Department of Biomedical Engineering, College of Medical Science and Technologies, Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
UPC, GRABI, Eduard Maristany, 14, 08036, Barcelona, Spain.
Injury. 2023 Dec;54(12):111125. doi: 10.1016/j.injury.2023.111125. Epub 2023 Oct 15.
The objective of this study was to quantitatively investigate the relationship between cerebral atrophy and the risk of injury in elderly individuals. To achieve this, a sophisticated computational biomechanics approach utilizing finite element analysis was employed to simulate the mechanical behavior of the brain and skull under various conditions. In addition, particular emphasis was placed on understanding the role of cerebral bridging veins (BVs) and their mechanical properties at different ages in the occurrence of head injuries. Head models representing healthy brains and five atrophy models were developed based on imaging data. After validation, the models underwent the identical impact loading conditions to enable the simulation of brain damage. The resulting outcomes of the models with brain atrophy were then compared to the results obtained from the healthy model, allowing for a comparative analysis. Simulations showed increased relative displacement with worsening brain atrophy, particularly in the frontal and occipital regions. Compared to the healthy brain model, relative displacement increased by 2.36 %-9.21 % in the atrophy models, indicating an elevated risk of injury. In severe brain atrophy (FEM 6), the strain reached 83.59 % in local model simulations, leading to damage and rupture of cerebral BVs in both young and elderly individuals. Mechanical tests on cerebral BVs demonstrated a negative correlation between age and ultimate force, stress, and strain, suggesting increased susceptibility to damage with age. An observed sharp decline of approximately 50 % in ultimate stress and 35 % in ultimate strain was noted as age increased. We implemented a 50 % reduction in the intensity of head impact forces; nevertheless, vascular damage continues to manifest in the elderly population. To establish a truly safe zone, it is imperative to further decrease the intensity of the impact. This investigation represents a significant step forward in our understanding of the complex interplay between cerebral atrophy, the mechanical properties of BVs at different age, and the risk of head injury in the elderly. Through continued research in this field, we can strive to improve the quality of care, enhance prevention strategies, and ultimately enhance the well-being and safety of the elderly population.
本研究旨在定量研究脑萎缩与老年人受伤风险之间的关系。为此，采用了复杂的计算生物力学方法，利用有限元分析模拟大脑和颅骨在各种情况下的力学行为。此外，特别强调了解大脑桥静脉（BVs）及其在不同年龄的机械特性在头部受伤发生中的作用。根据影像学数据，建立了代表健康大脑的头部模型和五个萎缩模型。经过验证后，对这些模型进行了相同的冲击加载条件模拟，以模拟脑损伤。然后将脑萎缩模型的模拟结果与健康模型的结果进行比较，进行对比分析。模拟结果显示，随着脑萎缩的恶化，相对位移增加，特别是在前额和枕部区域。与健康大脑模型相比，萎缩模型的相对位移增加了 2.36%-9.21%，表明受伤风险增加。在严重的脑萎缩（FEM6）中，局部模型模拟中的应变达到 83.59%，导致年轻和老年个体的大脑 BVs 破裂和损伤。BVs 的力学测试表明，年龄与极限力、应力和应变呈负相关，表明随着年龄的增长，BVs 更容易受损。随着年龄的增长，观察到极限应力和极限应变分别约下降 50%和 35%。我们将头部撞击力的强度降低了 50%；然而，血管损伤在老年人群中仍持续存在。为了建立真正的安全区，必须进一步降低撞击强度。这项研究代表了我们对脑萎缩、不同年龄 BVs 的力学特性以及老年人头部受伤风险之间复杂相互作用的理解迈出了重要的一步。通过在该领域的持续研究，我们可以努力提高护理质量、加强预防策略，并最终提高老年人群的福祉和安全。
