Kenzie Erin S, Parks Elle L, Carney Nancy, Wakeland Wayne
Oregon Rural Practice-Based Research Network, Oregon Health and Science University, Portland, OR, United States.
Systems Science Program, Portland State University, Portland, OR, United States.
Front Bioeng Biotechnol. 2022 Aug 12;10:854358. doi: 10.3389/fbioe.2022.854358. eCollection 2022.
Traumatic brain injury (TBI) is a highly complex phenomenon involving a cascade of disruptions across biomechanical, neurochemical, neurological, cognitive, emotional, and social systems. Researchers and clinicians urgently need a rigorous conceptualization of brain injury that encompasses nonlinear and mutually causal relations among the factors involved, as well as sources of individual variation in recovery trajectories. System dynamics, an approach from systems science, has been used for decades in fields such as management and ecology to model nonlinear feedback dynamics in complex systems. In this mini-review, we summarize some recent uses of this approach to better understand acute injury mechanisms, recovery dynamics, and care delivery for TBI. We conclude that diagram-based approaches like causal-loop diagramming have the potential to support the development of a shared paradigm of TBI that incorporates social support aspects of recovery. When developed using adequate data from large-scale studies, simulation modeling presents opportunities for improving individualized treatment and care delivery.
创伤性脑损伤（TBI）是一种高度复杂的现象，涉及生物力学、神经化学、神经学、认知、情感和社会系统等一系列的紊乱。研究人员和临床医生迫切需要对脑损伤进行严格的概念化界定，这需要涵盖所涉及因素之间的非线性和相互因果关系，以及恢复轨迹中个体差异的来源。系统动力学作为系统科学的一种方法，已经在管理和生态学等领域使用了数十年，用于对复杂系统中的非线性反馈动态进行建模。在这篇小型综述中，我们总结了该方法最近在更好地理解TBI的急性损伤机制、恢复动态和护理方面的一些应用。我们得出结论，像因果循环图这样基于图表的方法有潜力支持建立一个包含恢复的社会支持方面的TBI共享范例。当利用来自大规模研究的充分数据进行开发时，模拟建模为改进个性化治疗和护理提供了机会。
