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撞击后与无诊断性脑震荡相关的脑组织反应估计。

Estimated Brain Tissue Response Following Impacts Associated With and Without Diagnosed Concussion.

机构信息

Simbex, 10 Water Street Suite 410, Lebanon, NH, 03748, USA.

Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA.

出版信息

Ann Biomed Eng. 2018 Jun;46(6):819-830. doi: 10.1007/s10439-018-1999-5. Epub 2018 Feb 22.

Abstract

Kinematic measurements of head impacts are sensitive to sports concussion, but not highly specific. One potential reason is these measures reflect input conditions only and may have varying degrees of correlation to regional brain tissue deformation. In this study, previously reported head impact data recorded in the field from high school and collegiate football players were analyzed using two finite element head models (FEHM). Forty-five impacts associated with immediately diagnosed concussion were simulated along with 532 control impacts without identified concussion obtained from the same players. For each simulation, intracranial response measures (max principal strain, strain rate, von Mises stress, and pressure) were obtained for the whole brain and within four regions of interest (ROI; cerebrum, cerebellum, brain stem, corpus callosum). All response measures were sensitive to diagnosed concussion; however, large inter-athlete variability was observed and sensitivity strength depended on measure, ROI, and FEHM. Interestingly, peak linear acceleration was more sensitive to diagnosed concussion than all intracranial response measures except pressure. These findings suggest FEHM may provide unique and potentially important information on brain injury mechanisms, but estimations of concussion risk based on individual intracranial response measures evaluated in this study did not improve upon those derived from input kinematics alone.

摘要

头部冲击的运动学测量对运动性脑震荡敏感,但特异性不高。一个潜在的原因是这些测量仅反映输入条件,并且可能与局部脑组织变形具有不同程度的相关性。在这项研究中,使用两个有限元头部模型(FEHM)分析了先前在高中和大学橄榄球队员的现场记录的头部冲击数据。模拟了与立即诊断为脑震荡相关的 45 次冲击,以及从同一运动员获得的无明确脑震荡的 532 次对照冲击。对于每种模拟,获得了整个大脑和四个感兴趣区域(ROI;大脑、小脑、脑干、胼胝体)内的颅内响应测量值(最大主应变、应变率、冯·米塞斯应力和压力)。所有响应测量值对诊断性脑震荡敏感;然而,观察到运动员之间的个体差异很大,并且敏感性强度取决于测量值、ROI 和 FEHM。有趣的是,峰值线性加速度比除压力以外的所有颅内响应测量值更能敏感地诊断脑震荡。这些发现表明,FEHM 可能提供关于脑损伤机制的独特且潜在重要的信息,但基于本研究中评估的个体颅内响应测量值的脑震荡风险估计并没有优于仅基于输入运动学的估计值。

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