eat-
- [Scotty] Yeah.
- You need to like relearn how to do stuff.
Mild TBI,
there's this really broad spectrum of you can perform,
but you're wiped out afterward,
or you can't do this, but you can do this.
It's this like, squishy space.
- Yeah.
- Where neuropsych tests
really have a very hard time figuring it out
because you might perform great,
but then afterward you're feeling horrible off the bats.
- Yeah. - Right.
- That's the kind of stuff that I've been dealing with.
- What this does is uncouples your performance on the test,
which we don't actually care about.
We care far more about
what's actually happening in the brain when that's going on.
Let's go ahead and start him on this guy-
- Yeah.
- And then we'll chat while he scanning.
All right, Chance.
So let's go ahead and check your button box.
Can you press one, two, three and four for me?
So, it'll light up here.
Are you ready to start?
- [Chance] Yes.
- Okay, let's do it.
MRI is not well suited to sync up with other tasks.
- Yeah.
- We literally just have to hit the buttons
at the same time.
(Scotty laughs)
(buttons click)
And, we're off.
- If it works.
- If it works, it works.
- So you don't get to see much in real time.
You know that you're getting images-
- [Tanner] You get to see images,
they come through as they're processed.
- [Scotty] Ah.
- So, you'll see kind of a stack come through.
Then, what we're doing is actually looking at
some rest periods and some active periods on that test
and sort of compiling all of those images into a 3D model,
laying that over his actual structural brain for accuracy
and then comparing the blood flow activation patterns
of his brain to a normal, healthy, standardized population.
- Got it.
- So, again looking over here,
essentially what we're seeing with the brightness, right?
Is not only the structure of the brain,
but how much blood flow
is being distributed in that part of the brain.
So what we're getting is,
it's called the BOLD signal,
and it's the ratio
of oxygenated and deoxygenated hemoglobin.
- And, oxygenated blood shows up brighter than deoxygenated?
- Right, right.
So, essentially a brain area that's using more blood flow
is going to have more deoxygenated blood,
and then it's going to have more-
- That's wild.
- Oxygenated blood flowing into it.
So, there's a postulate in neuroscience that we aren't
actually looking at directly at neuron activity,
which for our purposes is great,
because your neurons are still working,
they're still alive,
they're still connected,
but they're not getting the blood flow that they need.
All right, Chance,
just check in with you after that one.
Everything still going okay?
- [Chance] Yes.
- Okay, very good.
All right, we're gonna go ahead and finish that one
and then we'll do that brain MRI
and show these guys what that looks like, okay?
- [Chance] Okay.
- So we're gonna set him up on this first one.
- And this is for the structural one?
- Right.
- So this is,
we're no longer looking at where blood is flowing-
- Right.
- We're just looking at where is there tissue in the brain.
- Is tissue in the right place?
Is it the right shape? Is it the right size?
Is there evidence of brain bleeds?
Those kinds of things.
- Got it.
- This one is the MRI that if you went to any MRI facility,
you're gonna get a structural MRI.
- Right.
And so, what's the output of this process
that goes on to the next step?
- So output of this,
if we look at Chance's scan here,
you'll notice that there's 2,024 images.
- [Scotty] Yep.
- [Tanner] Those are DICOM images.
You can convert them to JPEG,
but you really don't want to
'cause they're stupid huge and large.
- And those are just flat, 2D images-
- Yep.
- But it's in a set-
- Right.
- That's basically a stackup.
- So it's essentially building a full 3D model
of your brain's blood flow.
What our analysis software is doing
is looking at all of those put together,
compiled together,
and then comparing against other people's brains.
So, we've got Chance's images back.
You can actually see,
we're gonna start at the top of his head
and it'll actually scroll down in much more-
- [Scotty] Oh, wow. That's wild.
- [Tanner] Fine slices all the way down through the brain
and start to see his eyeballs in there.
- Yeah.
- You can actually convert and then 3D print
a model of your brain.
- Nice. I might do that.
- I had a research lab once that that was their schtick,
is that they would print to a 3D model of their brain
and then they would just print
the same 3D model of a brain for everyone.
(Scotty laughing)
This is your brain!
- That's terrible!
- It's like, yeah, this is not your brain.
This is some- - That's terrible.
- And that's the way they got volunteers?
- Yeah. Oh, yeah.
- That's awful.
- Well, let's go get Chance out of there.
I'm sure he's dying.
We've been filming here for,
I don't know, half hour, 45 minutes?
- Probably.
You doing okay in there?
(items clunking)
Oh, he can't hear us.
- He's got his ear plugs in.
- [Tanner] I think you're done!
It's not microwaves, I promise.
No one has ever been cooked in an MRI.
- Yeah, no.
- I did read a theoretical math problem once
about what it would take to cook a chicken in an MRI.
- Oh, yeah?
- It would take about four or five hours.
- I feel weird tinglies.
- So the weird tinglies,
this is actually going-
- Oh! Is this a thing?
- It is.
It is called peripheral nerve stimulation
because, you likely had your hands folded
or your legs crossed or something touching somewhere.
If you create a loop,
the radio frequencies will actually travel in that loop.
- Oh, like an antenna?
- Like an antenna.
- Holy cow.
- So it'll actually hit your muscles and cause a twitch.
Okay. You're gonna hop up, my friend.
- Thank you for being so patient with us.
