Citation

Hernandez F, Camarillo DB. J. Neurotrauma 2019; 36(7): 1125-1135.

Affiliation

Stanford University, 6429, Bioengineering, Stanford, California, United States ; dcamarillo@stanford.edu.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4758

PMID

29848152

Abstract

We investigated whether humans could sustain high head rotational velocities without brain injury. Rotational velocity has long been implicated for predicting concussion risk, and has recently been used to develop the rotational velocity-based Brain Injury Criterion (BrIC). To assess the efficacy of rotational velocity and BrIC for predicting concussion risk, we instrumented 9 male subjects with sensor-laden mouthguards and measured six-degree-of-freedom head accelerations for 27 rapid voluntary head rotations. The fastest rotations produced peak rotational velocities of 12.6 rad/s, 17.4 rad/s, and 25.0 rad/s in the coronal, sagittal, and horizontal planes, respectively. All of these exceeded the corresponding medians from padded sports impacts (8.9 rad/s, 10.7 rad/s, and 8.4 rad/s, respectively), and in the case of sagittal and horizontal rotation, were within 1 standard deviation of published concussion averages. In the horizontal plane, 4 voluntary rotations exceeded the concussive impact median BrIC. The area under the precision-recall curve was lower in BrIC (0.49) than just using horizontal rotational acceleration (0.8), which distinguished concussive and subconcussive motions better. Voluntary motions produced less than 4% max principal strain (MPS) in finite element simulation, 5 times below predictions from dummy impacts used to develop BrIC. Despite having the highest critical velocity in BrIC, coronal rotation produced more tract-oriented strain in the corpus callosum than other planes. Baseline and post-experiment neurological testing revealed no significant deficits. We find that the head can tolerate high-velocity, low-acceleration rotational inputs too slow to produce substantial brain deformation. These findings suggest that the time regime over which angular velocities occur must be carefully considered for concussion prediction.

Language: en

Keywords

ASSESSMENT TOOLS; AXONAL INJURY; FINITE ELEMENT MODELS; HUMAN STUDIES; TRAUMATIC BRAIN INJURY