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职业橄榄球运动中的脑震荡:脑损伤动物模型——第15部分

Concussion in professional football: animal model of brain injury--part 15.

作者信息

Viano David C, Hamberger Anders, Bolouri Hayde, Säljö Annette

机构信息

Mild Traumatic Brain Injury Committee, National Football League, New York, New York, USA.

出版信息

Neurosurgery. 2009 Jun;64(6):1162-73; discussion 1173. doi: 10.1227/01.NEU.0000345863.99099.C7.

Abstract

OBJECTIVE

A concussion model was developed to study injury mechanisms, functional effects, treatment, and recovery. Concussions in National Football League football involve high-impact velocity (7.4-11.2 m/s) and rapid change in head velocity (DeltaV) (5.4-9.0 m/s). Current animal models do not simulate these head impact conditions.

METHODS

One hundred eight adult male Wistar rats weighing 280 to 350 g were used in ballistic impacts simulating 3 collision severities causing National Football League-type concussion. Pneumatic pressure accelerated a 50 g impactor to velocities of 7.4, 9.3, and 11.2 m/s at the left side of the helmet-protected head. A thin layer of padding on the helmet controlled head acceleration, which was measured on the opposite side of the head, in line with the impact. Peak head acceleration, DeltaV, impact duration, and energy transfer were determined. Fifty-four animals were exposed to single impact, with 18 each having 1, 4, or 10 days of survival. Similar tests were conducted on another 54 animals, which received 3 impacts at 6-hour intervals. An additional 72 animals were tested with a 100g impactor to study more serious brain injuries. Brains were perfused, and surface injuries were identified.

RESULTS

The 50 g impactor matches concussion conditions scaled to the rat. Impact velocity and head DeltaV were within 1% and 3% of targets on average. Head acceleration reached 450 g to 1750 g without skull fracture. The test is repeatable and robust. Gross pathology was observed in 11%, 28%, and 33% of animals in the 7.4-, 9.3-, and 11.2-m/s single impacts, respectively. At 7.4 m/s, a single diameter area of less than 0.5 mm of fine petechial hemorrhage occurred on the brain surface in the parenchyma and meninges nearest the point of impact. At higher velocities, there were larger areas of bleeding, sometimes with subdural hemorrhage. When the 50 g impactor tests were examined by logistic regression, greater energy transfer increased the probability of injury (odds ratio, 5.83; P = 0.01), as did 3 repeat impacts (odds ratio, 4.72; P = 0.002). The number of survival days decreased the probability of observing injury (odds ratio, 0.25 and 0.11 for 4 and 10 days, respectively, compared with 1 day). The 100g impactor produced more severe brain injuries.

CONCLUSION

A concussion model was developed to simulate the high velocity of impact and rapid head DeltaV of concussions in National Football League players. The new procedure can be used to evaluate immediate and latent effects of concussion and more severe injury with greater impact mass.

摘要

目的

建立一种脑震荡模型,以研究损伤机制、功能影响、治疗和恢复情况。美国国家橄榄球联盟(National Football League)的脑震荡涉及高冲击速度(7.4 - 11.2米/秒)和头部速度的快速变化(速度变化量[DeltaV])(5.4 - 9.0米/秒)。目前的动物模型无法模拟这些头部撞击条件。

方法

108只体重280至350克的成年雄性Wistar大鼠用于模拟导致美国国家橄榄球联盟式脑震荡的3种碰撞严重程度的弹道撞击实验。气动压力将一个50克的撞击器加速至头盔保护头部左侧的速度分别为7.4、9.3和11.2米/秒。头盔上的一层薄衬垫控制头部加速度,在头部与撞击点相对的一侧进行测量。确定了头部峰值加速度、DeltaV、撞击持续时间和能量传递。54只动物接受单次撞击,每组18只,分别存活1、4或10天。对另外54只动物进行了类似测试,它们每隔6小时接受3次撞击。另外72只动物用100克撞击器进行测试,以研究更严重的脑损伤。对大脑进行灌注,并识别表面损伤。

结果

50克撞击器符合按大鼠比例缩放的脑震荡条件。撞击速度和头部DeltaV平均在目标值的1%和3%以内。头部加速度在无颅骨骨折的情况下达到450克至1750克。该测试具有可重复性和稳定性。在7.4米/秒、9.3米/秒和11.2米/秒单次撞击的动物中,分别有11%、28%和33%观察到大体病理学变化。在7.4米/秒时,在撞击点附近的脑实质和脑膜表面出现单个直径小于0.5毫米的细小瘀点出血区域。在更高速度下,有更大面积的出血,有时伴有硬膜下出血。当通过逻辑回归分析50克撞击器测试结果时,更大的能量传递增加了受伤的概率(优势比为5.83;P = 0.01),3次重复撞击也是如此(优势比为4.72;P = 0.002)。存活天数减少了观察到损伤的概率(与1天相比,4天和10天的优势比分别为()0.25和0.11)。100克撞击器造成了更严重的脑损伤。

结论

建立了一种脑震荡模型,以模拟美国国家橄榄球联盟球员脑震荡的高冲击速度和快速的头部DeltaV。该新方法可用于评估脑震荡的即时和潜在影响以及更大撞击质量导致的更严重损伤。

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