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Cao Y, Liu Y, Tang L, Jiang Z, Liu Z, Zhou L, Yang B. Quantitative assessment of brain injury and concussion induced by an unintentional soccer ball impact. Injury 2024; 55:111658. [PMID: 38879923 DOI: 10.1016/j.injury.2024.111658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/21/2024] [Accepted: 06/03/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Accidental impact on a player's head by a powerful soccer ball may lead to brain injuries and concussions during games. It is crucial to assess these injuries promptly and accurately on the field. However, it is challenging for referees, coaches, and even players themselves to accurately recognize potential injuries and concussions following such impacts. Therefore, it is necessary to establish a list of minimum ball velocity thresholds that can result in concussions at different impact locations on the head. Additionally, it is important to identify the affected brain regions responsible for impairments in brain function and potential clinical symptoms. METHODS By using a full human finite element model, dynamic responses and brain injuries caused by unintentional soccer ball impacts on six distinct head locations (forehead, tempus, crown, occiput, face, and jaw) at varying ball velocities (10, 15, 20, 25, 30, 35, 40, and 60 m/s) were simulated and investigated. Intracranial pressure, Von-Mises stress, and first principal strain were analyzed, the ball velocity thresholds resulting in concussions at different impact locations were evaluated, and the damage evolution patterns in the brain tissue were analyzed. RESULTS The impact on the occiput is most susceptible to induce brain injuries compared to all other impact locations. For a conservative assessment, the risk of concussion is present once the soccer ball reaches 17.2 m/s in a frontal impact, 16.6 m/s in a parietal impact, 14.0 m/s in an occipital impact, 17.8 m/s in a temporal impact, 18.5 m/s in a facial impact or 19.2 m/s in a mandibular impact. The brain exhibits the most significant dynamic responses during the initial 10-20 ms, and the damaged regions are primarily concentrated in the medial temporal lobe and the corpus callosum, potentially causing impairments in brain functions. CONCLUSIONS This work offers a framework for quantitatively assessing brain injuries and concussions induced by an unintentional soccer ball impact. Determining the ball velocity thresholds at various impact locations provides a benchmark for evaluating the risks of concussion. The examination of brain tissue damage evolution introduces a novel approach to linking biomechanical responses with possible clinical symptoms.
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Affiliation(s)
- Yangjian Cao
- School of Civil Engineering and Transportation, State Key Laboratory of Subtropical Building and Urban Science, South China University of Technology, Guangzhou 510640, China
| | - Yiping Liu
- School of Civil Engineering and Transportation, State Key Laboratory of Subtropical Building and Urban Science, South China University of Technology, Guangzhou 510640, China.
| | - Liqun Tang
- School of Civil Engineering and Transportation, State Key Laboratory of Subtropical Building and Urban Science, South China University of Technology, Guangzhou 510640, China
| | - Zhenyu Jiang
- School of Civil Engineering and Transportation, State Key Laboratory of Subtropical Building and Urban Science, South China University of Technology, Guangzhou 510640, China
| | - Zejia Liu
- School of Civil Engineering and Transportation, State Key Laboratory of Subtropical Building and Urban Science, South China University of Technology, Guangzhou 510640, China
| | - Licheng Zhou
- School of Civil Engineering and Transportation, State Key Laboratory of Subtropical Building and Urban Science, South China University of Technology, Guangzhou 510640, China
| | - Bao Yang
- School of Civil Engineering and Transportation, State Key Laboratory of Subtropical Building and Urban Science, South China University of Technology, Guangzhou 510640, China
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Huber CM, Patton DA, Maheshwari J, Zhou Z, Kleiven S, Arbogast KB. Finite element brain deformation in adolescent soccer heading. Comput Methods Biomech Biomed Engin 2024; 27:1239-1249. [PMID: 37477178 PMCID: PMC10799973 DOI: 10.1080/10255842.2023.2236746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/27/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023]
Abstract
Finite element (FE) modeling provides a means to examine how global kinematics of repetitive head loading in sports influences tissue level injury metrics. FE simulations of controlled soccer headers in two directions were completed using a human head FE model to estimate biomechanical loading on the brain by direction. Overall, headers were associated with 95th percentile peak maximum principal strains up to 0.07 and von Mises stresses up to 1450 Pa, and oblique headers trended toward higher values than frontal headers but below typical injury levels. These quantitative data provide insight into repetitive loading effects on the brain.