- Yeah, of course.
- [Tanner] How do you feel?
- I feel tingly.
- [Scotty] Is it just in your arms?
- Well, I felt in like, my fingertips.
They were like- - Yep.
- Folded like this-
- Oh yeah, you built a good solid loop.
- And I felt vibration.
- Yeah. - Yeah.
- Your small muscles are where you'll feel it the most
because it doesn't take much electricity
to get them to turn.
Let's show you the back room.
- Yes.
- [Tanner] So.
(machine whirring)
- [Scotty] Oh, wow.
- Back in the day-
- This is like a proper server room.
- This was full.
Totally full.
Full of just computers.
- Moore's law in action here.
- Uh huh.
- So let's see what you got left.
- So what we got left is this-
- This has become a storage room in here, I can see.
- Yep. An extremely large air conditioner.
- Wow.
- Because, before we had to keep
a whole crap ton of computers going.
So this is our actual MRI computer.
So it's the part that's bringing in all of that signal,
analyzing it and then spitting out the images.
So it shrank from the size of a small room, to this.
This one is part of our helium circulator.
Our helium is actually in liquid form,
circulating in the magnet
to keep it cold while it's running.
It's part of what helps it to maintain
that electrical circuitry of the electromagnet.
And then this one's pumping that helium.
So it's pumping in, pumping out.
You can hear kind of that chirping sound?
- And, if you have to vent your helium,
that's kind of a big deal.
(Tanner chuckles)
- Let's walk out there and we'll tell you about it.
We obviously have warning signs, literally everywhere.
And we have really strict screening protocols.
Let's say somebody goes in with metal, right?
If it's a small metal,
typically it'll just fly off and stick to the magnet.
- [Scotty] Yeah.
- It's happened once or twice with like a bobby pin, right?
If it's large metal like a desk chair or,
heaven forbid an oxygen tank or fire extinguisher,
you're screwed.
- Yeah.
- Because, what it will actually do,
and you can look up videos on YouTube,
but it will pull it into the magnet
and then it will shoot it and shoot it
and shoot it and shoot it along the magnetic line.
- Yeah.
- And it will be shooting it through
anything and everyone that's in its way.
(Scotty shuddering)
So bad, bad, bad vibe.
- Yeah. That's a bad day at the office.
- Now, there's no off button for the magnet.
We can turn off the coils,
we can turn off the console.
The magnet is literally, always on.
Always, always, always.
So, in case of absolute life or limb emergencies,
we can do what's called a quench.
What a quench does
is actually shoot all of that liquid helium,
converts it into gas helium,
and shoots it out through the roof.
The magnet gets too hot,
it dissipates and is totally fine. Now-
- [Scotty] And does that ruin the magnet?
- It causes like, $500,000 worth of damage.
- Ohh!
- It's really catastrophic,
and a hidden button,
and there's some manual switches,
and I can't show you any of those for legal reasons.
You push the button and within five to 10 seconds,
your magnet's gone.
Now that's if somebody's trapped or pinned
or in dire, dire circumstances.
So, you never want to quench a magnet.
And most magnets never, ever even need to be quenched
because again,
we put layered safety protocols in place
to make sure that nothing can go wrong.
- Well, let's hope you never have to do that.
- Never have.
Hope to never, ever, ever have to do that.
- Fingers crossed.
- So that's our MRI.
- Well, awesome.
Thank you so much for-
- You're welcome.
- Taking the time to show us this.
This is amazing.
It's really cool to see how this works on a hands-on basis.
- Yep.
It's stuff that you never get to see
'cause usually you're in the tube
and we're out here running it and getting the images
and then just showing you a report.
- Yeah.
Thank you for,
not only being our test patient here
and letting us scan your brain,
but also for hooking this up in the first place.
I'm so grateful that you reached out
when I said I had a concussion in my last video
and you guys have been really generous
in exchanging some of the treatment here
in return for telling some stories.
I'm really excited to go back home
with all of the results of all my scans
and watch the improvements over the next few months.
- Yeah, I'm super glad
that you don't just hide it behind a curtain,
but you let people know and,
because you're able to do that,
I could reach out to you
and we could get this information to,
not just you, but-
- [Scotty] Yeah.
- Other people who could be dealing with
just exactly what you're dealing with.
- Yeah.
How should people get ahold of you
if they're suffering from long-term concussion symptoms?
- So we have a consultation button on our website
that if anybody wants to get a consultation with our clinic,
they can definitely reach out to us in that way.
We also have a phone number on our website
that people can call if they have any questions as well.
And, honestly,
anybody that has been through our treatment,
loves talking about their treatment.
- Cognitivefx.com? Is that the website?
- It's cognitivefxusa.com.
- In addition, if, like me,
you're suffering from headaches from a head injury,
check out their online course on how to manage headaches.
Use offer code strangeparts10
for 10% off at the link down in the description.
And, if you'd just like to learn more about concussions,
recovering from them and all the cool technology involved,
I recorded several really interesting conversations
with the neuroscientists that run Cognitive FX,
which I put up on my second channel, Stranger Parts.
You can find a link to those
in the description down below, as well.
And, stay tuned for more videos.
I've been setting up my new shop here in Colorado
for the past six months,
and I've been putting together a video
of that whole process.
And I'm finally feeling well enough
to start making videos regularly again.
I'll see you again soon.