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

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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.

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Acknowledgments

This work was supported in part by awards R01HD048638, R01NS094410, R01NS055020, R01NS092853, and R21NS088781 from the National Institutes of Health, R01CE001254 and 5R49CE000196 from the Centers for Disease Control and Prevention, and NOCSAE (07-04, 14-19). HIT System technology was developed in part under NIH R44HD40473 and research and development support from Riddell, Inc. (Chicago, IL). We thank the researchers and institutions from which the data were collected: Mike Goforth MS, ATC, Virginia Tech Sports Medicine; Dave Dieter MS, ATC, Virginia Tech Sports Medicine; Russell Fiore ATC, Brown University Sports Medicine; Bethany Wilcox PhD, Brown University; Ron Gatlin ATC, Casady HS; Jeff Frechette ATC and Scott Roy ATC, Dartmouth College Sports Medicine; Dean Kleinschmidt ATC and Brian Lund, University of Indiana Sports Medicine; Jesse Townsend ATC, Greensburg Salam HS; Jeff Cienick ATC, Blackhawk HS; John Burnett ATC, Karns City HS; Chris Ashton ATC, University of Minnesota Sports Medicine; Scott Hamilton, Unity HS; Scott Oliaro, Scott Trulock, and Doug Halverson, UNC-Chapel Hill Sports Medicine. Additionally, we would like to especially thank Lindley Brainard and Wendy Chamberlin, Simbex for coordination of data collection from Dartmouth College, Brown University, and Virginia Tech, and Rema Raman PhD and Sonia Jain PhD, University of California San Diego, for review of the statistical analysis.

Conflict of Interest

Authors Crisco, Greenwald, Chu, and Beckwith and Simbex have a financial interest in the instruments [HIT System; Sideline Response System (Riddell, Inc.)] that were used to collect the data reported in this study. The remaining authors have no financial interests associated with this study.

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Authors and Affiliations

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

    Jonathan G. Beckwith, Amaris G. Ajamil, Richard P. Bolander, Jeffrey J. Chu & Richard M. Greenwald

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

    Wei Zhao & Songbai Ji

  3. Thayer School of Engineering, Dartmouth College, Hanover, NH, USA

    Songbai Ji & Richard M. Greenwald

  4. Department of Psychiatry, Indiana School of Medicine, Indianapolis, IA, USA

    Thomas W. McAllister

  5. Department of Orthopaedics, Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI, USA

    Joseph J. Crisco

  6. Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA

    Stefan M. Duma & Steven Rowson

  7. NeuroTrauma Research Laboratory, University of Michigan, Ann Arbor, MI, USA

    Steven P. Broglio

  8. Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Kevin M. Guskiewicz & Jason P. Mihalik

  9. Department of Intercollegiate Athletics, University of Oklahoma, Norman, OK, USA

    Scott Anderson

  10. Departments of Orthopedics and Athletics, University of Oklahoma, Norman, OK, USA

    Brock Schnebel

  11. Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA

    P. Gunnar Brolinson

  12. Departments of Orthopaedic Surgery and Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Michael W. Collins

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  1. Jonathan G. Beckwith
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  2. Wei Zhao
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  3. Songbai Ji
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  4. Amaris G. Ajamil
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  8. Joseph J. Crisco
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  9. Stefan M. Duma
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  11. Steven P. Broglio
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  12. Kevin M. Guskiewicz
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  13. Jason P. Mihalik
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  14. Scott Anderson
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  15. Brock Schnebel
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  16. P. Gunnar Brolinson
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  17. Michael W. Collins
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  18. Richard M. Greenwald
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Correspondence to Jonathan G. Beckwith.

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Associate Editor Elena S. Di Martino oversaw the review of this article.

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Beckwith, J.G., Zhao, W., Ji, S. et al. Estimated Brain Tissue Response Following Impacts Associated With and Without Diagnosed Concussion. Ann Biomed Eng 46, 819–830 (2018). https://doi.org/10.1007/s10439-018-1999-5

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  • DOI: https://doi.org/10.1007/s10439-018-1999-5

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