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Affiliation(s)
- Colin M. Huber
- Department of Bioengineeing, University of Pennsylvania, Philadelphia, United States of America
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, United States of America
| | - Declan A. Patton
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, United States of America
| | - Jalaj Maheshwari
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, United States of America
| | - Zhou Zhou
- Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Svein Kleiven
- Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Kristy B. Arbogast
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, United States of America
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
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3
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Patton DA, Huber CM, Jain D, Kleiven S, Zhou Z, Master CL, Arbogast KB. Head Impact Kinematics and Brain Tissue Strains in High School Lacrosse. Ann Biomed Eng 2024:10.1007/s10439-024-03513-0. [PMID: 38649514 DOI: 10.1007/s10439-024-03513-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
Male lacrosse and female lacrosse have differences in history, rules, and equipment. There is current debate regarding the need for enhanced protective headwear in female lacrosse like that worn by male lacrosse players. To inform this discussion, 17 high school lacrosse players (6 female and 11 male) wore the Stanford Instrumented Mouthguard during 26 competitive games over the 2021 season. Time-windowing and video review were used to remove false-positive recordings and verify head acceleration events (HAEs). The HAE rate in high school female lacrosse (0.21 per athlete exposure and 0.24 per player hour) was approximately 35% lower than the HAE rate in high school male lacrosse (0.33 per athlete exposure and 0.36 per player hour). Previously collected kinematics data from the 2019 high school male and female lacrosse season were combined with the newly collected 2021 kinematics data, which were used to drive a finite element head model and simulate 42 HAEs. Peak linear acceleration (PLA), peak angular velocity (PAV), and 95th percentile maximum principal strain (MPS95) of brain tissue were compared between HAEs in high school female and male lacrosse. Median values for peak kinematics and MPS95 of HAEs in high school female lacrosse (PLA, 22.3 g; PAV, 10.4 rad/s; MPS95, 0.05) were lower than for high school male lacrosse (PLA, 24.2 g; PAV, 15.4 rad/s; MPS95, 0.07), but the differences were not statistically significant. Quantifying a lower HAE rate in high school female lacrosse compared to high school male lacrosse, but similar HAE magnitudes, provides insight into the debate regarding helmets in female lacrosse. However, due to the small sample size, additional video-verified data from instrumented mouthguards are required.
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Affiliation(s)
- Declan A Patton
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Roberts Pediatric Research Building, 2716 South Street, 13th Floor, Philadelphia, PA, 19146, USA.
| | - Colin M Huber
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Roberts Pediatric Research Building, 2716 South Street, 13th Floor, Philadelphia, PA, 19146, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Divya Jain
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Roberts Pediatric Research Building, 2716 South Street, 13th Floor, Philadelphia, PA, 19146, USA
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Svein Kleiven
- Division of Neuronic Engineering, KTH-Royal Institute of Technology, Stockholm, Sweden
| | - Zhou Zhou
- Division of Neuronic Engineering, KTH-Royal Institute of Technology, Stockholm, Sweden
| | - Christina L Master
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Roberts Pediatric Research Building, 2716 South Street, 13th Floor, Philadelphia, PA, 19146, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Sports Medicine and Performance Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Roberts Pediatric Research Building, 2716 South Street, 13th Floor, Philadelphia, PA, 19146, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Inam SHA, Chaychi MTM, Mannan MS, Hanson JE, Ferguson P, Nolte J. Cerebellar Stroke in a Young Adult Following an Amusement Park Ride. Cureus 2023; 15:e44165. [PMID: 37753051 PMCID: PMC10519367 DOI: 10.7759/cureus.44165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2023] [Indexed: 09/28/2023] Open
Abstract
The incidence of stroke in young individuals has been showing an increasing trend. In such cases, atypical mechanisms of stroke should be considered. Here, we report a case of a 37-year-old healthy female who presented with complaints of right-sided ataxia and clumsiness that started after an amusement park ride where she was swung rapidly. Imaging revealed an infarct in the right cerebellar hemisphere. This case report highlights certain mechanisms that can cause a stroke in this situation, with special emphasis on recognition, timely medical management, public awareness of such risk factors, and the prevention of complications.
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Affiliation(s)
- Syed Hashim Ali Inam
- Neurology, Joan C. Edwards School of Medicine, Marshall University, Huntington, USA
| | | | | | - Jonathan E Hanson
- Neurology, Joan C. Edwards School of Medicine, Marshall University, Huntington, USA
| | - Paul Ferguson
- Neurology, Joan C. Edwards School of Medicine, Marshall University, Huntington, USA
| | - Justin Nolte
- Neurology, Joan C. Edwards School of Medicine, Marshall University, Huntington, USA
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Chen A, Kuo C, Blouin JS. A portable and low-cost solution for real-time manipulation of the vestibular sense. J Neurosci Methods 2022; 382:109709. [PMID: 36116537 DOI: 10.1016/j.jneumeth.2022.109709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The vestibular system encodes head motion in space which is naturally accompanied by other sensory cues. Electrical stimuli, applied across the mastoid processes, selectively activate primary vestibular afferents which has spurred clinical and biomedical applications of electrical vestibular stimulation (EVS). When properly matched to head motion, EVS may also manipulate the closed-loop relationship between actions and vestibular feedback to reveal the mechanisms of sensorimotor recalibration and learning. NEW METHOD We designed a portable, low-cost real-time EVS system using an Arduino microcontroller programmed through Simulink that provides electrical currents based on head angular motion. We used well-characterized vestibular afferent physiological responses to head angular velocity and electrical current to compute head-motion equivalent of real-time modulatory EVS currents. We also examined if our system induced recalibration of the vestibular system during human balance control. RESULTS Our system operated at 199.997 Hz ( ± 0.005 Hz) and delivered head-motion-equivalent electrical currents with ∼10 ms delay. The output driving the current stimulator matched the implemented linear model for physiological vestibular afferent dynamics with minimal background noise (<0.2% of ± 10 V range). Participants recalibrated to the modulated closed-loop vestibular feedback using visual cues during standing balance, replicating earlier findings. COMPARISON WITH EXISTING METHODS EVS is typically used to impose external perturbations that are independent of one's own movement. We provided a solution using open-source hardware to implement a real-time, physiology based, and task-relevant vestibular modulations using EVS. CONCLUSIONS Our portable, low-cost vestibular modulation system will make physiological closed-loop vestibular manipulations more accessible thus encouraging novel investigations and biomedical applications of EVS.
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Affiliation(s)
- Anthony Chen
- School of Kinesiology, University of British Columbia, Vancouver, Canada.
| | - Calvin Kuo
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada.
| | - Jean-Sébastien Blouin
- School of Kinesiology, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada; Institute for Computing, Information and Cognitive Systems, University of British Columbia, Vancouver, Canada.
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Hori YS, Gramer RM, Penumaka A, Northam WT, See AP. Multifocal Subdural Hematoma in a Teenager after a Fourth-Dimension Roller Coaster Ride. Pediatr Neurosurg 2022; 57:138-140. [PMID: 35203080 DOI: 10.1159/000523780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/23/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Yusuke S Hori
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA,
| | - Robert M Gramer
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Anirudh Penumaka
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Weston T Northam
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Alfred P See
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Filben TM, Pritchard NS, Miller LE, Miles CM, Urban JE, Stitzel JD. Header biomechanics in youth and collegiate female soccer. J Biomech 2021; 128:110782. [PMID: 34656012 DOI: 10.1016/j.jbiomech.2021.110782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022]
Abstract
Concerns about the effects of intentional heading in soccer have led to regulatory restrictions on headers for youth players. However, there is limited data describing how header exposure varies across age levels, and few studies have attempted to compare head impact exposure across different levels of play with the same sensor. Additionally, little is known about the biomechanical response of the brain to header impacts. The objective of this study was to evaluate head kinematics and the resulting tissue-level brain strain associated with intentional headers among youth and collegiate female soccer players. Six youth and 13 collegiate participants were instrumented with custom mouthpiece-based sensors measuring six-degree-of-freedom head kinematics of headers during practices and games. Kinematics of film-verified headers were used to drive impact simulations with a detailed brain finite element model to estimate tissue-level strain. Linear and rotational head kinematics and strain metrics, specifically 95th percentile maximum principal strain (ε1,95) and the area under the cumulative strain damage measure curve (VSM1), were compared across levels of play (i.e., youth vs. collegiate) while adjusting for session type and ball delivery method. A total of 483 headers (n = 227 youth, n = 256 collegiate) were analyzed. Level of play was significantly associated with linear acceleration, rotational acceleration, rotational velocity, ε1,95, and VSM1. Headers performed by collegiate players had significantly greater mean head kinematics and strain metrics compared to those performed by youth players (all p < .001). Targeted interventions aiming to reduce head impact magnitude in soccer should consider factors associated with the level of play.
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Affiliation(s)
- Tanner M Filben
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA; School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Winston-Salem, NC, USA
| | - N Stewart Pritchard
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA; School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Winston-Salem, NC, USA.
| | - Logan E Miller
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA; School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Winston-Salem, NC, USA
| | - Christopher M Miles
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jillian E Urban
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA; School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Winston-Salem, NC, USA
| | - Joel D Stitzel
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA; School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Winston-Salem, NC, USA
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8
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Tweet MS, Olin JW, Bonikowske AR, Adlam D, Hayes SN. Physical activity and exercise in patients with spontaneous coronary artery dissection and fibromuscular dysplasia. Eur Heart J 2021; 42:3825-3828. [PMID: 34097033 DOI: 10.1093/eurheartj/ehab307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/19/2020] [Accepted: 05/04/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Marysia S Tweet
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, 200 First St SW, MN 55905, USA
| | - Jeffrey W Olin
- IMarie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai, Icahn School of Medicine, Zena and Michael A. Wiener Cardiovascular Institute, One Gustave L. Levy Place, Box 1030 New York, NY 10029, USA
| | - Amanda R Bonikowske
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, 200 First St SW, MN 55905, USA
| | - David Adlam
- Department of Cardiovascular Sciences and Leicester NIHR Biomedical Research Centre, Glenfield Hospital, Groby Road University of Leicester, Leicester LE3 9QP, UK
| | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, 200 First St SW, MN 55905, USA
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9
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Nolet PS, Nordhoff L, Kristman VL, Croft AC, Zeegers MP, Freeman MD. Is Acceleration a Valid Proxy for Injury Risk in Minimal Damage Traffic Crashes? A Comparative Review of Volunteer, ADL and Real-World Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2901. [PMID: 33809101 PMCID: PMC8001694 DOI: 10.3390/ijerph18062901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 11/16/2022]
Abstract
Injury claims associated with minimal damage rear impact traffic crashes are often defended using a "biomechanical approach," in which the occupant forces of the crash are compared to the forces of activities of daily living (ADLs), resulting in the conclusion that the risk of injury from the crash is the same as for ADLs. The purpose of the present investigation is to evaluate the scientific validity of the central operating premise of the biomechanical approach to injury causation; that occupant acceleration is a scientifically valid proxy for injury risk. Data were abstracted, pooled, and compared from three categories of published literature: (1) volunteer rear impact crash testing studies, (2) ADL studies, and (3) observational studies of real-world rear impacts. We compared the occupant accelerations of minimal or no damage (i.e., 3 to 11 kph speed change or "delta V") rear impact crash tests to the accelerations described in 6 of the most commonly reported ADLs in the reviewed studies. As a final step, the injury risk observed in real world crashes was compared to the results of the pooled crash test and ADL analyses, controlling for delta V. The results of the analyses indicated that average peak linear and angular acceleration forces observed at the head during rear impact crash tests were typically at least several times greater than average forces observed during ADLs. In contrast, the injury risk of real-world minimal damage rear impact crashes was estimated to be at least 2000 times greater than for any ADL. The results of our analysis indicate that the principle underlying the biomechanical injury causation approach, that occupant acceleration is a proxy for injury risk, is scientifically invalid. The biomechanical approach to injury causation in minimal damage crashes invariably results in the vast underestimation of the actual risk of such crashes, and should be discontinued as it is a scientifically invalid practice.
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Affiliation(s)
- Paul S. Nolet
- CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6211 LM Maastricht, The Netherlands; (P.S.N.); (M.P.Z.)
| | | | - Vicki L. Kristman
- EPID@Work Research Institute, Department of Health Sciences, and the Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON P7B 5E1, Canada;
| | - Arthur C. Croft
- Spine Research Institute of San Diego, San Diego, CA 92118, USA;
| | - Maurice P. Zeegers
- CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6211 LM Maastricht, The Netherlands; (P.S.N.); (M.P.Z.)
| | - Michael D. Freeman
- CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6211 LM Maastricht, The Netherlands; (P.S.N.); (M.P.Z.)
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Arrué P, Toosizadeh N, Babaee H, Laksari K. Low-Rank Representation of Head Impact Kinematics: A Data-Driven Emulator. Front Bioeng Biotechnol 2020; 8:555493. [PMID: 33102454 PMCID: PMC7546353 DOI: 10.3389/fbioe.2020.555493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 08/14/2020] [Indexed: 11/26/2022] Open
Abstract
Head motion induced by impacts has been deemed as one of the most important measures in brain injury prediction, given that the vast majority of brain injury metrics use head kinematics as input. Recently, researchers have focused on using fast approaches, such as machine learning, to approximate brain deformation in real time for early brain injury diagnosis. However, training such models requires large number of kinematic measurements, and therefore data augmentation is required given the limited on-field measured data available. In this study we present a principal component analysis-based method that emulates an empirical low-rank substitution for head impact kinematics, while requiring low computational cost. In characterizing our existing data set of 537 head impacts, each consisting of 6 degrees of freedom measurements, we found that only a few modes, e.g., 15 in the case of angular velocity, is sufficient for accurate reconstruction of the entire data set. Furthermore, these modes are predominantly low frequency since over 70% of the angular velocity response can be captured by modes that have frequencies under 40 Hz. We compared our proposed method against existing impact parametrization methods and showed significantly better performance in injury prediction using a range of kinematic-based metrics—such as head injury criterion (HIC), rotational injury criterion (RIC), and brain injury metric (BrIC)—and brain tissue deformation-based metrics—such as brain angle metric (BAM), maximum principal strain (MPS), and axonal fiber strains (FS). In all cases, our approach reproduced injury metrics similar to the ground truth measurements with no significant difference, whereas the existing methods obtained significantly different (p < 0.01) values as well as substantial differences in injury classification sensitivity and specificity. This emulator will enable us to provide the necessary data augmentation to build a head impact kinematic data set of any size. The emulator and corresponding examples are available on our website1.
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Affiliation(s)
- Patricio Arrué
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States
| | - Nima Toosizadeh
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States.,Arizona Center on Aging (ACOA), Department of Medicine, University of Arizona, Tucson, AZ, United States.,Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - Hessam Babaee
- Department of Mechanical Engineering and Material Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kaveh Laksari
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States.,Department of Aerospace and Mechanical Engineering, University of Arizona, Tucson, AZ, United States
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11
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Miller LE, Urban JE, Whelan VM, Baxter WW, Tatter SB, Stitzel JD. An envelope of linear and rotational head motion during everyday activities. Biomech Model Mechanobiol 2020; 19:1003-1014. [PMID: 31786677 PMCID: PMC7210075 DOI: 10.1007/s10237-019-01267-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/16/2019] [Indexed: 10/25/2022]
Abstract
Various studies have characterized head kinematics in specific everyday activities by looking at linear and/or rotational acceleration characteristics, but each has evaluated a limited number of activities. Furthermore, these studies often present dissimilar and sometimes incomplete descriptions of the resulting kinematics, so the characteristics of normal everyday activities as a whole are not easily collectively summarized. The purpose of this study was to evaluate the literature investigating head kinematics associated with everyday activities and to generate a comprehensive kinematic boundary envelope describing these motions. The envelope constructed constitutes the current state of published knowledge regarding 'normally occurring' head accelerations. The envelope of kinematics represents activities commonly encountered and posing zero to minimal risk of injury to healthy individuals. Several kinematic measures, including linear accelerations, rotational velocities, and rotational accelerations, one may encounter as a result of normal everyday activities are summarized. A total of 11 studies encompassing 49 unique activities were evaluated. Examples of activities include sitting in a chair, jumping off a step, running, and walking. The peak resultant linear accelerations of the head reported in the literature were all less than 15 g, while the peak resultant rotational accelerations and rotational velocities approach 1375 rad/s2 and 12.8 rad/s, respectively. The resulting design envelope can be used to understand the range of acceleration magnitudes a typical active person can expect to experience. The results are also useful to compare to other activities exposing the head to motion or impact including sports, military, automotive, aerospace and other sub-injurious and injurious events.
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Affiliation(s)
- Logan E Miller
- Wake Forest University School of Medicine, 575 N. Patterson Ave., Suite 120, Winston-Salem, NC, USA.
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem, NC, USA.
| | - Jillian E Urban
- Wake Forest University School of Medicine, 575 N. Patterson Ave., Suite 120, Winston-Salem, NC, USA
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem, NC, USA
| | | | | | - Stephen B Tatter
- Wake Forest University School of Medicine, 575 N. Patterson Ave., Suite 120, Winston-Salem, NC, USA
| | - Joel D Stitzel
- Wake Forest University School of Medicine, 575 N. Patterson Ave., Suite 120, Winston-Salem, NC, USA
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem, NC, USA
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12
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Neural Mechanisms Underlying High-Frequency Vestibulocollic Reflexes In Humans And Monkeys. J Neurosci 2020; 40:1874-1887. [PMID: 31959700 DOI: 10.1523/jneurosci.1463-19.2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 12/30/2019] [Accepted: 01/07/2020] [Indexed: 01/16/2023] Open
Abstract
The vestibulocollic reflex is a compensatory response that stabilizes the head in space. During everyday activities, this stabilizing response is evoked by head movements that typically span frequencies from 0 to 30 Hz. Transient head impacts, however, can elicit head movements with frequency content up to 300-400 Hz, raising the question whether vestibular pathways contribute to head stabilization at such high frequencies. Here, we first established that electrical vestibular stimulation modulates human neck motor unit (MU) activity at sinusoidal frequencies up to 300 Hz, but that sensitivity increases with frequency up to a low-pass cutoff of ∼70-80 Hz. To examine the neural substrates underlying the low-pass dynamics of vestibulocollic reflexes, we then recorded vestibular afferent responses to the same electrical stimuli in monkeys. Vestibular afferents also responded to electrical stimuli up to 300 Hz, but in contrast to MUs their sensitivity increased with frequency up to the afferent resting firing rate (∼100-150 Hz) and at higher frequencies afferents tended to phase-lock to the vestibular stimulus. This latter nonlinearity, however, was not transmitted to neck motoneurons, which instead showed minimal phase-locking that decreased at frequencies >75 Hz. Similar to human data, we validated that monkey muscle activity also exhibited low-pass filtered vestibulocollic reflex dynamics. Together, our results show that neck MUs are activated by high-frequency signals encoded by primary vestibular afferents, but undergo low-pass filtering at intermediate stages in the vestibulocollic reflex. These high-frequency contributions to vestibular-evoked neck muscle responses could stabilize the head during unexpected head transients.SIGNIFICANCE STATEMENT Vestibular-evoked neck muscle responses rely on accurate encoding and transmission of head movement information to stabilize the head in space. Unexpected transient events, such as head impacts, are likely to push the limits of these neural pathways since their high-frequency features (0-300 Hz) extend beyond the frequency bandwidth of head movements experienced during everyday activities (0-30 Hz). Here, we demonstrate that vestibular primary afferents encode high-frequency stimuli through frequency-dependent increases in sensitivity and phase-locking. When transmitted to neck motoneurons, these signals undergo low-pass filtering that limits neck motoneuron phase-locking in response to stimuli >75 Hz. This study provides insight into the neural dynamics producing vestibulocollic reflexes, which may respond to high-frequency transient events to stabilize the head.
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Evans V. Newton’s Laws, G-forces and the impact on the brain. AUSTRALASIAN JOURNAL OF NEUROSCIENCE 2020. [DOI: 10.21307/ajon-2020-003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Harris TC, de Rooij R, Kuhl E. The Shrinking Brain: Cerebral Atrophy Following Traumatic Brain Injury. Ann Biomed Eng 2019; 47:1941-1959. [PMID: 30341741 PMCID: PMC6757025 DOI: 10.1007/s10439-018-02148-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/01/2018] [Indexed: 11/29/2022]
Abstract
Cerebral atrophy in response to traumatic brain injury is a well-documented phenomenon in both primary investigations and review articles. Recent atrophy studies focus on exploring the region-specific patterns of cerebral atrophy; yet, there is no study that analyzes and synthesizes the emerging atrophy patterns in a single comprehensive review. Here we attempt to fill this gap in our current knowledge by integrating the current literature into a cohesive theory of preferential brain tissue loss and by identifying common risk factors for accelerated atrophy progression. Our review reveals that observations for mild traumatic brain injury remain inconclusive, whereas observations for moderate-to-severe traumatic brain injury converge towards robust patterns: brain tissue loss is on the order of 5% per year, and occurs in the form of generalized atrophy, across the entire brain, or focal atrophy, in specific brain regions. The most common regions of focal atrophy are the thalamus, hippocampus, and cerebellum in gray matter and the corpus callosum, corona radiata, and brainstem in white matter. We illustrate the differences of generalized and focal gray and white matter atrophy on emerging deformation and stress profiles across the whole brain using computational simulation. The characteristic features of our atrophy simulations-a widening of the cortical sulci, a gradual enlargement of the ventricles, and a pronounced cortical thinning-agree well with clinical observations. Understanding region-specific atrophy patterns in response to traumatic brain injury has significant implications in modeling, simulating, and predicting injury outcomes. Computational modeling of brain atrophy could open new strategies for physicians to make informed decisions for whom, how, and when to administer pharmaceutical treatment to manage the chronic loss of brain structure and function.
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de Rooij R, Kuhl E. Physical Biology of Axonal Damage. Front Cell Neurosci 2018; 12:144. [PMID: 29928193 PMCID: PMC5997835 DOI: 10.3389/fncel.2018.00144] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 05/09/2018] [Indexed: 11/29/2022] Open
Abstract
Excessive physical impacts to the head have direct implications on the structural integrity at the axonal level. Increasing evidence suggests that tau, an intrinsically disordered protein that stabilizes axonal microtubules, plays a critical role in the physical biology of axonal injury. However, the precise mechanisms of axonal damage remain incompletely understood. Here we propose a biophysical model of the axon to correlate the dynamic behavior of individual tau proteins under external physical forces to the evolution of axonal damage. To propagate damage across the scales, we adopt a consistent three-step strategy: First, we characterize the axonal response to external stretches and stretch rates for varying tau crosslink bond strengths using a discrete axonal damage model. Then, for each combination of stretch rates and bond strengths, we average the axonal force-stretch response of n = 10 discrete simulations, from which we derive and calibrate a homogenized constitutive model. Finally, we embed this homogenized model into a continuum axonal damage model of [1-d]-type in which d is a scalar damage parameter that is driven by the axonal stretch and stretch rate. We demonstrate that axonal damage emerges naturally from the interplay of physical forces and biological crosslinking. Our study reveals an emergent feature of the crosslink dynamics: With increasing loading rate, the axonal failure stretch increases, but axonal damage evolves earlier in time. For a wide range of physical stretch rates, from 0.1 to 10 /s, and biological bond strengths, from 1 to 100 pN, our model predicts a relatively narrow window of critical damage stretch thresholds, from 1.01 to 1.30, which agrees well with experimental observations. Our biophysical damage model can help explain the development and progression of axonal damage across the scales and will provide useful guidelines to identify critical damage level thresholds in response to excessive physical forces.
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Affiliation(s)
- Rijk de Rooij
- Department of Mechanical Engineering and Bioengineering, Stanford University, Stanford, CA, United States
| | - Ellen Kuhl
- Department of Mechanical Engineering and Bioengineering, Stanford University, Stanford, CA, United States
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